Health Care Reform Within Five Professional Competencies

Wound management is one of the cornerstones for nursing care however, effective wound care extends far beyond the application of the wound itself. Nurses may be required to assess, plan, implement, and evaluate wound care; therefore, order to fill these roles it’s critical to have an understanding of the several different areas of wound care such as, integumentary system, classification of wounds, wound procedures, and documentation. Knowledge in each of these areas will allow nurses to make well informed decisions about wound care, and as a result play an active part in wound healing.

A meaningful event from my clinical experience was during week six when one of my colleague and I along with the RN performed a wound care procedure on one of my client who had pressure ulcers on her coccyx area and wound on the right foot. It was my first time doing wound care on a client who has severe wound type. Client is a 90 years old female who has been admitted to the unit for Osteomyelitis, it is an infection of the bone, caused by bacteria breaking into the body’s tissues and entering the bloodstream through an open wound (LeMone, p.1382). The client said a dog bit her foot at a park few years ago and that’s how she got the wound. Client has a wound care dressing order that needs to be changed daily with Betadine soaked gauze for all areas,

As the clinic RN, I assisted and learned to do many types of wound dressings, wound care debridement, and with wound care equipment. My strengths and skill sets are from years of OR experience with incisions/wounds, infection control, assessment and direct patient care. I offer wonderful interpersonal skills that include leadership through mentoring and building rapport with professional and nonprofessional staff, experienced and effective public speaker in any venue, and patient/community education through honest and effective communication. I have been successful in every nursing area I have worked and I would like to join and add to your Wound Healing team.

Even in the hospital setting while in Basildon Hospital Stroke Rehabilitation (Lister Ward) and in Mountnessing Court Billericay (The Mental Health Placement), I have found caring for patients with open wounds very interesting and diverse. Considering my interests in wound care, I slowly realised following this career path is what would suit me.

The process of wound assessment requires accurate and appropriate interventions while dealing with the patients. There are some major components which the operator must consider to effectively access an infection, and they require a range of skills and knowledge. These factors are the knowledge of relevant anatomy and physiology, the understanding of the various factors that accelerate wound growth, and the ability to listen and understand the patient’s needs. In wound accessing, the doctor should have an idea concerning the number and location of wounds, the required treatments depending on the type of infection, the type of wound in accordance to various grading given, and the procedures to follow to achieve the treatment

In addition residents of new medical programs are being trained to be educated of maintaining quality care and implementing systems to reduce errors and improve quality of care ( Shojania & Levinson, 2009). As stated by the authors, faculty must be educated to provide the education essential to the needs to improve quality care and implement QI standards of teaching to ensure the highest standard of care. Finally, the patient must be held accountable to ensure they are as proactive as possible to receive the most efficient care possible, as well as cost effective care.

“All health care disciplines share a common and primary commitment to serving the patient and working toward the ideal of health for all.” (American Association of Colleges of Nursing, 2014, p. 1) There are many different professional members in the healthcare system. Each of them, have a specific specialty and responsibility to the patient and play an important role in the patient’s overall plan of care. “The scope of health care mandates that health professionals work collaboratively and with other related disciplines. Collaboration emanates from an understanding and appreciation of the roles and contributions that each discipline brings to the care delivery experience.” (American Association of Colleges of

The Institute of Medicine (IOM) has recognized five key core competencies (CCs) that all healthcare professionals should be aware of during practice. The initial competency described concentrates on patient-centered care. Throughout history, the nursing community has continued to evolve, both in the practicing aspect and in level of caring for patients. During this evolution of nursing care, nurses providing hands on care to patients must refer to the Institute of Medicine, peer reviews and/or evidenced-based research to guide them properly as it applies to the core concepts of nursing. The first core competency according to the IOM is patient-centered care.

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

Today’s healthcare system requires that healthcare professionals across the globe change their focus towards evidence-based practice to meet the needs of the complex clinical setting and constantly strive to improve patient care and outcomes. The United States Institute of Medicine (IOM) has created five core competencies to be utilized by all health care providers in order to enhance patient outcomes (Inter-professional Education Collaborative Expert Panel, 2011). The competencies are employing evidence-based practice, working in interdisciplinary teams, applying quality improvement, utilizing informatics, and providing patient-centered care (Institute of Medicine, 2010).

There are five core competencies needed for health care professionals and they are provide patient centered care, work in interdisciplinary teams, employ evidence based practice, apply quality improvement, and utilizing informatics. In this paper, I will go into further detail how providing patient centered care is challenging, how to overcome the challenges, how it relates to my chosen profession, and how this competency can impact delivery of care to patients.

The five core competencies identified by IOM and the sixth added by QSEN, safety, are believed to be necessary to improve both quality and safety of the healthcare system within which nurses work (Multimethod teaching). The six core competencies outlined are patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, informatics, and safety (Diffusing Qsen). While all competencies are significant to the healthcare system, patient centered care is vital to positive patient outcomes and focuses on the patient’s perspective within the healthcare system.

Wound care nurses play a special role in the hospital environment, and hospitals without those specialized nurses may not be able to offer the level of care as hospitals that have these specialized professionals. "Wound care nurses, sometimes referred to as wound, ostomy, and continence (WOC) nurses, specialize in wound management, the monitoring and treatment of wounds due to injury, disease or medical treatments. Their work promotes the safe and rapid healing of a wide variety of wounds, from chronic bed sores or ulcers to abscesses, feeding tube sites and recent surgical openings" (Nursing Schools, 2012). While it may seem as if any nurse should be qualified to perform these functions, it is critical to realize that it is a specialized field. "Their main objectives are to assess the wounds, develop a treatment plan, clean wounds and monitor for signs of

Nursing involves greater purpose beside the objective of treating patients’ ailments in an efficient and effective manner. Nurses, physicians, and health care providers across the board uphold the duty to treat patients with the utmost value of care. As a universal definition of care does not exist, Anita Finkelman and Carole Kenner explain care is drawn from four perspectives: a sense of care involving compassion, knowledge and expertise that allows nurses to advocate for the patient in addition to treating the medial complication, and “…competence in carrying out all the required procedures, personal and technical, with true concern for providing the proper care at the proper time in the proper way (Finkelman & Kenner, 2013) . Combining the foundation of every perspective leads to the Institute of Medicine’s (IOM) first core competency of patient-centered care. Sans the image of patient-centered care the practice of nursing and medicine alike will lack the passion the American Nursing Association envisions for “the protection, promotion, and optimization of health and abilities, prevention of illness and injury, alleviation of suffering through the diagnosis and care of individuals, families, communities, and populations” (Finkelman & Kenner, 2013). Therefore, the author of this paper explores the IOM’s definition of patient-centered care, implementation of the concept, and its pivotal relationship to the nursing profession.

Being a doctor has often been called the most noble of professions. They are many reasons for this. It is a profession where you put someone else 's life above your own. As a physician, you are trying to stop the inevitable, which is death. A career and even a life in Medicine is about sacrifice. It is about going above and beyond for strangers, it is about missing family functions, get togethers, birthdays, anniversaries, you name it. You will undoubtedly spend your time saving the lives of complete strangers and sometimes outright being forced to not be there for those who are near and dear to you. Often times, there is a lot of talk about the equality in the demographics of patient care, how the wealth gap seems to trickle down to the levels of patient care, and the topic of healthcare reform always looms large in the minds and seem to be an ever-present part of every political campaign, even more so when it is an election year. But does anyone look at the disparities in the caregivers?