In the healthcare system, nurses are involved in a great number of important processes of patient care. One of the integral aims of academic research is to formulate coherent estimates of nursing care that may clearly show whether a patient outcome is beneficial. Koch et al. (2020) indicate that scholars often develop frameworks that include a broad base of indicators to assess quality. In this paper, the role of nursing-quality indicators in care will be critically analyzed and applied to a described scenario of a 72-year-old retired rabbi. The main conclusion is that patient satisfaction, patient falls, and pressure ulcers may be used as the most important part of indicators to supervise nursing care.
Application of Nursing-Quality Indicators
As it was noted, quality indicators are the means to evaluate nurses’ actions. Thus, they should be objective enough to avoid the influence of informal ties among staff and corruption. Connecting these indicators with the role nurses play, Báo et al. (2018) point out that “the nurse contributes with the results, from the best actions adopted in health care and guided by the evidence-based practice” (p. 361). In other words, nurses may participate in improving the overall quality of healthcare by reporting the best practices and tools they found during practice. The second utility of indicators is that it shows managerial staff the problems existing in particular areas of patient care in a medical facility (Báo et al., 2018). The great difference in nursing-quality indicators between different departments or in comparison with previous years shows the downfall of quality in specific places.
Considering utility in the scenario, patient satisfaction may be the most useful indicator for monitoring. In fact, it is considered by many researchers as the most important indicator. Lotfi et al. (2019) explain that “[patient satisfaction] increases the profitability of hospitals in the competitive market, increases patient involvement in their own treatment and has a better chance of improving their health condition” (p. 1189). This criterion includes a set of various complex indicators, so the administration in the facility would quickly become aware of poor-quality care. Mr. J could talk about poor quality food for a Jew and the negative impact of restraints.
Applicability of Hospital Data
One of the key drawbacks of collecting patients’ responses about the quality of care is the danger of subjectivity. Some patients may exaggerate the problems of care, while others express pure politeness and modesty. Thus, the hospital administration may collect data reflecting the real situation. In the scenario, three measurable techniques are patient falls, pressure ulcers, and skin quality supervision. Firstly, if the number of falls is small, this should show the nursing team that there is no need to impose restrictions. Secondly, skin checks and pressure ulcers should provide information about the patient’s condition and how often the patient should change position. This information can be gathered by a team formed by a hospital that will gather information and then independently analyze it. Such monitoring should be carried out in close contact with nursing staff in order to avoid misunderstandings and distrust.
The benefit of centralized hospital data gathering is that it can be analyzed systematically. With a large amount of information, data researchers may analyze relations between different variables and formulate concrete conclusions about the drawbacks of nursing care. In fact, both the qualitative (responses of patients about their experience) and quantitative data may be interconnected in a system of evaluation. The final numbers may be compared to national averages and global standards.
Solutions to the Ethical Issue
An integral part of the proposed scenario is an ethical issue related to food quality. The Jewish patient did not receive food suitable for his religious beliefs. The meat offered was not prepared according to kosher standards. The situation is aggravated by the nurses deciding not to inform their daughter about this situation. It was only after a coincidence that the daughter found out the truth. Such concealment of the truth from patients could cause local public outcry and significantly lower the reputation of this medical institution in the region.
This case shows the apparent lack of cultural competencies among staff members. First of all, the hospital administration may use their data resources to understand whether Mr. J’s case is systematic or not. Nevertheless, even a single case of negligence can be the trigger for systematic change. One of the solutions is to educate leaders on basic principles that should guide patient care. After that, they may distribute their knowledge among colleagues. It may be coupled with feedback from dietary workers who will explain the essentials of caring for people with eating needs.
To sum up, nursing-quality indicators are effective tools to monitor and detect mistreatment and injustice in healthcare facilities. The collected qualitative and quantitative data of nurses’ and patients’ responses, measurements, and expert assessments could be customized for deeper analysis through statistical computing. In the discussed examples, two major problems were the patient’s bad nutrition experience because of cultural incompetency and lack of supervision which was substituted by restraints. The availability of nursing-quality indicators to the facility’s administration may change the status quo and provoke changes in nurses’ habits.
Báo, A. C. P., Amestoy, S. C., Moura, G. M. S. S. D., & Trindade, L. D. L. (2019). Quality indicators: Tools for the management of best practices in health. Revista brasileira de enfermagem, 72, 360-366.
Koch, D., Kutz, A., Conca, A., Wenke, J., Schuetz, P., & Mueller, B. (2020). The relevance, feasibility and benchmarking of nursing quality indicators: A Delphi study. Journal of Advanced Nursing, 76(12), 3483-3494.
Lotfi, M., Zamanzadeh, V., Valizadeh, L., & Khajehgoodari, M. (2019). Assessment of nurse–patient communication and patient satisfaction from nursing care. Nursing Open, 6(3), 1189-1196.