ORGANIZATIONAL SYSTEMS 1
OrganizationalSystems and Quality Leadership
A. Nursing Sensitive Indicators
The practitioners in this case could have used severalnursing-sensitive indicators to identify issues that may interferewith patient care. For example, the patient`s family was dissatisfiedwith the services rendered at the hospital. Mr. J`s daughtercustomarily visited her father, who was admitted to the facility.During one of her visits, she spotted a red, depressed area on thepatient`s lower spine. The pressure ulcer seemed to result from theclient’s restraints to the bed. However, the certified nursingassistant dismissed the rash as nothing to worry about. In thisregard, the nurse should have reassured the client by investigatingthe red, depressed area. The CNA could also have promised to relaythe issue to the physician. Such professionalism would havecultivated trust between the nursing staff and the patient’sfamily.
Furthermore, the nurses and other hospital staff were insensitive tothe cultural needs of the patient. Since Mr. J was Jewish, his dietcould not contain pork. In fact, his meal order was stipulated asregular, kosher, chopped meat. The nurse should have been in the roomwhen the food tray was delivered to the patient’s room. Hence, shewould have realized that the meal comprised of chopped pork cutlets.Both the nurse and the supervisor betrayed the family’s trust bychoosing to keep the matter hidden. Full disclosure would have shownproper respect for Mr. J and his daughter.
Besides, the nurse showed immense disrespect by stating that eatingpork would never have fatal consequences. The physician alsoconfirmed that similar cases arose over the past six months. Thehospital’s staff showed little regard for the dietary restrictionsof patients from the Jewish community. The kitchen supervisor had tocommunicate to his workers and hence ensure that such incidents didnot become commonplace. Although the town had few Jewish residents,the nurses had to manifest proper respect for all patients at thefacility.
B. Quality Patient Care
Hospital data on particular nursing-sensitive indicators could ensurequality patient care throughout the facility. For example, the staffshould be educated on the incidence of pressure ulcers. Mr. J had ared, depressed area over his lower spine. The spot was caused by theapplication of pressure on his back over an extended period. Sincethe client was confined to bed, it was expected that blood flowthrough the skin would be disrupted (Lyder et al., 2012). Moreover,the nursing staff should have known that people over 70 years had anincreased likelihood of developing pressure ulcers. Since Mr. J was72 years old, it was normal to expect mobility problems (Lyder etal., 2012). In this respect, hospital data would have helped thenursing staff to recognize the patient’s vulnerability to pressureulcers.
Additionally, Mr. J was diagnosed with mild dementia. The patient wasalso admitted after suffering a fall in his home. Consequently, Mr. Jhad fractured his right hip and needed assistance while performinginstrumental activities of daily living. The restraints were quiteessential since they prevented the client from suffering additionalpain. The fractured right hip would need time to heal completely.Besides, lying in a still position would help the bones to stabilize.Since Mr. J was diagnosed with mild dementia, it was likely that hewould try to walk (Bahar-Fuchs, Clare, & Woods, 2013). Hence,appropriate precautions had to be put in place to prevent the patientfrom compounding his injury. Hospital data concerning the use ofrestraints would have helped the nursing staff to anticipate thedevelopment of pressure ulcers. The staff at the facility should alsohave maintained constant watch over the patient in case they wantedto visit the bathroom.
C. System Resources, Referrals, or Colleagues
The nursing shift supervisor could enforce several guidelines toaddress the ethical issue in the scenario. Firstly, all nurses couldbe instructed to improve their interactions with the patient’sfamily. In this regard, staff members had to show proper respectthrough their words and actions. Any health concerns raised by thepatient’s family were to be considered seriously. For example, thenurse should be instructed to use various dressings, gels, and creamsto alleviate the pressure ulcers (Qaseem et al., 2015). Systemresources could also help the nursing shift supervisor to realize thepotential for gangrene or blood poisoning. Therefore, nurses could berequired to change the client’s lying position several times.Special equipment such as cushions and mattresses could also be usedto protect vulnerable parts of Mr. J’s body (Qaseem et al., 2015).
Besides, the nursing shift supervisor should have discussions withthe kitchen supervisor to address the higher number of order mix-ups.In particular, staff members should be more conscientious to thedietary requests of Jewish patients. Although certain populationgroups were rare in the neighborhood, it was still vital to respectthe beliefs of all patients. Additionally, the kitchen supervisorshould be instructed to assign some workers to countercheck mealorders before food is served. The nurse should also stay with thepatient to prevent any mistakes. In the scenario, the patient ate thepork cutlet for half an hour before a practitioner realized theerror. Therefore, the nursing shift supervisor could resolve theethical issue by utilizing system resources, referrals, andcolleagues.
Bahar-Fuchs, A., Clare, L., & Woods, B. (2013). Cognitivetraining and cognitive rehabilitation for persons with mild tomoderate dementia of the Alzheimer`s or vascular type: a review.Alzheimers Res Ther, 5(4), 35.http://dx.doi.org/10.1186/alzrt189
Lyder, C., Wang, Y., Metersky, M., Curry, M., Kliman, R., Verzier,N., & Hunt, D. (2012). Hospital-Acquired Pressure Ulcers: Resultsfrom the National Medicare Patient Safety Monitoring System Study.Journal of the American Geriatrics Society, 60(9),1603-1608. http://dx.doi.org/10.1111/j.1532-5415.2012.04106.x
Qaseem, A., Humphrey, L., Forciea, M., Starkey, M., & Denberg, T.(2015). Treatment of Pressure Ulcers: A Clinical Practice Guidelinefrom the American College of Physicians. Annals of InternalMedicine, 162(5), 370-9.http://dx.doi.org/10.7326/m14-1568