Nursing Sensitive Indicators
Nursing sensitive indicators are designed to help highlight areas which may contribute to the quality of nursing care and thus reflect on the patient (Xu, 2015). It is important to understand these issues and how they are used in order to highlight areas for improvement, as they are specially designed for this purpose. There are several nursing sensitive indicators that are relevant to the case at hand which highlight their importance in practice. Briefly, these are RN education level, workload intensity, pressure ulcers, the use of restraints, and patient/family satisfaction with nursing care (Xu, 2015).

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In the case scenario, these nursing sensitive indicators can help highlight why there have been so many issues affecting the patient. RN education level may help to account for the fact that the nurses are not aware of the importance of his dietary needs, and cultural sensitivity training may help to alleviate this problem. Workload intensity may also be an indicator of why the patient has not been treated with the utmost care (Heslop & Lu, 2014). The patient safety issues of pressure ulcers and the use of restraints are also useful in understanding this case because it highlights where nurses are making errors that are physically affecting the patient (Heslop & Lu, 2014). Finally, patient/family satisfaction is an indicator that is used to highlight how well the nurses are doing in meeting the patient’s needs. In this case, dietary and religious/spiritual requirements are not being met and this has a negative effect on the patient/family satisfaction with the level of care received (Burston et al., 2014).

Quality Patient Care
Hospital data, both that which is routinely collected and special efforts to understand patient needs more in a particular setting, can be used in order to improve patient care. In the case of this scenario, the pressure ulcers and use of restraints would already be part of routine collection practice (Burston et al., 2014). This means that nurses can use the data to identify when rates of these negatives are higher than would be expected of best practice, and use methods in which to reduce the problem in the clinical scenario (van Oostveen et al., 2014). RN education level can also be routinely tracked, and it should be a simple task to identify which nurses may benefit from extra training in cultural matters in order to improve patient care and understanding (van Oostveen et al., 2014).

As noted, it is likely that most healthcare providers already collect data on most, if not all, of the nursing sensitive indicators. This makes it easy to identify areas which need improvement. The data can be collated as part of a wider study, for example, into the rates of bedsores and whether evidence-based practice can reduce this incidence. Data can be used as an indicator or a comparator with other similar healthcare providers to assess nursing sensitive indicators in practice (Xu, 2015).

System Resources, Referrals, or Colleagues
There are a number of ways in which the ethical data that is presented in the scenario could be improved by use of resources, referrals or colleagues. The first is that colleagues can be brought together to brainstorm about why the scenario happened and the specific steps that might help to prevent similar issues presenting themselves in the future (Xu, 2015). Resources about cultural sensitivity and the importance of religious and dietary beliefs are also important here, and can be circulated amongst the staff to ensure that they are up-to-date with the needs of their patients. Finally, referrals to other hospitals (in this case, those that have large numbers of Jewish patients and may be better equipped for dealing with requirements) can be useful to ensure that patient needs are being met.

  • Burston, S., Chaboyer, W., & Gillespie, B. (2014). Nurse-sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues. Journal of Clinical Nursing, 23(13-14), 1785–1795.
  • Heslop, L., & Lu, S. (2014). Nursing-sensitive indicators: a concept analysis. Journal of Advanced Nursing, 70(11), 2469–2482.
  • van Oostveen, C., Smeulers, M., & Vermeulen, H. (2014). Nurse-sensitive indicators suitable to reflect nursing care quality: a review and discussion of issues1). Nederlands Tijdschrift Voor Evidence Based Practice, 12(1), 14–16.
  • Xu, X. (2015). Identification of nursing-sensitive indicators for nursing quality monitoring and reporting in an Australian context. Retrieved from