organ development task 1
In this scenario there are numerous opportunities for improvement. Many of the national guidelines don’t appear to have been met or even properly addressed for example if a patient needs to be in restraint the need for toileting must be addressed minimum of every 2 hours and as needed. Since the patient in question was oriented and appropriate, I feel as if restraints may have been unnecessary the same outcome could be achieved with increased supervision or a one to one sitter if it’s a safety concern. Also, since the patient is in restraints someone must be present during feedings not only to assist but also make certain that no safety issues occur while eating due to movement restrictions. If the patient had been placed with a safety sitter several issues could have been avoided such as the reddened area over his sacrum, the mix-up in trays as the sitter ideally would have verified the diet order before assisting him with meal time. That simple action alone could have increased satisfaction regarding the patient and his daughter by avoiding a violation of his dietary restrictions. It also could have increased staff satisfaction by not creating a situation that wasn’t told to the daughter. As caregivers we have a responsibility to our patients to provide ethical and excellent care. one of the ways that care is measured is by the nursing quality indicators. if we can track each hospitals performance with those indicators, we can see what areas are in need of improvement and where we are excelling.
B-in situations like the one we are studying we must look at the overall performance of the specific hospital. We are able to track this data by monitoring nursing quality indicators. Nursing quality indicators are protocols driven by best practice research measurable occurrences that have shown improve patient outcomes. (Montalvo, 2007). For example what is the occurrence of pressure ulcers in this facility versus the national average. this can be found when we look at the national database for nursing quality indicators and we can see how this facility measures up in comparison to the national average. (National Database of Nursing Quality indicators. (n.d.) Regarding this specific issue of restraints, there seem to be numerous issues, one with the application and monitoring of restraints, typically when a patient is placed in safety restraints that patient becomes a one to one patient meaning the patient requires constant observation to monitor for circulation, respiratory status and other safety issues. If this particular facility were to designated follow national guidelines that dictate what warrants the use of restraints and how the restraints are to be monitored or when the restraints can be discontinued this could have prevented Mr. J pressure ulcer. When applying and monitoring restraints it is of great importance to check and preserve skin integrity. If the CNA had followed appropriate monitoring and turning of...
