The Theory Of Goal Attainment With Patients

patient and family satisfaction could go a long way to advance the quality of patient care throughout the hospital.

This paper will describe current quality outcome measures and the significance for improving medical care. Organizational accountability and transparency has improved with the emergence of Hospital Inpatient Quality Reporting (IQR) programs and Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPs). This article will review the role of the nurse manager in creating a culture for quality care as well as the nurse for meeting organizational and patient expectations. Organizations like The Joint Commission (JC), Agency for Healthcare Research and Quality (AHRQ), Centers for Medicare and Medicaid Services (CMS), and The American Nurses Association (ANA) have been critical in establishing standards for quality. This paper will also report on the most recent hospital statistics and steps taken to improve HCAHP scores and reduce readmission rates at the University of Tennessee Medical Center in Knoxville (UTMCK). Statistics at UTMCK will also be compared to the Tennessee and National averages found on the Medicare website Hospital Compare. The aim of this paper is to explore if healthcare system initiatives are improving quality and enhancing patient outcomes.

| Customer Satisfaction * Complete the customer satisfaction every quarter; addressing over 50% of all negative statements * Build a strong family base * Set up a nurse hot line * Reduce patient utilize the emergency departments

Imogene King was born in 1921in Iowa. Growing up, she dreamed of being a teacher but began nursing school to escape her small town life. She graduated with a diploma in nursing in 1945, then three years later earned a Bachelor of Science in Nursing Education and worked as medical-surgical instructor and an assistant director at St. John’s School of Nursing until 1958, fulfilling her lifelong dream of being a teacher wither nursing career. She went on to earn a Master of Science in Nursing in 1957 and a doctorate in education in 1961 (Imogene King, 2011). King then became an associate professor at Loyola University in Chicago and formed a master’s degree program that was based on her nursing concepts, which later became the framework for her theory.

Effective goal setting involves collaboration between the patient and RD. I would involve to the patient and their family in establishing goals and work together to setting goals because patients are more committed to changes that they select. I would listen carefully to Martin and his family about fillings, attitudes, economic status, values and beliefs. I could bring up things that I think are important. I would discuss with the patient the things that need to be modified and which do not need to be changed according to the nutrition assessment. I would ask which goal he wants to address first and assesses the importance of each goals. I would work with the client on possible solutions to problems. For example foods and minerals that should be limited, or cooking techniques, that should be changed. I would ask question to the patient such as: What would be the easiest? The hardest? How does he feel about making change? What are the pros and cons of making change? Goals selected should be specific, measurable, attainable, realistic, and time specific, such as “I will use low sodium seasoning instead table salt in my meals starting today”. I would provide positive feedback no mater how small the change is.

Health care organizations should work on putting more emphasis on patient experience and satisfaction, such as giving evaluations when giving care. When it comes to patient satisfication the healthcare system should put their sole focus on making sure patient were well taken care of during their visit. Whether if the patient was satisfied or not with their experience. Patient experience/satisfaction in a hospital should always be a number one priority and getting the person back at 100%. Hospitals are always looking for ways to improve several different things such as technology, health in populations, reducing cost, maintaince, etc. But they fail to focus on the quality care, Avoidable harm is a worthy goal that all health care system should benefit

The gaps that show areas of improvement are of the nurse’s perceived service and the patient’s perceived experience based on the patient’s expectations (Dabney and Tzang 2013). A patient’s expectations are modeled by past experiences, culture, personal needs, and word of mouth from other patient experiences. If a provider does not implement a patient-centered approach to patient care the patient’s needs cannot be met due to the gap in patient expectations and perceived service (Dabney and Tzang 2013).

Patients want and expect to receive high quality care. Nurses want to provide the best care possible to their patients and like everybody else; want a pleasing job environment. Hospitals, on the other hand, are expected to provide a safe environment to patients, have enough nursing staff and remain profitable (Keller, Dulle, Kwiecinski, Altimier & Owens, 2013). The ultimate goal is to improve quality of care and patient safety across the United States; therefore, all the different interests of these major stakeholders should be taken into

Throughout the United States, patient satisfaction has become increasingly significant in the quality of healthcare that is delivered to patients (Bleich, Özaltin, & Murray, 2009). The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey is one national survey that has become more widely used in hospitals that measures patients’ perspectives of hospital care today (CMS, 2015). There are two

Patient satisfaction is an important phenomenon that affects hospital ratings and reimbursements. Hospitals across nation are seeking measures to improve patient satisfaction, decrease patient falls and call light usage. A medical surgical clinical nurse specialist (CNS) at a northeast hospital collected data on the rate of patient falls, patient satisfaction for a period of 15 months and usage of call light for 4 weeks, which showed that this is a crucial problem that the hospital is facing and there is a lot of opportunity for improvement. The CNS assembled a team to identify measures to improve the current situation and decided to replicate the study on rounding conducted by Meade and colleagues (2006).

Barry Hill (2017) performed studies related to the quality of care that patients receive and what factors are associated with those perceptions. One area that was noted to be of importance and directly related to quality of care provided to patients is staff dissatisfaction and burnout. This study also found that longer shifts contributed to increased amounts of emotional exhaustion leading to decreased quality of care for patients. Addressing staffing needs early and intervening can decrease the amount of nurse burnout and dissatisfaction that is often seen. This study has shown that hiring additional competent nurses reduces medication errors, falls, infections, wounds, and decreases hospital litigation costs, while improving staff morale, patient experience and care, and cost-effectiveness for the hospital.

Hospitals nationwide are experiencing nurse shortage and increased workloads because of shorter hospital stays, fewer support resources and higher acuity in patients (Vahey, D. C., Aiken, L. H., Sloane, D. M., Clarke, S. P., & Vargas, D., 2004). Higher nurse workloads are directly associated with job burnout and job dissatisfaction which in turn causes more voluntary nurse turnover and relates to the increased nursing shortage. According to the Missouri Hospital Association the turnover rate of nurses has increased by fourteen percent in the last five years (Browning M., 2012). Nursing shortage is a real threat to the patient population. According to the Quality Health Outcomes Model by the American Academy of Nursing by Donabedian, effects of the healthcare interventions are characterized by the environment the staff works in (Vahey et al., 2004). Donabedian describes that quality metrics can be divided into three broad categories, structural, process, and clinical.

Imogene King was the Midwestern, twentieth century nursing theorist that developed the conceptual system and theory of goal attainment and transactional process. Although not without controversy, her theory has been the spring board for some middle range nursing theories and nursing education programs. This theory is particularly intriguing to individuals who are goal driven and will be explored in detail in the following paragraphs.

Belizario, S. (2011, August). Inspiring change. Boosting patient satisfaction scores-and nurses’ morale. Nursing 2011, 41(8), 18-21. Retrieved from: http://dx.doi.org/doi:http://dx.doi.org.proxy.library.ohiou.edu/10.1097/01.NURSE.0000399591.81228.3e.

It takes a combination of theories to make healthcare organizations function at a quality standard. Providing the patients with the best care possible is always the goal for any healthcare organization. It takes, not only the nurses, but all the staff of the organization to achieve this goal. Non-nursing theories exist to help guide all staff and provide an optimal work environment to allow quality care to be given to the patient. In this paper, some non-nursing theories will be examined and the importance of each one will be ranked according to this nurse.