Nurse-Sensitive Indicators -Week 3 Solution

This article covers a sample assignment solution about Nurse-Sensitive Indicators.

Instructions

Assignment Content

This assignment is designed to illustrate the importance of nurse-sensitive indicators in relationship to patient outcomes.

·         Select a condition or disease.

·         Identify the nurse-sensitive indicators that relate to your selection, and indicate if they are structural, process, or outcome in nature.

·         Create a plan of care showing how you would employ the indicators to improve the outcome.

·         Citeat least two sources from past 5 years in an APA-formatted reference page.

·         Format your plan of care and summary of the disease and nurse-sensitive indicator outcomes as one of the following:

875word paper

Solution

Nurse-Sensitive Indicators

Introduction

The Nurse-Sensitive Indicators (NSIs) are the parameters that reflect the aspects of patient care that are influenced directly by nursing practice. These nurse-sensitive indicators are grouped into three types: structural indicators, process indicators, and outcome indicators.

The structural indicators are the elements concerning the staffing supply of nursing and their skills, competence, and educational qualification. NSIs are used in our daily nursing practice to guide nursing practice and shape patient outcomes and quality improvement. This paper discusses how nurse-sensitive indicators affect nursing practice among breast cancer patients.

Breast Cancer NSI

In breast cancer management, nurse-sensitive indicators reflect three aspects, i.e., structural, process, and outcome indicators. Structural indicators include skills, education, and certification levels of nursing personnel and short staffing. Process indicators include nursing care, overall care, and medical information. Outcome indicators include pain management, readmission rates, and rate of invasion of cancerous cells. Although an early cancer diagnosis is treatable and survivable, most diagnoses happen at later stages, making it chronic, costly, and challenging to manage.  

Effective breast cancer management is determined by patient’s satisfaction with nursing and overall care, medication education, and pain management. Breast cancer patients face unique challenges that necessitate a focused, multidisciplinary effort from oncology nurses and other advanced care practitioners. In addition, oncology nurses are better positioned to develop rapport with cancer patients to guide educational efforts (Cummings, Lee & Tate, 2018). Therefore, the number of oncology nurses, skills, and level of education contribute to negative patient satisfaction of nursing interventions.

On the other hand, nursing processes are determined by the efficacy and quality of nurses’ care delivery. According to Schellongowski et al. (2016), between 5% and 10% of cancer patients have life-threatening conditions that necessitate admission into the intensive care units. In this regard, oncology nurses are trained to match the evolution of cancer treatments and minimize critical deterioration.

In addition, oncology nurses are involved in assessing a patient’s emotional and physical status and other clinical parameters to guide appropriate diagnosis and prescription (Cummings et al., 2018).  Moreover, oncology nurses coordinate the complex clinical technologies used in cancer diagnosis and treatment (Schellongowski et al., 2016). Therefore, they have the foresight to identify patient symptoms and respond appropriately to avoid exacerbation, morbidity, or mortality.

Consequently, a successful nursing process leads to better patient outcomes. However, cancer presents various health issues that influence wellbeing. For example, depression, a sense of hopelessness, and helplessness often engulf newly diagnoses patients (Iddrisu, Aziato, & Dedey, 2020). Outcome indicators for breast cancer treatment include pain relief, lower readmission rates, and controlled invasion rates of the cancerous cells, leading to effective breast cancer management.

According to Khorana et al. (2019), delays in treating new cancer patients often contribute to patient distress and adverse treatment outcomes.  Nevertheless, chemotherapy, radiotherapy, and surgical interventions have adverse reactions leading to negative outcomes (Iddrisu et al., 2020).

For example, chemotherapy and radiotherapy are associated with unintentional weight loss, skin color and hair loss, body weakness, and vomiting, limiting daily activities. Conversely, surgical interventions cause scarring and breast deformity, which cause loss of self-esteem and self-perception.

Lastly, hormonal therapy causes cramping, joint pain, stiffness, and loss of libido. These outcomes result in psychological distress and concerns, including social seclusion, irregular menstrual cycles, infertility, lack of sexual intimacy. These outcomes necessitate appropriate nursing interventions to determine and establish the most appropriate coping strategies.

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Plan for Nursing Indicators to Improve Patient Outcome

By identifying nurse-sensitive indicators, responsible nurses pioneer evidence-based practice to achieve positive health outcomes (Oner et al., 2021). In this case, the nurse leaders and assigned nurses can use the nurse-sensitive indicators to:

1. Employ additional qualified nurses to ensure nurses have enough time to attend, assess, and monitor patients’ symptoms. Qualified, particularly with baccalaureate degrees, including oncologists, offer the best nursing care (Cummings et al., 2018).
2. Instruct the patient care team to focus on effective communication, on-job training, and teamwork (Rosen et al., 2018). Effective communication is a critical factor in patient-centered care since it involves input from patients, families, and the clinical team. On the other hand, on-job training and teamwork ensure that an effective nursing process is utilized to achieve a better outcome.
3. Improve breast cancer management by enhancing diagnosis in primary care, supporting high-quality treatment, and proper management of patient symptoms (Cummings et al., 2018). These improvement actions can be made possible by enhancing process and structural indications by employing an additional qualified workforce, adopting modern treatment technology, and providing on-job training.
4. Routine appraisal of breast cancer management nursing interventions and performance of the nursing team.

Conclusion

Diagnosis with breast cancer increases life challenges that interfere with a patient’s life, contributing to psychological and physical effects. In addition, breast cancer treatment also has an impact on patient’s body perception, socializing factors, sexual and reproductive lives. Usually, breast cancer treatment aims to identify sensitive measures to the specific health professionals’ contribution. As a result, nurses are responsible for measuring, assessing, and improving nursing practice. In this regard, nurse-sensitive indicators must be scientifically proven, relevant, and flexible to different underlying risk factors in the patient.

References

Cummings, G. G., Lee, S. D., & Tate, K. C. (2018). The evolution of oncology nursing: Leading the path to change. Canadian OnCOlOgy nursing JOurnal, 28(4), 314. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6516934/

Khorana, A. A., Tullio, K., Elson, P., Pennell, N. A., Grobmyer, S. R., Kalady, M. F., … & Bolwell, B. J. (2019). Time to initial cancer treatment in the United States and association with survival over time: an observational study. PloS one, 14(3), e0213209. https://doi.org/10.1371/journal.pone.0213209

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing‐sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8(3), 1005-1022. https://doi.org/10.1002/nop2.654

Rosen, M. A., DiazGranados, D., Dietz, A. S., Benishek, L. E., Thompson, D., Pronovost, P. J., & Weaver, S. J. (2018). Teamwork in healthcare: Key discoveries enabling safer, high-quality care. American Psychologist, 73(4), 433. 10.1037/amp0000298

Schellongowski, P., Sperr, W. R., Wohlfarth, P., Knoebl, P., Rabitsch, W., Watzke, H. H., & Staudinger, T. (2016). Critically ill patients with cancer: chances and limitations of intensive care medicine—a narrative review. ESMO Open, 1(5), e000018. 10.1136/esmoopen-2015-000018

Iddrisu, M., Aziato, L., & Dedey, F. (2020). Psychological and physical effects of breast cancer diagnosis and treatment on young Ghanaian women: a qualitative study. BMC psychiatry, 20(1), 1-9. https://doi.org/10.1186/s12888-020-02760-4

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