Decrease in the quality nursing care related to interventions in Meso Clinic

Decrease in the quality nursing care related to interventions in Meso Clinic

Care Clinic Scenario: The Executive Team of Care Clinic prides itself in the care that is provided to the community of Summerville, Florida. The Clinic is known for holistic approach to the individuals served at the clinic as well as presenting various community outreach programs. Annually, the Executive Team of Care Clinic reviews the client satisfaction benchmark results related to client service and quality indicators. The scores have substantially decreased in the past 12 months in the categories of client satisfaction and quality care.

Observations from the care clinic scenario:

Video 1: 45 year old patient comes to the clinic with a history hypertension and diabetes and uses the insulin pump.

 Nurse greets patient and states “the clinic is very busy today” then she ask patient what brings him to the clinic on this day

 Patient: ‘Well nurse, my blood sugar has been very high lately and I haven’t been feeling good’

 Nurse: ‘Well im sorry to hear that, let me check yourblood pressure

Blood pressure reads 160/80.
 Nurse: “well it is a bit on the high side”
RN moves to check recent lab work and notices patient’s last lab work shows high glucose levels.
 Nurse: “are you doing a diabetic diet? Which diabetic diet are you on”?
 Patient: “I am on a 1400 calorie diet”
 Nurse: “I know its hard to resist carbohydrates and sweets but you have to count your calories correctly”
 Patient: “I know how to count my calories”
 Nurse: “Are you experiencing pain of loss of feeling in your feet? “
 Patient: “No. not really”
 Nurse: “I am going to print out a food log for 7 days. I will print out information on diabetic diet and you need to make a follow up appointment in the front desk. When you come I will give your more information just when Im not as busy as today”
Video 2:Scenario: Nursing assistant enters patient’s room to take vital signs. Care assistant performs handwashing and explains to the patient what she will do. As care assistant is getting ready to take patient’s vital signs a code is called where assistant is needed and she explains to the patient she will return to take his vital signs.
RN at station is reviewing patient’s chart to begin medication administration.
 RN: “Hmmm I wonder what the patient’s blood pressure is since I have to give him labetalol and it’s the blood pressure medication. The nursing assistant still has not documented any vital signs yet.
Nursing assistant returns to the patients’ room as promised and the RN walks into the room.
 RN: hey you have not documented any vital signs
 Assistant: I have been very busy and I haven’t been able to document yet
 RN: what was the patients bp and what time did u take it?
 Assistant: 10 minutes right before I got called by another patient and the blood pressure was 140/86
 RN: “can you please go and document the now” okay, I can give you your blood pressure medication sir. Let me scan your bracelet.
As the RN is scanning the patient and opening the medication, the medication fall to the floor
 RN: these darn packages are so difficult to open. Thank God for the 5 second rule
 Patient: I cant take that! You didn’t wash your hands and that pill fell on the floor! You better go wash those hand and bring me another pill.
From your leadership perspective, determine how the declining benchmarks can be addressed and improved. Discuss the actions/changes that need to be implemented in order to improve the satisfaction scores and attained Care Clinic quality outcomes
1. Client satisfaction benchmark to be discussed:
a. Decrease in the quality nursing care related to interventions provided to clients at the Clinic.


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