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C489

Organizational Systems and Quality Leadership – C489

TASK 1

Western Governors University

Organizational Systems and Quality Leadership Task 1

A. Understanding of Nursing Quality Indicators

 For the task assigned I will be using nursing quality indicators (NQI) to help

identify potential issues that may affect Mr. J’s care. Nursing quality indicators include using

outcome, structure, and processes to reflect on parts of nursing care. In the case involving Mr, J.,

NQI’s could have been assessed to help guide the staff’s behavior in three ways. Those ways

include prevention of pressure ulcers, use of restraints, and following cultural beliefs regarding

food choices. According to Montalvo et al., 2007, these standards are part of national standards

set to evaluate nursing quality care.

 In the situation of Mr. J’s care, the staff had placed Mr. J in restraints. When a

patient is in restraints, they have limited range of motion and ability to reposition themselves in

bed. The inability to adjust the pressure on bony prominences can irritate and increases the risk

of skin breakdown. Once Mr. J’s daughter pointed out to the staff that there was a reddened

depressed area on his lower back over a bony prominence that should have been a red flag to

staff that there is the potential for a pressure ulcer to develop. The development of a pressure

ulcer adds additional complications to Mr. J’s care. A pressure ulcer opens the door for an

increased risk of infection. Additionally, a hospital-acquired pressure ulcer means that the

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hospital would be responsible for payment for the patient’s hospital stay. Wound care would now

need to be involved in the patient’s care. Wound care is a great resource that provides direction

for the best ways to care for a pressure ulcer. Pressure ulcers are easily preventable by frequently

repositioning patients that are unable to move around frequently. A better understanding of the

NQI’s by the nursing staff could help in the prevention of negative patient outcomes, in this case,

the prolonged stay and potential repeat hospitalizations for the care of a pressure ulcer.

B. Advancing Quality Patient Care

To determine the efficacy of a quality indicator there must be a collection of data. The

development of The National Database of Nursing Quality Indications (NDNQI) allows for

information to be objectively collected into a single database. The NDNQI allows hospitals to

view past and current data to assist in the adjustment of structures of care that build the

foundation for better patient care and outcomes (Montalvo, 2007).

The ability to analyze the data found in the NDNQI database allows hospitals the

opportunity for increased education to nurses and nursing staff in the areas that show a

significant need for improvement. Hospitals can use data obtained from the nursing staff to help

set goals to assist in improving patient care. The hospital can encourage staff to come up with

ideas to improve numbers in categories where the hospital scores lower than the desired level.

Frequent education that reflects the most up to date information will also help the nursing staff

be able to provide the best patient education. Data from the NDNQI has gone a long way to

improving patient outcomes in regards to central line-associated bloodstream infections

(CLABSI). In the way of foley catheters, the indicators have shown frequent assessment of the

site, proper foley care, and hand hygiene have significantly reduced infections in patients. This

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