What Will YOU Do to Improve Nursing Care?
In response to the Affordable Care Act (ACA), nursing leaders must discover innovative, cost-effective ways to deliver higher quality, safer nursing care to the aging American public.
Information technology and recent advances in medicine provide consumers with the ability to actively participate in their care, live longer lives with multiple chronic conditions, and make informed health care decisions according to publicized outcome data. The modern patient has a significant voice compared to the paternalistic health care system our grandparents once knew. In light of the cultural shift in today's health care system, there is growing interest in quality improvement at the point of care.
Hospitals provide nursing care to patients of increasing complexity and shorter lengths of stay. Much of health care is delivered in the outpatient setting in response to increasing costs. Therefore, inpatient nursing staff must provide high acuity care to complex patients, keep abreast of latest advances in technology, and educate patients and families on how to continue care upon discharge. The demands on nursing staff to provide high quality, safe, effective care for increasingly complex patients in hospitals that face decreased federal reimbursement requires attention. To avoid a perfect storm, hospital microsystems must be assessed for gaps in care that lead to poor patient outcomes.
Much focus in quality improvement centers on errors of commission, yet the extent of errors of omission remains unclear. Recent nursing research by Kalisch and colleagues focuses on elements of and reasons for omitted nursing care. Few studies clearly define the impact of missed nursing care on patient outcomes.
When you have a busy 12 hour shift and no nursing assistant, what will you leave out? Will you get everything done and finally chart once night shift arrives? Will you remember everything that happened? Do you feel guilty for not being able to accomplish all of your objectives that day? Are you exhausted? Did your patients get the best possible care?
We have all had days like these.... Our generation will be faced with improving nursing care with a tighter budget, more elderly patients than nurses to go around, and increasing acuity in hospitals. What can each of us do to help? We are all responsible to protect our patients and our great profession.