Shared Compliance Case Study

This author spoke with several nurses to discuss Summa’s shared governance. There were two that had two opposing views of it. One nurse, who was younger, felt that the shared governance was just for show to achieve Magnet status. The cons she found was that the recommendations that staff nurses made were just ignored. Another problem she found was that the work that was put into it was not being reimbursed financially. Problem with shared governance is that it is believed to exist where there is empowerment, but it is has more to do with traditional board governance with some staff input. The result is that it is not founded in the actions of the staff nurse, but the actions of administration (Joseph & Bogue, 2016). The other nurse, who was older, was very excited to discuss shared governance. Her department was the first at Summa to initiate shared governance. Some of the pros were nurses had a voice and a path to follow to institute change. She explained how she

Shared governance empowers nurses by recognizing that nurses, as front line staff, are in a position to have a unique understanding of the complexities of daily patient care. Utilization of unit-based councils made up of staff nurses to solve problems and evaluate procedures ensures that evidence-based best practices are implemented (Fray, 2011). Shared decision making in nursing units increases the use of best practices through process development, sharing of successes across multi-unit areas and in the development of new nurse leaders. Unit-based councils are often chaired by younger nursing staff and nursing leaders act more as facilitators allowing these young new nurses to be

There are many way in which nurses could contribute leadership to improve the health care system to provide advance patient care. IOM states that, “serving as strong patient advocates, nurses must be involved in decision making about how to improve the delivery of care” (IOM, 2011, p. 222). In order to have a voice in the health care reform, nurses need to take opportunities to be involve in committees or board meetings and participate in making policies. The IOM “committee believes there will be numerous opportunities for nurses to help develop and implement care

Healthcare reform in the United States (U.S.), continues to be a hot topic in the news. Whether it discusses how the program will be financed, the need to redesign the organization, or how the process of delivering healthcare will be implemented; one thing that is a frontrunner, is the need for registered nurses (RNs) and advanced practice registered nurses (APRNs) to fill the increased demands on the primary care system (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 375). “Several programs and initiatives included in the health reform legislation involve interdisciplinary and cross-setting care coordination and care management services of RNs” (Institute of Medicine, & Robert Wood Johnson Foundation, 2011, p. 377).

Advance practice nurses (APNs) are at the forefront of today’s healthcare system. To keep up with the aging population and the demands of complex healthcare needs of this society, APNs need to perform at the highest quality to provide efficient, effective, holistic and improve patient outcome and satisfaction while reducing cost. To provide such care, APNs need to implement the six core competencies as outlined by Hamric. These six core competencies are: direct clinical practice, expert coaching and advice, consultation, research skills, clinical and professional leadership, collaboration, and ethical decision-making. This paper will explore how APNs can implement each of the six core competencies to support the effective improvement of outcomes such as patient satisfaction, readmissions, cost, health status, and complications. In addition, each of the six core competencies of the APN’s role identified by Hamric will be outlined and applied using a fictitious patient case study.

The healthcare industry has intensely advanced throughout the world, in turn changing the principles that incorporate the practice and culture of nursing practice. Altering the model of care to a patient-centered mode signifies an organizational culture shift and requires the participation of executives at the senior level (Cliff, 2012). To practice this care to provide the best care possible, it goes beyond the nurse to all healthcare professionals and senior leadership. The days of patients and nurses following a physician’s order without favor to care has now loaned themselves to more of an interdisciplinary approach to practice. Though, it is encouraged that the patient makes decisions for themselves, after receiving the proper education and information on their condition. Part of the patient-centered care is to be the patients’ advocate, by letting them know you are there for them when they are unable to speak and advocate for themselves and what is in their best interest. That goes in hand with educating them on “self-management of care, health literacy, patient, and family education through nurse-patient communication and interaction (Finkelman & Kenner, 2016, p. 271).”

I would define the nurse as the facilitators of patient care on all levels from management to direct patient care , unfortunately nurses aren’t always included in policy changes or changes in direction of patient care on the local and other levels . They may find it difficult to initiate or identify change when they identify problems due lack of support and training. I see great changes in nursing over the next 10 years. The affordable care Act will potentially change the paradigm of healthcare and offer many challenges to the nursing profession, as more people than ever in the history of our country now have access to healthcare, nursing shortages combined with struggles to get RN’s educated at a BSN or higher degrees will stress the healthcare system. We must embrace change , this includes education about policy and politics for our nurses , nursing students , and collaborate with other professions and disciplines to reach our goals as stated in the Future of Nursing report by IOM ( Hendren 2010 ) . Nurses we now have center stage due to Obama Care. Let’s take advantage of this opportunity and help decide how we will deliver healthcare to our patient’s .to the make a

As nursing leaders, the empowerment of staff to improve the delivery of safe quality care is imperative in today’s healthcare environment. The Management and Leadership track of the American Sentinel MSN program has provided the guidance to cultivate and prepare future nurse leaders to develop a sense of ownership and commitment to their work and organization. The evidenced based practice (EBP) project that is proposed will be implemented at the Veterans Administration Medical Center (VAMC); it will support the staff to improve the quality of care for the veteran population at this facility.

The third barrier discussed in the IOM’s Future of Nursing report was that nurses need to be full partners, with all other health care professionals, in order to redesign health care in the United States (IOM, 2010). To do this nursing education must add leadership aspects to the education programs. In doing this it will ensure that nurse are ready to actively participate and lead in decisions regarding healthcare

Each member of the team brings a different specialty to the table. Knowledge of each individual’s strengths and limitations can help to improve patient care and multi-disciplinary collaboration. Nurse Practioner (NP) and advance practice nurse (APN) are working to redefine roles in scopes of practice. According to research by Andregård and Jangland (2015), the introduction of the NP as a part of the healthcare team had mixed results, they ranged from “threat to professional boundaries” to “a resource for the team.” The physicians and nurses had opposing opinions on the ideology, medical or holistic the NP should align with. This can cause stress in multi-disciplinary situations and impede patient care. It is the responsibility of all health care team members to work together to define roles and provide stable care to the patient no matter the

According to 2010 patient protection and the Affordable Care Act, it was obvious that it needed all the possible help from all health professional, especially nurses for it to function and achieve all its aims such as affordable coverage and quality care, making all Americans to have health care that would improve the quality of life and inexpensive. There is no doubt if registered nurses do not have a strong position as partners in Affordable health care to make it a success. Three colleagues were interviewed regarding their knowledge concerning innovative health care conveyance including the current nurse’s responsibility in the health center environments, communities, health centers, as well as medical homes. Their questions were also expanded to their knowledge of Accountable Care organizations, the way they are organized, and the nurse’s opportunities in this program. What they know about medical homes and how they are organized, including nurse’s opportunities and their views on Nurse-managed Health Clinics (NMHCs and the nurse’s benefits).

Hess, discusses shared governance involvement with the nursing shortage that healthcare facilities are now facing. Hess focused on the purpose of shared governance, which is to give registered nurses control over their practice. This will help ensure nurse involvement in the workplace. In expressing his struggle, Hess clearly defines shared governance with the order of structures and processes involved within each organization (Hess, 2004). However, he does agree with its purpose that nursing shared governance helps with every situation a nurse may encounter in the healthcare setting. The following article further evaluates workplace advocacy in a way that relates to shared governance.

Clinical nurse specialists wear many hats in their day-to-day work setting. The five major components of the CNS role comprise of: expert clinical practice, educator, researcher, consultant, and leadership/management (Fulton, Lyon & Goudreau, 2014). Working as part of a multi-disciplinary team, CNSs can effect change by improving patient care, mentoring junior staff and colleagues, and refine organizational processes through improved standards of care. In addition to fulfilling the five major role components, the CNS integrates care across three spheres of influence: patients/families, nursing staff, and the organization/system of care.

Shared governance is defined as a professional practice model, inspired by the ideology of equity, partnership, accountability and ownership that will assist in the formation of a work structure that will allow sustainable and responsible decisions by an interdisciplinary plan to excel in patient care (Vanderbilt University Medical Center. (2013). Allowing this type of affiliation promotes collaboration, collective decision making and responsibility for quality of care of patients. Instead of having practices completely controlled by senior executives, shared governance permits nurses to have more power and be more independent in their field (Crow & French, 2015). Shared governance allows nurses to plan, make decisions and take actions with

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.