Change In Nursing

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

The facility my change project has potential impact upon is a teaching hospital which is known for promoting, supporting, and encouraging clinical research and implementing latest evidence-based practice. Erlanger serves as the region's only academic teaching hospital and strives to employ healthcare professionals who are knowledgeable in the latest skill, technique, and evidence based practice (EBP) (Erlanger Health System, 2017). This serves as both a strength and opportunity for the facility. A major strength for the hospital is the support that is has for research and implementation of all change processes. In 2013 the Institute for Clinical Research (EICR), was developed to solidify unity of two objectives, providing patients’ access

People generally like to stay in their comfort zone, they do not like changes. However, change is a necessary part of life, we see change in nature every day. Change can be positive or negative. We can choose to embrace the change or reject it, we also can choose to allow the change to have a negative or positive impact on our lives. Helmstetter lists six steps when dealing with change. First to recognize the change, then to decide if you are going to accept or reject the change. The next step is to choose your attitude toward the change, then choose how you are going to deal with it and what actions you are going to take. The last step is to evaluate your progress of accepting the change (Lamberton and Minor, 2012)

The Institute of Medicine’s 2010 report on The Future of Nursing: Leading Change, Advancing Health acknowledges the changing healthcare sector in the US and describes future vision of healthcare and the role of nurses to fulfill that vision. The United States always strives to provide affordable and quality healthcare to the entire population of the country. In order to achieve this goal an overall restructuring of the healthcare system was necessitated. Nurses are considered to be the central part of the healthcare system to provide high quality and safe patient care. Nursing in the US is the single largest segment of the healthcare workforce with almost 3 million nurses working in different areas across the county. The changing

In the healthcare facility there are many things that can benefit from change. Bedside rounding with the inclusion of the entire care team would be a beneficial change to any healthcare facility. By doing bedside rounding it promotes patient and family involvement in the exchange of information and planning of their care. This also allows for the interdisciplinary team to be completely involved rather than picking up bits and pieces of information throughout the day from multiple different people. This is also a great opportunity for the patient and their family to ask questions with the entire care team available for answers.

An example of this is that a nurse can specialize in educating patients on how to manage their chronic conditions such as diabetes and hypertension. The same nurse can educate the community on wellness and preventative measures for diabetes and hypertension. Nurses can coordinate the patient’s care and carry out many of the duties required for their care. This decreases the amount of time required for the main provider, allowing them to see more patients. This will help increase patient satisfaction, and allow the main provider to see more patients or see those who are more critical (IOM, 2011). “If the United States is to achieve this necessary transformation of its health care system, the evidence points to the importance of relying on nurses in enhanced and reconceptualized roles” (IOM, 2011, p. 95)

IOM (Institute of Medicine), in partnership with RWJF (Robert Wood Johnson Foundation), developed the report “The Future of Nursing: Leading Change, Advancing health on October 5, 2010.This detailed study focus on the significant connection between the health needs of various, varying populations and the actions of the nursing staff. The health care delivery system and nursing profession consider this report as a framework for transformation. The changes in health care system and nursing workforce are directed to health care researchers, payers, national, state and local government leaders, professionals

Change is always vital to progress and the field of nursing is constantly in change. The world that we live in today is creating a higher need for more nurses, changing the way that nurses are educated and creating new approaches to utilize nurses out in the field. On October 5th, 2010, the Institute of Medicine (IOM) released the report “The Future of Nursing: Leading Change, Advancing Health.” The report elaborates on the need for the nursing profession to prepare for the changes that are occurring due to the health care reform and the current

The Carnegie Foundation reports that nurses today “are undereducated for the demands of practice” (Benner, Sutphen, Leonard, & Day, 2009, ¶ 17). Education of the ADN centers around the hands-on skills needed to care for a patient at bedside and less on the scientific theories that allow the holistic treatment of a patient. A report by the Milbank Memorial Fund in 2001 reports that nurses educated at the ADN level have a higher incidence of mistakes made while performing their duties (Rosseter, 2011, ¶ 24). Registered nurses who graduate with the two year degree lack research skills, leadership and managerial skills as well as informatics needed to deliver quality medical care within today’s health care system (Orsolini-Hain & Waters, 2009, p. 269).

This paper seeks to expand upon the 2010 Institute of Medicine’s report on the future of nursing, leading change, advancing health and illustrating its impact on nursing education, practice and leadership. There is an ongoing transformation in the healthcare system necessitated by the need to achieve a patient centered care in the community, public, and primary care settings in contrast to previous times. Nurses occupying vital roles in the healthcare system, need improvements in the areas mentioned above to

Being a registered nurse affords one the option of working in many diverse healthcare settings. In any practice setting the climate of health care change is evident. There are diverse entities involved in the implementation and recommendation of these practice changes. These are led by the Robert Wood Johnson Foundation (RWJF), the Institute of Medicine (IOM), nursing campaign for action initiatives, as well as individual state-based action coalitions. Nurses need to be prepared and cognizant of the transformations occurring in health care settings as well as the plans that put them at the forefront of the future.

In November of 2010, the Institute of Medicine (IOM) released “The Future of Nursing: Leading Change, Advancing Health”. This special report examined the current state of nursing and changing landscape of the American healthcare system and offered recommendations for the future role nurses should play. The committee that released the report, Committee on the Robert Wood Johnson Foundation, divided it into three parts. Part II of the study, focused on transforming the nursing profession in order to improve America’s healthcare system. In order to achieve this transformation, the committee recommended that nurses attain higher levels of education and training, practice to the full extent of that education and training, and assume more

Changes in the Health Care System and the Practice of Nursing have become complex. Technological changes, complicated client needs, short hospital length of stay, and departure from acute care to community based care, all these changes have underscore the need for professional nurses to think critically in order to provide safe and effective client care. A better educated nursing workforce can provide good health education to patients and their families. The affordable care of 2010 has required the need for nurses to expand their role of practice to meet complicated patient demands. This has prompted the Institute Of Medicine to review the “Future of Nursing, Leading change and Advancing Health”. {Creasia & Fribery,2011}

Ongoing development and changes in healthcare delivery enable nurses to maintain standards of nursing and develop their competence and performance. Through this the patients well-being is maintained, respecting them through accessing up to date knowledge and skills that are essential in an ever changing environment.

After reading The Future of Nursing: Leading Change, Advancing Health article by the Institute of Medicine, I gained a clearer view of the overall goal for nursing. Although there are many diverse parties that need to be associated in perfecting the continuously changing health care system, nurses vital to the contribution. Nurses provide direct patient care, deal with the health care system and health care policies, as well as interact with the interdisciplinary team. So the Institute of Medicine has a great nursing blueprint for help nurses make a different for not only the future of the health care system