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Florence nightingale case studies
Florence nightingale case studies
Nurse to patient ratio
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“Nursing is an art, and if it is to be made an art, requires as exclusive a devotion, as hard a preparation, as any painter’s or sculptor’s work...” (Nightingale, 1868) In today’s health care system, “quality” and “safety” are one in the same when it comes to patient care. As Florence Nightingale described our profession long ago, it takes work and vigilance to ensure we are doing the best we can to care for our patients. (Mitchell, 2008) The World Health Organization outlines 6 areas of quality that help shape our definition of what makes quality care. Those areas are; (1) Effective: using evidence bases practice to improve health outcomes based on needs of individuals and communities. (2) Efficient: healthcare that maximizes resources and minimizes waste. (3) Accessible: timely care that is provided in a setting where the skills and resources are appropriate for the medical need and is geographically reasonable. (4) Acceptable/Patient-Centered: healthcare that considers individual needs, preferences, and culture. (5) Equitable: healthcare quality that does not vary because of race, gender, ethnicity, geographical location, or socioeconomically status. (6) Safe: healthcare that minimizes harm and risks to patients. (Bengoa, 2006) Another factor being looked at in quality of care is patient satisfaction. There has been some debate as to whether the patient’s perception of their care truly reflects the quality of care. I feel like this can be looked at from both angles. The nurse to patient ratio certainly factors into this as well as the acuity of the patients which can vary dramatically. Just stepping onto the floor we have a long list of “to do’s” for our patients; doctors to call, test results to look for, protoco... ... middle of paper ... ...de of sentinel events. Nursing Management, 37(5), 20. Lippincott , Williams, & Wilkins, (2012). Sentinel event alert spotlights nurse fatigue. Clinical Rounds, 42(3), 27-29. doi: 10.1097/01.NURSE.0000411416.14033.f5 Mitchell, P. H. (2008). Defining patient safety and quality care an evidence-based handbook for nurses. Rockville,Maryland: Hughes. DOI: //www.ncbi.nlm.nih.gov/books/NBK2681/ Bengoa, R. (2006). Quality of care: a process for making strategic choices in health systems.. Geneva: World Health Organization. Wall, Y., & Kautz, D. (2011). Preventing sentinel events caused by family members. Dimensions of Critical Care Nursing, 30(1), 25-27. doi: 10.1097/DCC.0b013e3181fd02a0 The Joint Commission. (2013). Sentinel events. Comprehensive Accreditation Manual for Hospitals, Retrieved from http://www.jointcommission.org/assets/1/6/CAMH_2012_Update2_24_SE.pdf
Safety competency is essential for high-quality care in the medical field. Nurses play an important role in setting the bar for quality healthcare services through patient safety mediation and strategies. The QSEN definition of safety is that it “minimizes risk of harm to patients and providers through both system effectiveness and individual performance.” This papers primary purpose is to review and better understand the importance of safety knowledge, skills, and attitude within nursing education, nursing practice, and nursing research. It will provide essential information that links health care quality to overall patient safety.
Young, W. B., Minnick, A. F., & Marcantonio, R. (1996). How wide is the gap in defining quality care?: Comparison of patient and nurse perceptions of important aspects of patient care. The Journal of Nursing Administration, 26(5), 15-20.
Nurses are key components in health care. Their role in today’s healthcare system goes beyond bedside care, making them the last line of defense to prevent negative patient outcomes (Sherwood & Zomorodi, 2014). As part of the interdisciplinary team, nurses have the responsibility to provide the safest care while maintaining quality. In order to meet this two healthcare system demands, the Quality and Safety Education for Nurses (QSEN) project defined six competencies to be used as a framework for future and current nurses (Sherwood & Zomorodi, 2014). These competencies cover all areas of nursing practice: patient-centered care, teamwork and collaboration, evidence-based practice, quality
Both report feeling safer and patients appreciate feeling more attended to (Cho et al., 2011). Furthermore, patients tend to report higher rates of satisfaction when they have shorter hospital stays & direct correlations between length of stay & more nursing time at the bedside have been established (Chan et al., 2011).
In her paper emerging model of quality, June Larrabee discusses quality as a construct that includes beneficence, value, prudence and justice (Larrabee, 1996). She speaks of quality and value as integral issues that are intertwined with mutually beneficial outcomes. Her model investigates how the well-being of individuals are affected by perceptions of how services are delivered, along with the distribution of resources based on the decisions that are made (Larrabee, 1996). She speaks of the industrial model of quality and how the cornerstone ideas of that model (that the customer always knows what is best for themselves) does not fit the healthcare model (Larrabee, 1996). Larrabee introduces the concept that the patient va provider goal incongruence affects the provide (in this case the nurse) from being able to positively affect healthcare outcomes (Larrabee, 1996). The recent introduction of healthcare measures such as HCAHPS: Patients' Perspectives of Care Survey has encouraged the healthcare community to firmly espouse an industrial model of quality. HCAHPS is a survey where patients are asked questions related to their recent hospitalization that identifies satisfaction with case based solely on the individuals’ perception of the care given. This can lead to divergent goals among the healthcare team or which the patient is a member. Larrabee’s model of quality of care model
The interpretation of quality health care varies with each person. Some place emphasis on the ability to access various treatments without interference. Others value the feature of being able to simply select one’s provider. Quality health care, according to the Institute of Medicine (2001), can be defined as care that is “safe, effective, patient-centered, timely, efficient and equitable” (p. 3). Furthermore, it should account for, in detail, a patient’s medical history, and improve overall patient well-being.
The Quality and Safety Education for Nurses (QSEN’s) goal is to prepare future nurses with the knowledge, skills, and attitudes (KSAs) that are needed to continuously improve the quality and safety of the healthcare systems within which they work. QSEN focuses on six main competencies; patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics. As we have learned in earlier classes these competencies and their KSAs offer a base to help us and other nurses as we continue our education and become RNs. As we will learn in this class these KSAs go hand in hand with health assessment.
... is an abstract model that proposes an exploratory plan for health services and evaluating quality of health care. In accordance with the model, information about quality of care can be obtained from three categories: structure, process, and outcomes. In addition, not long ago The Joint Commission include outcomes in its accreditation valuations (Sultz, & Young, 2011, p. 378).
The overall goal for the Quality and Safety Education for Nurses (QSEN) plan is to meet the challenge of educating and preparing future nurses to have the knowledge, skills and attitudes that are essential to frequently progress the quality and safety of the healthcare systems in the continuous improvement of safe practice (QSEN, 2014).Safety reduces the possibility of injury to patients and nurses. It is achieved through system efficiency and individual work performance. Organizations determine which technologies have an effective protocol with efficient practices to support quality and safety care. Guidelines are followed to reduce potential risks of harm to nurses or others. Appropriate policies
Healthcare around the world is constantly changing and improvement in quality of care is pursued. Quality assurance is vital to healthcare. According to the American Society for Quality [ASQ], quality assurance is “the planned and systematic activities implemented in a quality system so that quality requirements for a product or service will be fulfilled” (n.d). In other words, once an issue in a system is identified, quality assurance involves the implementation of activities to fix the issue and meet the required standards. The short video “Quality improvement and healthcare reform: Patient experience with David Feinberg” depicts the journey of a UCLA hospital in identifying issues in its health
Nursing is an art: and if it is to be made an art, It requires an exclusive devotion as hard a preparation, as any painter’s or sculptor’s work; for what is the having to do with dead canvas or dead marble, compared with having to do with the living body, the temple of God’s spirit? It is one of the Fine Arts: I had almost said, the finest of Fine Arts. (Masters, 2005 (p.186)
improving the quality of care, it is important to begin by defining quality. Quality is purposed by
Understanding quality measurement is essential in improving quality. Teams need to be able to understand whether the changes being made are actually leading to improved care and improved outcomes. For data to have an impact on an improvement initiative, providers and staff must understand it, trust it, and use it. Health care organization must understand the measurement of quality provided by the Institute of Medicine (patient outcomes, patient satisfaction, compliance, efficiency, safe, timely, patient centered, and equitable. An organization cannot improve its performance if it does not know how it is performing. Measuring quality improvements is essential as it reflects the quality of care given by the providers and that by comparing performance
Historically, the nursing profession has been actively involved in the health promotion and disease prevention among the general public. However, while caring for others, nurses often neglect their personal safety, which ultimately results in the high level of work-related injuries. Failure to timely address risk factors for nursing can have dire consequences for patient outcomes, since it is often associated with increased medication errors and patient falls, poor quality of care, and permanent disability of the nursing staff (Stokowski, 2014).
In the healthcare field, it is important to understand the patient’s perspective. When we understand the patient, only then can we give the patient the best quality care possible. Quality care incorporates both patient care and patient safety practices that ensure that the patient will have a comfortable, non-stressful visit under your care.