ORGANIZATIONAL SYSTEMS & QUALITY LEADERSHIP Organizational Systems and Quality Leadership

Efforts to measure and improve the quality of nursing care provided to patients began with Florence Nightingale, who measured patient outcomes and worked towards the improvement of hospital conditions. Recently, studies linking nurses to patient outcomes have been given significant focus within healthcare. Efforts to measure the indicators of the quality of care dispensed by nurses have led to the phrase "nursing sensitive indicators," which has become a buzzword in healthcare. These are "outcomes from patient care that reflect the nursing care provided" (Kelly, Vottero, & Christie-McAuliffe, 2014). These indicators reflect the structure, nursing care process, and nursing care outcomes (American Nurses Association, 2014). Structural indicators include nursing staff supply, skill level of nurses and certification. The process indicators include patient assessment measures of nursing interventions while outcome indicators include all patient experiences such as falls, pressure ulcers, and readmissions and reflect the quality and quantity of nursing care provided at the facilities (American Nurses Association, 2014). Understanding the concept of such indicators enables nurses to identify problems in healthcare delivery and indicate areas in which the quality of nursing care can be improved.

The nursing sensitive indicators confirm the association between nurses and patient outcomes like hospital-acquired nosocomial infections, patient falls, pressure ulcers, medication and feeding errors and other patient outcomes (Buerhaus, Staiger, & Auerbach, 2012). They explain the premise that nurses are responsible for dispensing good quality nursing care to patients. For example, falls portray patient's neglect and the failure of nurses to ensure that their safety...

However, dissatisfaction indicates is an indicator that portrays that the patient's expectations are not met.
In the case of Mr. J, the error in feeding, the presence of pressure ulcers, the poor communication between nurses and the patient's daughter, and the dissatisfaction of the daughter with the quality of care provided are helpful indicators determining the factors affecting nursing care in the facility. The understanding of these indicators requires nurses to work tirelessly for the betterment of services to the patient. In case the nurses were careful and had an understanding of the sensitive indicators relating to Mr. J, they would analyze the nursing problems and identify the possible solutions within the hospital.

For example, the nurses can examine the occurrence of errors in feeding of Mr. J and other patients. Besides, they can analyze the occurrence of pressure ulcers and their possible interference in with their prospect of offering high-quality care to patients. The factors interfering with quality of nursing care may include a shortage of nursing staff, poor nursing mix (RNs, LPNs, and nurse assistants), dissatisfaction of nurses with the working environment, and low education levels of nurses. The nurses would be able to identify nursing problems in the facility if they understood and developed the indicators.

The development of new indicators involves the identification of patient outcome issues via empirical researches (American Nurses Association, 2014). Data on patient outcomes and other nursing issues in hospitals is important in creating clear linkages between nursing contributions and nursing care outcomes. In the facility where Mr. J is receiving nursing care, hospital data on specific indicators can significantly lead to the formulation of appropriate strategies for the improvement of healthcare…