As healthcare providers, nurses in an acute care setting have the opportunity to review and evaluate the impact of their care delivery. The orthopedic nursing staff at a not-for-profit tertiary care community hospital in Michigan decided to undertake this challenge when they began to pursue a quality management (QM) review of patients admitted to their unit. The QM study targeted the elective surgical candidate admitted for a lumbar decompression with spinal fusion. The quality care issue focused on the complication known as an abdominal ileus. Two basic questions helped the staff to establish the indicators within this project: (1) what common variables could be measured within the high-risk patient population, and (2) by assessing these variables within the plan of care, could a link or association be made to reduce the incidence of the ileus complication?