Patients are struggling with their discharge plans, unable to manage their care as evidenced by complications reported after discharge (McBride & Andrews, 2013; Kangovi et al., 2012). Postoperative complications may be related to the nurse’s inability to assess a patient's comprehension of discharge instructions accurately (Ashbrook & Sehgal, 2012; Fredericks, 2010). Nurses as part of the healthcare team are responsible for effectively preparing patients for the transition to self-care in the home setting. Opportunities for practice improvement exist as nurses perform this important task. Teaching performed in the acute care setting generally consists of standardized content, rather than information based on the patient’s individual …show more content…
The use of evidence-based teach-back techniques provides nurses with the necessary tools to assess the patient’s health literacy while confirming effective learning. Educational interventions implementing “teach-back” have proven to be successful in evaluating retention and comprehension of patient education material (Bobay et al., 2015; Kornburger et al., 2013). Teach-back methodology is an evidence-based strategy utilized at the bedside to verify understanding and reinforce important discharge information (Kornburger et al., 2013). Teach-back, also known as the “show me” and “repeat back” technique, is used as a strategy to minimize miscommunication between patient and nurse (National Quality Forum, 2005; White et al., 2012). The National Quality Forum (NQF) has promoted the teach-back method as “one of thirty-four proven safe practices mitigating medication errors and adverse events “(Jager & Wynia, 2012, p.295). Furthermore, the Joint Commission (JC), Institute for Healthcare Improvement (IHI) and the Agency for Healthcare Research and Quality (AHRQ) support the use of teach-back as best practice when completing discharge teaching to ensure positive outcomes (Jager & Wynia, 2012; Kornburger et al., 2013; White et al., 2012). Instituting best practice, as well as communication that is timely, accurate and understood by the patient can reduce adverse events and …show more content…
According to The Code of Ethics for Nurses (2014), provision eight states, “The nurse collaborates with other health professionals and public in promoting community, national, and international efforts to meet health needs” (p. 23). Nurses as responsible practitioners need to be knowledgeable about their patients’ specific health care needs. Provision eight focuses on nursing’s responsibility to educate the public, promote healthy lifestyles, and address barriers to care (ANA, 2014). Providing appropriate discharge education will ensure patients are adequately prepared for safe discharge to home. To further ensure positive patient outcomes, compliance with Healthy People 2020 goals supporting effective educational programs to improve individual’s health and quality of life should be exercised. (Healthy People. Gov.,
As a registered nurse practicing in the state of California I am responsible for practicing within my states legal regulations and nursing scope of practice. My concern for the welfare of the sick and injured allows me to practice ethical provisions of nursing. These are required if I am to carry out competent and effective nursing care. Nursing encompasses the prevention of illness, the alleviation of suffering, and the protection, promotion, and restoration of health in the care of individuals. Therefore, as health care professionals we must be familiar with the different philosophical forces, ethical principles, theories and values that influence nursing. At the same time, we must be respectful to our patient’s
Improving the quality of discharge planning in acute care include addressing the lack of appropriate staff and patient education about appropriate planning for discharge (4). This includes implementing proper discharge teaching regarding signs and symptoms to seek medical attention, management and care of medical equipment, and access to community resources (4, 5). Other challenges are patients with complex comorbidities too difficult to discharge as well as lack of community supports and equipment for newly discharge patients and lack of rehabilitation and nursing home beds (4). Consequently, acute care units are pressured to vacate hospital beds in response to the growing elderly population. Hospital professionals tend to focus discharge teaching and preparation on medical areas such as diet, activity, treatments, and medications (5). Community referrals to appropriate services at the time of hospital discharge does not often happen contributing to poorer patient outcomes and re-hospitalizations
Nursing is a career that is governed by a set of ethical principles. The duties of a nurse consist of care and support and its important that nurses are aware of their professional ethics. These principles are put into place to uphold and maintain moral values in healthcare. The American Nurses Association (ANA) code of ethics for nurses consists of nine provisions, outlined in the Code of Ethics for nurses with Interpretive Statements. These provisions are constructed to blueprint the role and responsibilities of a nurse. The chosen provisions being discussed will refer to the three main principles of patient autonomy, patient confidentiality, and patient rights.
The American Nurses Association (ANA) Code of Ethics provides many professional traits that can be incorporated to an interdisciplinary team of healthcare professionals such as compassion and respect, advocacy, accountability for nursing practice and participation in advancement of the nursing career (Cherry, 2011). Compassion is a very important aspect of the nursing profession. It would be very difficult to be a nurse without being compassionate. Nurses demonstrate compassion and respect daily in their work by actively listening to patients’ and family members’ problems and concerns and by empathy when appropriate. Advocacy is a nursing trait constantly used by the entire interdisciplinary team. Nurses advocate for patients’ right of autonomy for decision making in regards to their care, treatments and procedures. Also, nurses are in the best position to serve as a bridge between the patient and the interdisciplinary team. Accountability is so essential in the nursing profession. Nurses are accountable for their own nursing practices and for our patients.
According to American Nurses Association (ANA), (2010) “the nurse promotes, advocates for and strives to protect the heath, safety and right of the patient” (p. 6). Nursing responsibilities should be acted at the highest standard and must be based on legal and ethical obligations.
Ineffective discharge teaching often leads to unnecessary admissions to the hospital resulting in negative patient outcomes and decreased patient satisfaction. This negatively impacts the well-being of the patient and creates a financial burden on institutions. As a result, this universal practice issue requires a call to action on the part of the nursing profession. Nurses can proactively assist in assuring incidents of readmission do not occur. Nurses as educators play a critical role in the successful transition of patients from hospital to home. The overall goal of discharge education is to ensure there is an exchange of critical information between the patient and nurse in which plans of care are understood and followed. The research
A nurse is given an opportunity to help patients, either if its by helping them through a very serious sickness or just helping a patient get to the bathroom on time, or a time when happiness is overfilling the room and a child is being born. Registered nurses provide a wide variety of patient care services (Mitchell, p.12). A Nurse must always know where to begin and where to stop, as any other career in the health field there is always something that cannot be done by everyone but only the certified person, a nurse must always remain inside her scope of practice to prevent any misunderstandings. A nurse must also follow a code of ethics , the code of ethics of the American Association of Medical Assistants states that a nurse should at all times render service with full respect and dignity of humanity, respect confidential information obtained by a patients file, uphold the honor and high principles the profession and accept its discipline, and last but not least always want to improve her services to better serve the health and well being of the community. (Mitchell, p.65).
Standard 16 of the American Nurses Association (ANA) Scope and Standards Practice, directs nurse leaders to advocate not only for patients but for all members of our healthcare community. As a discharge planner, I am in a unique position to advocate not only for patients but for caregivers as well. As part of my responsibilities, I participate in daily multi-disciplinary team rounds. The meetings take place so that all disciplines can openly discuss patient care needs. They provide the perfect opportunity for anyone to bring to light problems or concerns.
I learned that as a nurse it is my duty to always consider my own well being, along with my patient’s. I must keep a high moral character both in the workplace and in my personal life. I must continue to educate myself and keep myself up to date with all the latest nursing practices and research. I must subject myself to peer review and evaluation. I must never let my personal feelings about a patient’s lifestyle affect my care for them. When met with a tough choice that places me in an ethical crisis I must keep a good head on my shoulders and always have my patient’s best interests in mind. If I feel that a situation at work is in direct conflict with my personal values or my oath to be an ethical nurse I must go through the proper channels to work through the problem.
Historically, a BSR was given verbally at the nursing station with frequent interruptions, taped on the recorder or a written paper report without the patient being involved in their care. As the healthcare industry has become more of a patient-centered, the hospitals are participating in a publicly reported government HCAHPS survey- a composite scale score that measure patient’s hospital experience through a metric satisfaction survey. An effective handoff is critical when transferring any medical information of a patient’s continuity of care from one nurse to another. According to the Health Professions Education: A Bridge to Quality: “all health professionals should be educated to deliver patient-centered care as members of an inter-disciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics.” (IOM, 2013). This paper analyzes an overview of nurse’s survey, direct observation on the BSR, a literature summary, nursing challenges and recommendations that might improve patient safety and quality of care.
Low literacy affects many individuals within today’s society. The amount of individuals that are unable to comprehend medication labels, medication regimens, and learning points from discharge teaching is shocking and result in further health related injuries (Koh et al., 2012). Nurses must take the important task of recognizing an individual literacy and comprehension ability before planning the individual’s care plan. The nurse must find out the ways an individual can receive information that
As an individual’s ethics will play a large part in their practice, there are specific guidelines and legislation that exist to ensure that nurses, as well as other health professionals, practice in a way that is ethical (Avery, 2013). These laws further exists to attempt to simplify the ethical issues that sometimes present in nursing practice and to attempt to guide one’s actions. The Nursing and Midwifery Board of Australia (NMBA) provides guidance to nurses by providing a number of professional codes and guidelines (Avery, 2013). The NMBA has developed a code of ethics for nurses comprising of eight codes (Avery, 2013). These are as follows; 1) Nurses value quality nursing care for all people; 2) Nurses value respect and kindness for self and others;
Nurses are subject to a plethora of legal, ethical, and professional duties which can be very challenging on a day to day basis. Some of these duties include respecting a patient 's confidentiality and autonomy, and to recognize the duty of care that is owed to all patients. As nurses our duties are always professional; however there are legal implications if these duties are breached. We also must consider when it is okay as nurses to breach these duties and therefore ethical issues arise. As nurses one of our main priorities is to advocate for our patients, without our own personal feelings on the matter taking over.
Codes of ethics contain a coherent set of normative principles underlying a nurse’s purpose and associated values (Vanlaere and Gastmans, 2007). Two perspectives of ethics are the ethics of justice and the ethics of care (Botes, 2000). The ethics of justice constitutes an ethical perspective in terms of which ethical decisions are made on the basis of universal principles and rules, and in an impartial and verifiable manner with a view to ensuring the fair and equitable treatment of all people (Botes, 2000). The ethics of care, on the other hand, constitutes an ethical approach in terms of which involvement, harmonious relations and the needs of others play an important part in ethical decision making in each ethical situation (Botes, 2000).
A professional nurse is one who puts the needs and importance of patient care above all others. While striving for professionalism, nurses need compassion, patience, empathy, strong moral and ethics, accountability and the commitment to always act in the best interest of their patients. Nurses are held accountable for providing quality, safe, and effective nursing care (Hood, 2014). A professional nurse has the responsibility to continually improve and implement nursing standards while maintaining integrity by involving themselves in various tasks. Regular involvement in reading professional literature and sharing of evidence- based research with other healthcare personal helps increase knowledge and skills. This nursing ability can be used to encourage the actions of others in the healthcare team resulting in improved patient care. Nurses should encourage each other to become involved in hospital committees, provide an environment to encourage the discussions of ethical dilemmas, promote professional growth of nurses to voice their concerns and share viewpoints to address issues. “A professional nurse should expect to commit to a life of continuous learning growth and development”. (Hood, 2014, pp. 29). Nurses choose this profession to help others. As professional nurses we must maintain our ethics, values, characteristics, and commitment to drive our profession forward (CCN, 2015). Nurses must be autonomous, accountable, and be able to delegate to unlicensed assistive personnel. Being autonomous as a nurse means having control over their practice (Hood, 2014). It allows a nurse to take risks while being held accountable for ones’ actions (Hood, 2014).