Quality of care within health organizations
Introduction
Patients
in health institutions not only need a comfortable environment, but they also
require safe and quality nursing care. Indeed, research has shown that improved
nursing quality has several health benefits to the patient. According to the
American nurses association (2014), quality nursing care is the provision of an
outstanding and efficient service to the patients. Safe and quality care can be accorded through
employing of qualified staff, proper motivation of nurses, staff knowledge
development, and also proper co-ordination and management of the nurses in the
institution (Hoeman, 2002). In addition, the use of process and outcome data
could be essential in the enhancement of safe and quality care in health
institutions.
The nursing
process can be defined as the interaction of the nurse and the relevant
patient. It encompasses the assessment, diagnosis, planning, implementation and
evaluation of the patient (Sole, 2012). The
assessment and careful monitoring of patients by their nurses is essential for acquisition
of process and outcome data. The process data recorded for analysis may be collected
by individual nurses, the health institutions, the government or other
stakeholders in the health industry (Hoeman, 2002). On the other hand, the
nursing outcomes can be defined as the relevant effects of the nursing
processes and interventions to the general health of the patient (Sole, 2012). It
involves evaluating the effectiveness of the nursing care in reference to
individual patients. When documented, Bethel
et.al (2010) explains that the outcome data could form the basis for future
safe and quality nursing practices.
This essay is
going to analyze how quality, efficiency and safety of patients in health
institutions can be improved by focusing on process and outcome data. To fully
elaborate on some ideas, the essay would consider an example of a patient
suffering from colon cancer. The patient,
in reference, is to be monitored and assessed before the treatment process
commences (Chemotherapy/ surgical operation).
The nursing care
process for patients with colon-cancer should ensure that the patient’s
physical health is in good condition before the surgery. This includes checking
the patient’s skin condition, blood pressure and pressure ulcer condition (Delaney,
et. al. 2004). In addition, the nurses should be able to carry out the
patient’s Waterlow and falls assessment so as to ascertain the magnitude of the
medical condition. According to data
WHO, about 35% of patients worldwide are faced with low quality nursing
practices (Bethel 2010). This has impacted negatively on the patients’ confidence
levels, safety and their recovery ability.
Moreover, the
nurses should be able analyze the mobility of the patient admitted in the
health institutions. According to the research on nursing process and outcome
(Delaney, 2004); about 7.5% of patients may develop pressure ulcers due to lack
of turning on a two-hour interval. Sole Lou Mary, PhD; further acclaimed that
the turning intervals are subject to a patients physiology, weight, skin
condition and type of medication (Sole, 2012). The nurses should also ensure
that the physical activities of the patient are keenly monitored throughout the
period of stay in the health institution. Finally, the nurses should ensure
that the progress notes are written and orderly kept for future reference. This
is essential for the delivery of safe and quality nursing care to the patients.
The need for safe and quality care
Quality nursing
care can be viewed as the provision of comfortable and up to standard nursing
care to the patients. It involves the use of qualified and dedicated nursing team
who extensively monitors and assesses the patient to ensure quick recovery.
Hoeman (2002) stated that safe nursing care involves the use of nursing methods
whose aim is to prevent the worsening of a medical condition.
Various medical-researches
have linked safe and quality nursing care to faster recovery of patients
(American Nurses association, 2014). Therefore, in regards to the patient with
colon cancer; a quick recovery would not only lead to minimal medical costs but
also result into reduced psychological stress (ANA, 2014). Also, safe and quality care would enable a
higher operational efficiency by the health institution hence preventing
complaints and law suits caused by patient negligence (Delaney, et. al. 2004).
Finally; safe and quality nursing care is beneficial to the economy of the
country by ensuring a stable labor force and productivity.
Risk management and incident report
The report by
institute of medicine (IOM) on building safer health; cited that 44000 deaths
are annually caused by medical errors in the United States (American Nurses
Association, 2014). This number is exponentially higher in the developing and
third world countries. Therefore, it is recommended for health institutions to
have an elaborate risk management method. First, in order for the nurses to
deliver quality care; the institution should ensure that ratio of nurses to
patient are as per the WHO requirements. This would minimize negligence
incidences and enhance safety in the institution. Risk management may include: assembling of
specialized personnel to handle certain cases, use of modern technology to
prevent and assess health risks; documenting of nursing incidents in the
incident reports and through the analysis and implementation of process and
outcome data (Delaney, et. al. 2004).
Uses of process and outcome data
The data from the
process and outcomes can be used for assessment of patients, diagnosis of
ailments, prevention of law suits, planning and also in medical research.
Assessment of patients
The outcome data
can be used by the health institutions to assess the progress of the patients. Ambler,
(2007) advocated for the comparison of data from the nursing processes with
their relative outcomes; hence enabling implementation of effective nursing
interventions for quality care. This assessment could be substantiated by the
use of scientific knowledge and general basic understanding of nursing
concepts. In this regard, the nurses would hence be able to ensure safe and
quality nursing care by retaining or improving on the current nursing
processes.
For example, in
the case of a patient suffering from colon cancer; the outcome data are
essential for monitoring the progress of the illness. Hence, the collection of
nursing process data such as number of checkups, checkup results, types of
meals given to the patient, types of medications, general body condition is
very important in the analysis of the patient’s progress (Yura, &
Walsh,1998). Also, the availability of the process and outcome data of the
colon-cancer patient would be instrumental in determining the type of favorable
treatment (surgery or chemotherapy). By using the most effective treatment
method; the patient’s safety and quality of care would be enhanced.
In addition, recording
of the assessment data would enable the nurses to emphasize on quality through
enhancing safe medical practices. Through constant assessment, Nursing Journal
(2014) explains that the nurses would be able to monitor certain side effects
such as allergic reactions, skin dryness, pressure ulcers (PU) or water
retention as a result of the medication given. This would reduce incidences of
patient negligence and therefore improves the quality and safety of the
patients in the health institutions.
Moreover, Gulanick,
& Myers, (2011) acclaim that the process and outcome data can be used for
reference by other nurses (due to shift-change); thus facilitating a smooth
flow of information. In this regard, the nurse on shift would be able to focus
on the patient’s key areas of concern hence delivering safe and quality care to
the patient.
Diagnosis
of ailments
Process data can
form the basis for the diagnosis of certain ailments. After acquiring such
data, the medical practitioners can analyze the symptoms recorded in the nursing
process so as to come up with a precise medical solution (Moorhead, 2008). For
example, in the case of a patient suffering from colon cancer; analysis of the
data recorded in the nursing process would enable the doctors to estimate the
nature of the cancer. This would prompt an easy, safe and effective way of
dealing with the cancerous cells in the colon.
The data from the
nursing outcomes can also be used for future diagnosis of the patients. These
data may be electronically stored in the health institution’s database for
future reference. Thus, it simplifies the diagnosis process since the medical
practitioners would be able to evaluate the patient’s medical history,
previously used drugs, allergic reactions, drug effectiveness and suitable
nursing interventions (Waltz, Jenkins, & Strickland, 2003). This
facilitates quality and safe service delivery to the patients in the health
institution.
On the other hand,
Lunney (2009) illustrated that the acquired data could be applied as a basis
for diagnosis of ailments which have unclear and uncertain symptoms. In certain
cases, the patients may be exhibit symptoms which do not match the common
conventional diseases in a given location. In such situations, the medical
practitioners may match previously recorded nursing processes and outcomes of
other people and use search interventions on a temporary basis (Navenec, 2005).
This may help to prevent the worsening of an illness and hence save a patient’s
life. Therefore, the process and outcome data can be used in the diagnosis of
ailments thus ensuring a safe and quality nursing care to the patients.
Planning
The process data
can be used for planning by all stakeholders in the health institutions hence
it promotes safe and quality care for the patients. First, the data can be used
by the management to financially plan on ways of improving service delivery
(Heath, & Sturdy, 2010). For example, data on the nursing process may reveal
some difficulties that the nurse may encounter during the assessment of the patient.
According to Sherwood (2012), these difficulties may arise from the use of poor
or outdated technologies by the health institution. In this regard, the
management would be able to allocate funds for the installation of new
technologies hence contributing to safe and quality nursing care.
In addition, the outcome
data can be used to plan for the usage of available drugs in the health
institution. Through analysis of the process data; details of the drugs
prescribed to the patients would be availed. According to LeFevre (2010), the
management can therefore use such information to assess the demand of a
specific drug and hence make early arrangements to purchase enough stock.
Moreover, for
terminally ill patients; the analysis of the process and outcome data would be
able to predict the approximate number of days that the patient can probably
live. This would enable them to make prior arrangements such as awarding
inheritance to family members, spending time with the family members. Also,
such terminally ill patients would be able to take measures so as to prolong
their lives.
On the other hand,
acquisition of patient progress information would enable the management to
determine the areas that require additional staffing of medical specialists
(Child, 2004). For example, in a health institution which reports a higher
incidence of patients who require surgical operations; the management (with
reference from the process and outcome data); would be able to employ
additional nursing specialists in the given area. Therefore, the process and
outcome data enables easy planning by the management hence boosting the safety
and quality of nursing care to the patients in the institution (Bethel, 2010).
Avoid
medical risks
The process and
outcome data can be used by the nurses to avoid risks and enhance patient
safety. Through documentation of the process data; the relevant nurses would be
able to fully understand the diseases suffered by the patients (Benner, Malloch,
& Sheets, 2010). For example, before surgery of a colon cancer patient, the
nurses should be able to ensure that: the patient is in good physical
condition, the emergency procedures are in place and the types of foods given
to the patient are carefully monitored so as to facilitate smooth surgery. In
this regard, the process data would be essential in providing the medical
information of the patient and hence contribute to the safety and quality of
the nursing care.
The outcomes data
forms an important set of information in the application of nursing interventions.
Using the outcomes data, Heath & Sturdy, (2010) reveal that the nurse would
be able to understand the effectiveness of the previous nursing care given to
the patient. Through understanding of these detailed nursing process and
outcomes; the nurses would be able to avoid previous mistakes which may be
fatal (Potter, 2011). For example, after the first surgery; a patient may show
deteriorating health due to the side effects of a given type of medication.
Therefore, the outcomes data can be used by the nurses to avoid repetition of
mistakes hence facilitating safe and quality nursing care.
Moreover, the
process and outcome data promotes safety of patients through documenting the
progress of the patient. In the case of the colon-cancer patient, the safety of
the patient would be enhanced as a result of monitoring and recording the
process and outcome data. Using this data, the nurses would be able to predict
the type of foods that the patient can consume, the amount of physical activity
that the patient can get involved in, the progress of the ailment (Bethel,
2010). Therefore, the process and outcome data can be used to reduce medical
risks for the patients hence promoting the patient safety and quality of
nursing care.
.
Medical
research
The process and
outcome data can be used by the government and other medical stakeholders for
research on certain ailments (ANA, 2014). This is because the process and
outcome data provides first hand information on experiences of the patients. In
regards to the colon cancer patient; this data may avail information such as;
the nature of pains that the patient experiences; the overall behavior of the
patient, skin assessment, side effects of the medications to the researchers
(Reverby, 1987). Hence, the analysis of various process data would enable the
nurses to come up with the most effective way of taking care of such patients.
The process and
outcome data would also bring an in depth understanding of the ailment. Jones, (2007)
stated that due to documentation of various processes and interventions; the
relevant medical practitioners would be able to research further on the
illness. This research may involve comparison of various data from different
patients hence assist in standardization of several nursing interventions (Stone,
& Walker, 2007). In essence this would result in a more safe and quality
nursing care to the patents.
Conclusion
In conclusion,
patients need safe and quality nursing care so as to facilitate their rate of
recovery from ailments. The delivery of safe and quality nursing care can not
only be enhanced through the use of qualified personal and technologies; but
can also be facilitated through the use of process and outcomes data. The data
recorded from the process and outcomes of the nursing care can be used for:
assessment of patients, diagnosis of ailments, prevention of law suits,
planning and also in medical research. In general, the analysis and
implementation of facts revealed by the process and outcomes data can be
essential in the delivery of safe and quality health care in health
institutions.
Reference list
American
nurses association (2014). The nursing process. Retrieved from http://www.nursingworld.org/EspeciallyForYou/What-is-Nursing/Tools-You-Need/Thenursingprocess.html
Ambler,
P,. (2007). Nursing: PA: Lippincott Williams
& Wilkins.
Bethel,
S,. et. al. (2010). Manual of critical care nursing: nursing interventions and
collaborative management. Maryland: Mosby publishers
Delaney, C. et. al (2004). Nursing process outcome linkage research: issues, current status, and health policy implications. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/14734941
Hoeman,
P, S,. (2002). Rehabilitation nursing: process, applications & outcomes.
Maryland: Mosby publishers
Jones,
R. A. (2007). Nursing leadership and
management theories, processes, and practice. Philadelphia, PA: F.A.
Davis Co.
Nursing
theory, (2014). Nursing theories and philosophy of nursing. Retrieved from http://nursing-theory.org/articles/nursing-theories-and-a-philosophy-of-nursing.php
National
Commission on Nursing. (1982)Nursing in
transition: models for successful organizational change.. Chicago, Ill.:
Sole,
L,. M. (2012). Introduction to critical nursing. New York: Saunders publishers.
Print
Stone,
P., & Walker, P. H. (2007). Focus
on patient safety. New York: Springer.
No comments:
Post a Comment