The Impact Of Nursing Care On Health Care Quality

This paper brings up my personal nursing philosophy that I am planning to deliver in my nursing career. I believe that nursing is more than merely as a profession, it also involves my medical knowledge combined it with a commitment to quality nursing care with compassion, respect, dignity, and advocacy for each patient. I believe that the interdisciplinary care and collaboration in the medical field are crucial elements that lead to a healthy relationship among healthcare professionals in promoting quality patient care that is individualized to each patient’s needs.

Nurse staffing and how it relates to the quality of patient care has been an important issue in the field of nursing for quite some time. This topic has been particularly popular recently due to the fact that there is an increasing age among those who make up the Baby Boomer era in the United States. There will be a greater need for nurse staffing to increase to help accommodate the higher demand of care. Although nursing is “the top occupation in terms of job growth,” there are still nursing shortages among various hospitals across America today. The shortage in nurses heavily weighs on the overall quality of care that each individual patient receives during their hospital stay (Rosseter, 2014).

quality of patient care, and can be implemented in practice, to provide solutions to nursing

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

Nursing-sensitive indicators are defined by the American Nursing Association (ANA) as “indicators that reflect the structure, process and outcomes of nursing care” (ANA, 2014). These indicators help define how nursing care is given by measuring the amount of nursing staff, skill level of the nursing staff, and the education level of nursing staff. These indicators depict the quality of care provided to patients and the outcomes of the care provided. Careful tracking of these indicators provides evidence for keeping current practices or for implementing new policy and procedures. A formal set of indicators measuring the impact nursing interventions have on patient care was not implemented until 1998 (Montalvo, I. (2007). With the establishment of the National Database of Nursing Quality Indicators (NDNQI), hospitals and other care settings are able to assess how nursing interventions impact patient outcomes, quality of care, and the overall work environment in health care facilities. Nursing-sensitive indicators are a quality improvement measure used to determine how the quality of nursing care is evaluated in hospitals and other healthcare facilities. Nurse sensitive indicators allow healthcare facilities to evaluate how the care they are providing is following evidence-based practices and how they can improve their practices to achieve better patient outcomes. The American Nurses Association is promoting these indicators as the definitive standards for patient care

The health care is reforming in a way that care delivery models have been formed and people will be paying for quality of care as a whole (Fairman, Rowe, Hassmiller, & Shalala, 2011). The health care reform law is attempting to balance the system of health care resources in that a balance will be yielded to award care value over the volume of care provided. This reform calls into nurse leadership and the input of nurses who contribute the largest labor to the health care system. Registered nurses are vital in the delivery model of patient centered care system.

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

Definitions of the quality of medical care are no longer left to clinicians who decide for themselves what technical performance constitutes “good care.” What are the other dimensions of quality care and why are they important? What has changed since the days when “doctor knows best?”

An interesting perspective on the definition of quality which would be interconnected with any managed care plans was highlighted by Carolyn M. Clancy, Director Agency for Health Care Research and Quality, U.S. Department of Health and Human Services in a subcommittee hearing to the U.S. Senate. The statement by Carolyn M. Clancy was presented on: March 18th, 2009 when discussing the topic of: What is Health Care Quality and Who Decides?

IOM defined quality as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge”

Dr. Avedis Donabedian developed a model for categorizing and measuring the quality of healthcare providing a framework that conceptualized quality in broad terms and classification to measure and assess different aspects of quality in nursing care (Sollecito & Johnson, 2013). In the footsteps of Donabedian’s framework, Dr. Beatrice Kalisch developed a model conceptualizing missed nursing care otherwise known as “unfinished nursing care” or “care left undone”. Missed nursing care as defined in the Missed Nursing Care Model is any aspect of required patient care that is omitted, either in part or whole, or delayed (Kalisch, Landstrom, & Hinshaw, 2009). The structural aspects Kalisch’s model include labor resources, nursing staff, competency level of staff, education and experience, material resources, teamwork and communication. Kalisch model indicates that nurses with recent restricted resources in the nursing process determining clinical priorities is costly making decisions either to delay or omit certain care and is heavily influenced by team perception, nurse judgment, ("Missed Nursing Care AHRQ," 2015).

Nursing care delivery is defined as the way task allocation, responsibility, and authority are organized to achieve patient care. Tiedeman and Lookinland (2004) suggested that systems of nursing care delivery are a reflection of social values, management ideology, and economic considerations. (Tiedeman&Lookinland, 2004) According to Fewer (2006), the quality of nursing care delivery systems affects continuity of care, the relationship between nurse and patient, morale, nurse job satisfaction and educational preparation.(Fewer, 2006) Nurses are essential human resources to provide medical services with professional knowledge and skills in the healthcare setting. However, the registered nurse turnover rate has increased in recent years resulting

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

Quality is one of the most essential elements of healthcare. As stated by the Agency of Health Research and Quality, “Everyday, millions of Americans receive high-quality health care that helps to maintain or restore their health and ability to function” (Agency of Health Research and Quality, 2014). Improvements have become vital to the success of health care organizations and in the Healthcare Quality Book, it is explained that quality in the U.S. healthcare system is not at the standard that it should be (Ransom, Joshi, Nash & Ransom, 2008). Although this has been a reoccurring issue, attempts to fix the insufficiency have been less successful than expected.

In the medical fraternity, nurses make up the largest healthcare profession. The care of patients depends on the well-being of the nurses, and issues affecting them may affect patients, directly or indirectly. As a profession, nursing, can be both an extremely rewarding and challenging activity. A number of problems exist, and most are becoming worse because of lack of lack of mechanisms to address these issues. The three greatest issues affecting nursing today include improving health education, lack of respect for nurses and cost cutting. Although these problems are not clinical, they influence the efficiency of the performance of nurses in their delivery of services.