University Nursing Quality Outcome Indicators: Case Study Report

This report examines nursing quality outcome indicators through a case study involving a 72-year-old patient, Mr. J, who experienced several incidents during his hospital stay. These incidents include improper use of restraints, a pressure ulcer, and the provision of non-kosher food. The analysis highlights the importance of nursing-sensitive indicators, adherence to ethical and legal guidelines, and the need for effective communication and interdisciplinary collaboration within the healthcare team. The report emphasizes the significance of respecting patients' religious and dietary needs, particularly in the context of Jewish dietary laws. It stresses the use of resources, referrals, and colleagues to ensure patient safety and quality of care. The report references the National Database Quality Indicators (NDNQI) and emphasizes the role of nurses in advancing patient-centered care. It concludes by advocating for increased awareness of religious views and the importance of kosher diets to avoid such incidents in the future.

Running Head: ORGANIZATIONAL SYSTEMS
NURSING QUALITY OUTCOME INDICATORS
Name of the Student
Name of the University
Author’s Note

1
ORGANIZATIONAL SYSTEMS
A. The profession of nursing has several protocols and guidelines to come to a certain
outcome. Nursing sensitive indicators are specifically used for nursing professionals and
is a common factor in a nursing care. Nurses require these quality outcome indicators for
the efficient quality care and safety of patients in a medical setting. The experience and
practice of nurses in this field is beneficial for their response in critical cases that require
ethical and legal interventions. Mr. J in this case study is a 72 year old Rabbi man who is
diagnosed of mild dementia and he only has his daughter to take care of him. He was
admitted because he fractured his right hip after he suffered a fall in his own home. He
stays drowsy but is able to answer questions appropriately. Mr. J went through certain
discrepancies during his stay such as an incident occurred in which his daughter saw him
restrained in the bed and he asked her to remove it (Jansson & Ene, 2016). She went to
the CNA to request her to remove the restraints and while she was doing it she noticed a
red depressed area in the lower area of the spine, which looked like a sunburn. When his
daughter asked about the mark, the nurse replied that it is not a matter of concern because
it will go away when he will get up. Another incident occurred when Mr. J was given a
diet to follow in which he was given regular kosher chopped meat for his meals.
However, when his tray was delivered to his room, the nurse noticed his tray after 30
minutes that his food was half eaten and it had pork cutlets instead of kosher meat, even
though it was labelled as regular kosher meat. The nurse reported it to the supervisors but
he told her to keep quiet about this incident (Shapiro & Galowitz, 2016). The next day
when his daughter visited him again during dinner time, she encountered the dietary work
who said that he is apologetic about yesterday’s order because the orders got mixed up.
His daughter went to the nurse to clarify about the incident and the nurse replied that a

2
ORGANIZATIONAL SYSTEMS
half cutlet will not harm anyone. This made the daughter inform the physician about the
issue and he called the hospital administrator. The physician is a Jew and he conveyed to
the hospital administrator that he is having such complaints from the past 6 months and
the people are complaining that the dietary needs of Jews are not being taken seriously
(Lytton, 2014). This whole scenario suggests that there have been unnecessary disrespect
of the code of conduct by the nurses here in both the incidents. Certain measures and
actions should have been taken by them nurses when such incidents occurred such as the
patient needed to be repositioned in particular intervals so he could avoid the red
depressed mark and when the CNA saw the mark she should have reported it to the
registered nurse. During the other incident, the nurse should have returned the half eaten
tray and request the dietary worker to deliver with proper regular kosher chopped meat.
The whole interdisciplinary team is responsible for the misconduct and it could have been
avoided to some extent if the nurse was not told to keep quiet and if she refrained from
replying insensitively that half a pork cutlet will not harm anyone (Jian et al., 2016).
Kosher meat is a dietary requirement for Jews, which should be respected by the hospital
administration.
B. Hospital data of specific nursing quality indicators helps in advancing the quality patient
care because it gives a picture about the present condition of the patients, which will give
a clear picture about the actions to be taken for a patient centred care. The National
Database Quality Indicators (NDNQI) has evidences to support the nurse sensitive
measures for the strategy of patient care in medical settings, which is an accurate
comprehensive source of data (Neuman, Wirtalla & Werner, 2014).

3
ORGANIZATIONAL SYSTEMS
C. The system of resources, referrals and colleagues should have been utilized in this
situation because the incident of the red mark should have been notified to the concerned
colleagues, which would ensure patient care and safety during his treatment. In another
instance, when the nurse saw the half eaten pork she should have reported it to the dietary
worker and asked for another one instead of keeping quiet as per the supervisor’s order.
She needed to apologize to the concerned person about the inconvenience caused. More
efforts should be made to aware people about respecting the religious views of different
community and the importance of kosher meat for Jews (Cheraghi, Manookian &
Nasrabadi, 2014).

4
ORGANIZATIONAL SYSTEMS
References
Cheraghi, M. A., Manookian, A., & Nasrabadi, A. N. (2014). Human dignity in religion-
embedded cross-cultural nursing. Nursing ethics, 21(8), 916-928.
Jansson, I., & Ene, K. W. (2016). Nursing students’ evaluation of quality indicators during
learning in clinical practice. Nurse education in practice, 20, 17-22.
Jian, W. Y., Zhou, Y. Q., Wu, Z. J., & YAO, L. (2016). The development and application of
nursing-sensitive quality indicators. Chinese Nursing Management, 16(7), 865-868.
Lytton, T. D. (2014). Jewish foodways and religious self-governance in America: the failure of
communal kashrut regulation and the rise of private kosher certification. Jewish
Quarterly Review, 104(1), 38-45.
Neuman, M. D., Wirtalla, C., & Werner, R. M. (2014). Association between skilled nursing
facility quality indicators and hospital readmissions. Jama, 312(15), 1542-1551.
Shapiro, J., & Galowitz, P. (2016). Peer support for clinicians: a programmatic
approach. Academic Medicine, 91(9), 1200-1204.