Question

9. Describe the 6 nursing sensitive indicators in NDNQI (Falls, restraints, VAP, CLABSI, CAUTI, HAPU), identify & explain 2 nursing actions for each indicator that can prevent these occurrences. Must have citations and references-see instructions.

Answer 1

Quality Indicator for falls.

1. if there is a previous history of fall.

2. if the patient's mental status is confused and disoriented.

Quality Indicator for Restrain.

1. The patient having a very low GCS.

2. The patient is confused and disoriented.

Quality Indicator for VAP(Ventilator-Associated Pneumonia)

1. Pneumonia after 48 hours of mechanical ventilation

Quality Indicator for CLABSI (Central line-associated bloodstream infection)

1. If there is an indication of sepsis after 48 hours central line insertion and there is no underlying cause of sepsis.

Quality Indicator for CAUTI (Catheter-associated urinary tract infection)

1. Evidence of UTI after 48 hours of insertion of Urinary catheter.

Quality Indicator for HAPU (Hospital-acquired pressure ulcer)

1. If the patient GCS is very low or there is restricted or limited movement of the body or any part of the body.

Nursing actions

Falls

1. Keep bed railings up every time when patient is on the bed to prevent falls.

2. Take special precautions during the shifting of the patient.

3. Give health education to patients and their family members.

Restrains

1. Look for proper indication and the proper type of restraint.

2. Monitor the vital signs in chemical restrain and restrain site in physical restraint.

VAP

1. maintain aseptic methods during suction of the endotracheal tube.

2. Change HME(Heat moist exchanger) in every 24 hours and vent tubing in every 48 hours.

CLABSI

1. Maintain an aseptic method during administering medication in the central line.

2. Clean the hub before and after medication administration and always attach a stopper cap on central line hub.

3. Keep an eye on central line dressing and change it if necessary.

CAUTI

1. Maintain an aseptic method during the insertion of the urinary catheter.

2. Maintain close drainage, Do not every disconnect the drainage system.

3. Prevent the backflow of urine by keeping the urinary bag below the bladder level.

HAPU

.1. Change the position of patient every hourly to remove pressure from one part of the body and to improve blood circulation.

2. Provide air, water or nimbus bed.