Nurse-Sensitive Indicators: Assessing Quality of Care - Essay Sample

Introduction

The intensifying emphasis on the quality of healthcare has shifted much attention on the practices of nurses and their efforts in limiting adverse patient outcomes. Numerous studies carried out within the last decade have consistently found a correlation between poor nurse staffing and adverse patient outcomes. Thus, assessing the contribution of nurses towards the quality of care is a necessary standard for limiting adverse health conditions. Coined in 1996, nurse-sensitive indicators are elements of patient care that directly depict the three aspects of the nursing practice, including structures, processes, and outcomes (The Sentinel Watch, 2020). The nursing indicators can indeed help in assessing the degree of nursing care with respect to a specific disease or condition. This analysis focuses on the nurse-sensitive indicators that are relatable to diabetes. Mastering the nurse-sensitive indicators is fundamental in ensuring that nurses caring for patients with diabetes are fully aware of the practices that would promote the safety and quality of care of the patients.

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Diabetes and the Related Nurse-Sensitive Indicators

Diabetes, officially known as diabetes mellitus, is a health condition that increases the content of blood sugar in the body by impairing the body's ability to process glucose effectively. As a consequence, high blood sugar levels within the body increases the risk of damage in the kidney, nerves, eyes, among other body organs (Schneiders et al., 2019). Thus, without proper and ongoing care, a diabetic patient is at a much higher chance of developing dangerous body complications such as stroke, heart disease, and kidney failure, amongst others. It is estimated that over 30 million people in the US have type 1, type 2, or gestational diabetes. The condition is associated with both genetic and environmental factors such as being overweight, sedentary lifestyle, age beyond 40, and family history of diabetes (Schneiders et al., 2019). The most eminent symptoms of diabetes include extreme fatigue, increased hunger, weight loss, frequent thirst, blurry vision, frequent urination, and soars that rarely heal.

Given the nature of the condition, the appropriate nurse-sensitive indicators that are worth considering include patient satisfaction with pain management, patient satisfaction with nursing care, and preventing patient falls. All the indicators identified are outcome indicators since they lean on the quality and quantity of nursing care (Heslop & Lu, 2014). Due to the high sugar content, a patient is vulnerable to organ failure, which leads to burning, sharp, and aching pain making breathing and movement difficult. The symptoms suggest the need for nurses to be keen on handling the impending pain, preventing falls due to difficulty in movement, and ensuring that the patient is satisfied with the general nursing care.

Plan of Care

An effective diabetes care plan aims at fostering effective management of the condition to normalize the levels of blood glucose and minimize potential complications that may arise as a result of the condition. The specific aspects that the plan is to focus on include the risks of abnormal levels of blood glucose, the risk for infection, fatigue, imbalanced nutrition, and risk for injury, among other factors. Thus, there is a need to consistently check blood sugar levels, treat hypoglycemia, treat hyperglycemia, help the patient move around and manage stress and proper diet, and ensure that the patient sticks to medication as prescribed. As a nurse, it is important to consistently assess signs of hyperglycemia such as increased urination, thirst, and hunger as well as blurry vision and fatigue (Schneiders et al., 2019). Additionally, ensure that glucose levels, especially before meal and bedtime, remain between 140-180mg/dL and that the patient's HbA1c-glycosylated hemoglobin is 6.5%-7% (Schneiders et al., 2019). Other factors to consider doing as part of the plan includes administering insulin, teaching the patient how to monitor glucose levels while at home.

How to Employ Nurse Sensitive Indicators to Improve the Outcome

Ensuring patient satisfaction with pain management, nursing care, and fall prevention is essential to improving the quality of health outcomes of patients with diabetes. Holding to the care plan and using the indicators to guide the attainment of goals set in the plan informs better healthcare in diabetic patients. To employ patient satisfaction with pain management as the first indicator, a nurse might need to undertake aggressive glycemic management using insulin, which has the potential of reducing the patients' morbidity (Heslop & Lu, 2014).

Flexible treatment goals can also be appropriate in managing hypoglycemia, which is a potential cause of pain among patients with diabetes. Performing frequent tests on coronary artery diseases, blood pressure, lipid levels, glycemic levels, and other related conditions may be helpful in attaining patient satisfaction with the nursing care (Mangold & Pearson, 2017). Frequent visits and accessibility of basic items by the patient might also help in preventing falls. In addition to these aspects, it is vital for nurses, physicians, dietitians, mental health professionals, and pharmacists to work as a coordinated team with the same interest in improving the quality of care for patients with diabetes.

Conclusion

Caring for patients with diabetes demands unique and focused nursing care. Observing the sensitive-nursing indicators provides a foundation that can easily guide nurses to achieve care goals for this category of patients. With the proper observation of these goals, the assessment of provided services, improvement of quality of care, and the definition of strategies to reach goals become easy. The indicators call for nurses caring for diabetic patients to commit more time, skills, and emotional intelligence in ensuring that their patients are satisfied not only with the care itself but also with the nurses. More importantly, caring for patients with chronic and acute conditions calls for the need for healthcare professionals to work together in determining better approaches to care, and the patients attain the best care outcomes.

References

Heslop, L., & Lu, S. (2014). Nursing-sensitive indicators: A concept analysis. Journal of Advanced Nursing, 70(11), 2469-2482. https://doi.org/10.1111/jan.12503

Mangold, K., & Pearson, J. (2017). Making sense of nursing-sensitive quality indicators. Journal for Nurses in Professional Development, 33(3), 159-160. https://doi.org/10.1097/nnd.0000000000000323

Schneiders, J., Telo, G. H., Bottino, L. G., Pasinato, B., Neyeloff, J. L., & Schaan, B. D. (2019). Quality indicators in type 2 diabetes patient care: Analysis per care-complexity level. Diabetology & Metabolic Syndrome, 11(1). https://doi.org/10.1186/s13098-019-0428-8

The Sentinel Watch. (2020, March 5). What are nursing-quality indicators? https://www.americansentinel.edu/blog/2011/11/02/what-are-nursing-sensitive-quality-indicators-anyway/