provide a response to Ashley's post:

Nursing-sensitive indicators identify care structures and processes that influence care outcomes and are distinct and specific to nursing (Montalvo, 2007). These indicators are used to evaluate and assess the effectiveness of nursing interventions in the healthcare setting. They focus on areas where nurses directly influence patient care and can help identify opportunities for improving patient safety, quality of care, and overall outcomes.

Two nurse-sensitive or nurse-driven quality indicators: Falls and Medication Errors

Falls are considered a key nursing-sensitive indicator because they are often preventable through appropriate nursing interventions, such as patient assessments, monitoring, and implementing fall prevention strategies. Falls are a clear example of an indicator where nursing care can make a substantial difference by monitoring and addressing fall rates, and healthcare organizations can assess the quality of care and improve patient safety, reducing fall-related injuries and improving overall patient outcomes. Lower fall rates typically indicate effective nursing care, while higher rates may suggest areas for improvement in patient safety practices, staffing, or environmental factors.

Medication errors are a critical nurse-sensitive indicator because they directly relate to the quality of care nurses provide. Medication errors can include mistakes in prescribing, dispensing, administering, or monitoring medications, and they are of particular concern because they can directly affect patient safety and outcomes. These errors can occur when a nurse administers a medication that may be an incorrect drug, dose, route, timing, or given to the wrong patient. By tracking, understanding, and preventing medication errors, nurses contribute to improved patient safety and quality of care and enhance patient outcomes.

Summary of 2 nurse sensitive articles issues:

1. In the article "Prevalence of medication errors and its related factors in Iranian nurses: An updated systematic review and meta-analysis," the authors set out to conduct a review study to investigate the prevalence of medication errors and the associated factors among Iranian nurses. The research was conducted using a systematic review and meta-analysis that searched studies provided by PubMed, Web of Science, Scopus, Google Scholar, IranMedex, Magiran, and SID databases using keywords and Boolean functions. This study concluded that nurses must work in a calm environment that allows proper nursing interventions to reduce medication errors. This study had some limitations, such as how many errors go unreported due to a lack of support from the management team. Hospital administrators should provide a calm and stress-free environment to reduce medication errors, alleviate nurses' workload, support nurses who report their errors, and implement appropriate measures for key factors contributing to errors (Fathizadeh et al., 2024).
2. In the article "Effects of Nurse-Led Fall Prevention Programs for Older Adults: A Systematic Review," the authors aimed to gain insight into nurse-led fall prevention programs' effects on older adults. This study used systematic Review and Meta-Analysis (PRISMA), consisting of a 27-item checklist and a four-phase flow diagram, to report this systematic review focused on the nurse-led/nurse-driven fall prevention interventions, especially those with an education component and nursing roles. This literature search used electronic databases such as CINAHL, MEDLINE, ERIC, Science Direct, and Google Scholar. This study concluded that fall prevention programs with an education component might be effective for older adults, and the combination of the outcomes of this review, fall rates, fall injury, and behavior change could maximize the effects of fall prevention program outcomes (Oladepe Ojo & Thiamwong, 2022).

Recommendations related to best practices to improve medication errors and patient fall outcomes.

Besides the standard best practice of medication administration like identifying the "five rights," barcode scanning, and double-checks, another best practice to reduce medication errors is fostering an environment that encourages and supports nurses to report mistakes and provides them with a focused, quiet environment is essential for making accurate medication decisions and performing tasks with precision. A culture of safety encourages staff to report mistakes or near-misses without fear of retribution, providing valuable insights for improving safety protocols. Open communication and transparency can lead to better team collaboration and fewer errors.

Another recommendation for best practice regarding nursing-sensitive indicators like falls is fostering a culture that emphasizes fall prevention, ensures that all team members understand the importance of fall prevention, and consistently applies evidence-based practices. It also promotes team accountability and the maintenance of a safe environment. Post-fall protocols help ensure that patients receive timely care and that the root causes of falls are identified and addressed, preventing recurrences and improving overall patient safety, which can be beneficial.

Nurse-sensitive indicators are essential for measuring and improving the quality of nursing care, such as reducing medication errors and patient falls. They provide critical data to guide clinical practice, improve patient safety, inform staffing decisions, and enhance patient outcomes. By continuously monitoring and acting on NSIs, healthcare organizations can improve care delivery, ensure accountability, and ultimately provide safer, more effective patient care.