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Importance of change in nursing
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For this discussion of week 2, I have chosen to go with option 1 and IOM. I have not been in the health care system as long as some of my co-workers that have seen more change than I have. With that said I have been in it long enough to notice the change from quality care to quantitative care. For being a nurse since 2009, I have seen the objectives in health care going more towards reimbursement and profit. The sad part is this is not the corporations driving this it is CMS. For the skilled nursing industry, they now are going to be reimbursing not on the patients that are in our facility that we care for but by the care received. We are graded by a system called quality measures that were set by CMS. While reading the IOM article, there are six …show more content…
If anyone knows me as a person, they will tell you that I’m adamant and open. I have no problem jumping up to the table and making my suggestions known if it has to do with a patient/resident getting the proper care. I learned from my clinical instructor it was that you stick up for your patients/resident no matter what and this is what I have set out to do. I always think that the resident/patient is my family member. With all the hustle and bustle of today and the pressures of the health care industry. I find that nurses have a hard time prioritizing their care and day. We either get scolded for not clocking out on time, the call bell on too long or using too many supplies. The companies and facilities want us to be happy and retain their nurses. When I am working day to day, I constantly am looking at the six “AIMS for Improvement”. The sixth on equitable is a
- Nurse should place the patients well being above their personal beliefs and values. They should focus on treating the patient and making sure the patient’s needs are being met. This also means that tough decisions have to be made in the process whether it goes against what the health care team wants or it goes against what Mrs. Dawson wants.
I pray that the busyness of life, the tasks that need to be done, the science of healthcare, sleep deprivation, or monotony will never cloud the love and compassion that I have for people. Personally, I love making connections with people. I love giving people a chance to tell their stories. During my nursing practice, I foresee that I will do my best to be the most caring nurse possible. The responsibility lays within each individual nurse as to the level of caring and compassion that they bring to carrying out their nursing duties. I will continually choose to focus on the needs of my patients above my own. Displaying empathy, I will strive to put myself in each one of their shoes and make self-reflection a priority. I foresee that I will do whatever is within my power to enhance trust, comfort, happiness, and wellness for my patients. This may look like spending extra time with a patient, visiting a patient when I’m off-duty, providing emotional or spiritual resources to a patient, respecting a patient’s beliefs and values, providing for any physical needs or extra comfort measures, or just lending a listening ear or a shoulder to cry on. My patients will always know that they are not
The reason for the controversy of the Hospital Consumer Assessment of Healthcare Providers & Systems, referred to as HCAHPS (pronounced “H-caps”), is the tie that the Center for Medicare and Medicaid Services (CMS) placed between the scores of the assessment and healthcare reimbursement (Westbrook, Babakus, & Grant, 2014). There are two sides to consider when addressing HCAHPS/Press Ganey surveys as they directly affect hospital reimbursement. Patient satisfaction, quality of care, and how they portray their hospital stay contributes to the reimbursement that hospital receives. The nurse-patient relationship plays a large role in influencing the quality of care than patients feel that they are receiving.
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
When caring for a person, I not only see the patient as an individual, but also realize that they have family and friends who are also concerned with their health. The environment that I work in can be a hectic one at times, but I ensure that I have the time to make sure every surgery and procedure is set up properly and/or any anticipated items needed are readily available. In regards to health and illness, when patients come into the operating room it is usually either to assist in diagnosing a health issue or to try and remedy a current one. I take all of my nursing actions very seriously and treat patients the way that I would want my family or myself to be
The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan...
This is one of the values that is of the utmost importance when being a nurse. We must have compassion for our patients. We as nurses will make an impact every single day in the lives of people in our community. We need to realize that we are the voice of the voiceless and the advocates for those who cannot advocate for themselves. You realize that even by helping one person, you are making a difference and are making the world a better place one patient at a time. Some of us may enter the field and some of us may be continuing on in our education, but we all share one thing in common, we are all nurses and we all made
Frequently, nurses are confronted with the task of finding the balance between advocating for the patient, and remaining loyal to their hospital or institution (Hanks, 2007). Risks that are associated with patient advocacy are more on the institutional level (Bu & Jezewski, 2007). Risks such as accusations of insubordination, reputation slander, hostile work environment, and loss of job security are among some of the top reasons nurses tend to shy away for patient advocacy (Bu & Jezewski, 2007). Another problem with advocacy is that there isn’t a universal definition as to what being an advocate means, along with inconsistency of interpretations (Bu & Jezewski,
Healthcare is viewed in an unrealistic way by most individuals. Many people view a physician as the only means to find a solution to their problem. Nurses are still seen by some as simply “the person who does what the doctor says.” This is frustrating in today’s time when nurses are required to spend years on their education to help care for their patients. In many situations nurses are the only advocate that some patients’ have.
Retrieved November 3, 2009, from http://abcnews.go.com/images/pollingunit/1091a2Healthcarereform.pdf Pardis, M., Wood, J., & Cramer, M. (2009, September-October). A policy analysis of health care . Nursing economic$ the journal for health care leaders, 27(no 5 2009 r). Retrieved from http://www.nursingeconomics.net/cgi-bin/WebObjects?NECJournal.woa/wa/viewSection?s_id=1073744460.
In Nursing, there will always be instances where the patient's nurse needs to advocate for their patient. There are numerous reasons why a nurse would advocate for their patient ranging from getting the doctor to change the patient’s orders, helping the patient’s treatment team understand what it is the patient is requiring for the day, to expressing the patient’s last wishes before death. In every situation, the nurse should do what is in the patient’s best interest. Tomajan (2012), “Advocacy skills are the ability to successfully support a cause or interest on one’s own behalf or that of another. Advocacy requires a set of skills that include problem solving, communication, influence, and collaboration”(p. 2). With those skills, the nursing staff will be able to work together to advocate for their patients. Along with those skills, nurses need to keep in mind the three core attributes that are: safeguarding patients’ autonomy; acting on behalf of patients; and championing social justice in the provision of health care. (Bu & Jezewski, 2006)
Quality and quality improvement are important to any healthcare organization because these principles allows organizations to fulfill their missions more effectively. Defining what quality is may differ depending on whom is asking the question, as differing participates may have differing ideas about what quality means and why it is important. Being that quality is what unites patients and healthcare organizations, we can see the importance of quality and the need for strong policies and practices that improve patient care and their experience while receiving that care. Giannini (2015) states that this dualistic approach to quality utilizes separate measurements, conformance quality that measures patient outcomes against a set standard and
The recommendations would lead to increased costs, but again, the benefits in quality of primary care and efficiency of nursing practice that will result from this far outweighs the financial resources put in, into the long-term. The result will be a nurses’ commitment to patient-centered, quality, safe, and reliable care, as well as improved efficiencies in health care
My core values and beliefs are honesty, caring, family, and lifelong learning, which I use every day in my life. The core of nursing is caring, knowledge, and integrity that focuses on the patient’s needs, healing, safety, and encouragement. Personal and professional beliefs overlap the driving force of nursing. The qualities of a good nurse are not or cannot be turned off and on, and are part of the person I am. We are just helping hands that are always striving to help others. I am not perfect. I am a human being and sometimes mistakes will be made, but I always try my best. If something goes wrong, I will examine the situation, and learn from it to make me a better nurse than I was before. I will monitor and reflect on my own actions to ensure that I am staying true to what I believe are the best nursing practices. When we find conflicts between our personal beliefs and those of the patient, we should uphold our personal and professional ethical standards. We should find someone to guide us through our conflict to find a solution that will not compromise our own
My future nursing practice is now changed because I understand the importance of patient advocacy. I need to trust in myself that I know when I am seeing something wrong, so I can speak up before it is too late. Because of this reflection I can see how trivial it was to be worried about my own professional risk over my patient’s quality of care. I am sure that I will never make that mistake again. As a health care provider, the well-being of patients should be a top priority,