Nursing: Organizational Systems and Quality Leadership
Organizational Systems and Quality Leadership
- Understanding of Nursing Quality Indicators
Nurses form the majority of the health care workforce. They play a critical role in the delivery of care services to patients. Just like other healthcare professionals, nurses are required to provide quality and safe services that can help to promote better patient outcomes (Stalpers et al., 2016; Gathara et al., 2020). This makes it necessary for the quality of their work to be monitored and reported on a regular basis (Gathara et al., 2020). This is achieved through the use of nursing quality indicators. The quality indicators refer to evidence-based approaches used to measure the level of clinical performance in relation to patient outcomes (Oner et al., 2020). They help to assess the effectiveness of nursing practice.
There are three main types of nursing quality indicators: process, structure, and outcome. Process indicators are used to measure the quality of the care activities of nurses (Lorini et al., 2018; American Sentinel College of Nursing and Health Sciences, 2021). Such indicators play an important role in examining the efficiency of nurses’ work. Examples include the strategies used to measure how nurses assess the health patients, and the interventions put in place. The level of job satisfaction is also part of the process indicators.
Structural indicators help to measure health care organizational aspects, and the availability of both material and human resources (Lorini et al., 2018; Gathara et al., 2020). In other words, these indicators are used to assess the attributes or characteristics of the settings within which healthcare services are provided. Examples of structural indicators include those that are used to determine the availability of nursing staff. It also involves indicators that are used to assess the knowledge, skills, and level of certification of the nursing staff.
Outcome indicators derive from patient outcomes. The indicators are normally used to measure change in healthcare status as a result of the care services provided by nurses (Lorini et al., 2018). Thus, they are used to measure both positive outcomes and adverse events. Outcome indicators tend to be nursing-sensitive due to their dependence on nursing care quality and quantity (American Sentinel College of Nursing and Health Sciences, 2021). Examples include patient falls, and pressure ulcers. It is important to note that some outcome indicators are not nursing-sensitive since they are associated with medical care elements (American Sentinel College of Nursing and Health Sciences, 2021). Examples of such indicators include kidney failure, and rate of readmission to hospitals.
- Advancing Quality Patient Care
Quality patient care generally refers to the type of care that helps promote desired health outcomes. That care has also to be consistent with the current nursing standards. There are many way through which nurses can help to advance the quality of care services they provide to patients. To begin with, nurses should ensure that they provide effective healthcare services to patients (Potter et al., 2020). For this to be achieved there is need to provide evidence-based practice that derives from scientific knowledge. For better outcomes to be achieved among patients, nurses are expected to provide safe care (Sherwood, 2017; Potter et al., 2020). In this case, safe care involves the provision of care services that are not harmful to patients. In order to achieve this, it is necessary to work on reducing medical errors and avoiding injuries that are preventable.
In their practice, nurses should ensure that they give timely healthcare services to their patients (Sherwood, 2017; OECD, 2018). Delays can be harmful. Some patients end up losing their lives as a result of delays in receiving care. Therefore, it is good to minimize such cases. Nurses have to work with efficiency for them to provide services of high quality (Potter et al., 2020). Efficiency in this case involves ensuring that care services are provided in a better way without wastage of healthcare resources. Therefore, nurses need to do everything possible to minimize the wastage. This can help to ensure that the health care system has enough resources that can enable it to function well in its role of providing healthcare services.
It is important for nurses to make sure that everybody has an equal opportunity in accessing healthcare services (OECD, 2018; Slusser et al., 2018). They should avoid situations whereby care services are provided based on patients’ gender, race, ethnicity, geographical background, and level of socio-economic status. Such a case is likely to lead to discrimination. Nurses also should ensure that they give services that are patient-centered (Slusser et al., 2018). This can help to ensure that the care needs of patients are met at the individual level. Patient-centered care is important in enhancing improved patient outcome. Moreover, nurses have got the responsibility of providing care that is consistent with the cultural preferences of patients (Slusser et al., 2018). To achieve this goal, they should ensure that the aspirations and needs of the community served are met. This is also necessary for better or positive patient outcomes.
- Resolution of Ethical Issues
Like other professionals in the health care system, nurses are often confronted by various ethical issues. Such issues need to be resolved well. Without doing so, there quality of the healthcare services they provide is likely to be compromised. One of the common ethical issues faced by nurses is how to deal with patient autonomy. Patient autonomy gives every patient the right to make decisions about his or her care (Chadwick & Gallagher, 2016; Scott, 2017). Therefore, a nurse should give a patient the opportunity to decide alone. It is unethical for a nurse to make such important decisions on behalf of the patient and his or her family. Another ethical issue is the one pertaining to informed consent. A nurse has the responsibility to inform patients and their respective family members about the treatment options available (Chadwick & Gallagher, 2016; Scott, 2017). Failure to do so amounts to unethical practice that is against professional standards of nursing.
Many nurses also face the ethical issue concerned with patient privacy. Since nurses and other healthcare professionals have access to the health records of patients under their care, they are not expected to release this information to other parties other than the patients alone. Since nurses have the best interest of their patients, they are obliged to protect both their privacy and medical information (Chadwick & Gallagher, 2016; Duquesne University, 2020). Nurses as well sometimes find it difficult to handle the ethical issue arising from incompetence among peers. This issue brings an ethical challenge since a nurse may be undecided on whether to report the incompetence of a colleague or not (Chadwick & Gallagher, 2016; Duquesne University, 2020). The best thing for the nurse to do is to talk to the concerned healthcare practitioner in order to determine if he or she is aware of that incompetence. It is also important to encourage such a colleague to undergo further training on the same.
References:
American Sentinel College of Nursing and Health Sciences. (2021). The 3 Types of Nursing Sensitive Indicators. Post University. Retrieved from https://www.americansentinel.edu/blog/2011/11/02/what-are-nursing-sensitive-quality-indicators-anyway/
Chadwick, R., & Gallagher, A. (2016). Ethics and Nursing Practice: A Case Study Approach. London: Macmillan Education UK.
Duquesne University. (2020). Ethical Issues in Nursing: Explanations & Solutions. Retrieved from https://onlinenursing.duq.edu/blog/ethical-issues-in-nursing/
Gathara, D., Zosi, M., Serem, G. et al. Developing metrics for nursing quality of care for low- and middle-income countries: a scoping review linked to stakeholder engagement. Hum Resour Health, 18 (34). https://doi.org/10.1186/s12960-020-00470-2
Lorini, C., Porchia, B.R., Pieralli, F. et al. Process, structural, and outcome quality indicators of nutritional care in nursing homes: a systematic review. BMC Health Serv Res, 18 (43). https://doi.org/10.1186/s12913-018-2828-0
Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2020). Nursing-sensitive indicators for nursing care: A systematic review (1997–2017). Nursing Open, 8 (3): 1005-1022. https://doi.org/10.1002/nop2.654
Organisation for Economic Co-operation and Development (OECD). (2018). Delivering Quality Health Services: A Global Imperative. Place of publication not identified: World Health Organization.
Potter, P. A., Perry, A. G., Stockert, P., & Hall, A. (2020). Fundamentals of Nursing. Amsterdam : Elsevier.
Scott, P. A. (2017). Key concepts and issues in nursing ethics. Cham, Switzerland : Springer.
Sherwood, G. (2017). Quality and safety in nursing: a competency approach to improving outcomes. John Wiley & Sons.
Slusser, M. M., Garcia, L. I., Re, C.-R., & McGinnis, P. Q. (2018). Foundations of Interprofessional Collaborative Practice in Health Care. St. Louis, Missouri : Elsevier Inc. : Mosby.
