Question

NSG4071 Assignment #2 The nursing leadership committee of a community based health center is concerned about recent indicators of lower than standard quali committee wants to have a high patient outcome and recognizes the need to address the following from inpatient and outpatient data. The care issues: The most recent quarter of patient satisfaction surveys, the nurse leader of the inpatient facility that satisfaction scores are below the mean for other inpatient facilities in the region (this information is provided by the contracted company who administers the survey) In particular, patients report low satisfaction with nurse-patient interaction. In the comments ction, two common themes are: 1) complaints about "hardly ever seeing a nurse": and 2) feeling unprepared to go home In reviewing the number and type of missed appointments for the past six months, the nurse leader of a community-based outpatient clinic notes that Hispanic patients are 3 times more likely than Caucasian patients to miss their scheduled appointments. The nurse leader confers with the head of the pharmacy that is part of the clinic and discovers that, likewise, Hispanic patients are the least likely of all racial/ethnic groups to get their medication refills Likewise, the most recent data from the annual human resources department indicate low job satisfaction among RNs throughout the health care center. Specifically, the majority of RNs report being overwhelmed by the amount of "paper work and performance of non nursing duties. There are also several comments from RNs related to dissatisfaction with the number of agency, "travel", and PRN nurses that are used. For example, one comment states, "Not a week goes by where I am not orienting someone new to the unit Issue/Problem: Changes need to be made to increase patient satisfaction with nursing care and increase RN job satisfaction. A disparity exists between Hispanic patients and Caucasian patients in terms of adherence to scheduled medical appointments and medication. Assignment: Choose the major elements/factors/things/processes that can be changed that can affect both patient satisfaction with nursing care, and RN job satisfaction. Design a Hispanics receiving care from the clinic. To consider: ess that increases adherence to medical appointments and medication among What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the requirements and implications regarding the Affordable Health Care Act? What would you change? Share the reasons that you chose these changes? How will changing these make a difference? How do you go about implementing these changes? How can these changes be sustained? What barriers might you encounter when making these changes? What reactions would you anticipate encountering these barriers? How would you overcome the barriers?: What additional information do you need to assist in making decisions (remember to create this information if needed)? What are the potential causes of the disparity? Identify the stakeholders in this community issue and the reasons you chose them. What is your program/process likely to address to decrease the disparity?

Answer 1

Patient satisfaction has been used as a tool for measuring whether the available health care supply meets patients’ health needs and expectations. This tool is widely used in the health care field around the globe. Patient satisfaction is a valuable indicator of health service quality and effectiveness, and it also has an impact on patient recovery. In recent decades, patients have become increasingly knowledgeable about health care. As a result, they have begun to require higher standards of medical effectiveness, health-staff services, expenditure, and so on. By using information gleaned from patient satisfaction studies, health care providers and regulatory institutions can better observe overall patient satisfaction, meet patient expectations, and discover deficits in medical service conditions, all of which would be beneficial for improving health care provision. Higher satisfaction ratings indicate fewer complaints and medical disputes, better patient recovery, and increased hospital assessment, so it is essential to conduct studies related to patient satisfaction. Because there is wide diversity in patient satisfaction among inpatients, outpatients, and emergency patients, this study focuses solely on inpatient satisfaction.

Patient satisfaction is the health care recipient’s reaction to aspects of his or her service experience. Patient satisfaction belongs to the service dimension as opposed to the technical dimension of quality of care. Most patients report few problems related to technical quality of care in hospitals and moreover do not feel qualified to judge technical quality and therefore assume technical competence. Patients do not seem to be affected by morbidity and mortality statistics but more by personal stories of care. Patient perception of quality is assessed through dimensions of what is personally valued, and often they do not distinguish between the provider of the service and the service received. Being treated with respect and dignity and involvement in treatment decisions are intangible issues of patient satisfaction that are paramount issues for patients.

Because nurses spend a lot of time with patients , they affect patient experiences of care. Research has shown that the nursing work environment is a determining factor. It seems that when patients have positive experiences of nursing care, nurses also experience a good and healthy work environment. A healthy work environment can be defined as a work setting in which nurses are able to both achieve the goals of the organisation and derive personal satisfaction from their work. A healthy work environment fosters a climate in which nurses are challenged to use their expertise, skills and clinical knowledge. Furthermore, nurses who work in such an environment are encouraged to provide patients with excellent nursing care. The researchers used grounded theory to identify eight ‘essentials of magnetism’ that define the nursing work environment and influence the quality of nursing care. From the perspective of nurses, the following eight ‘essentials’ are crucial in a work environment to the provision of high quality nursing care:

• Clinically competent nurses
• Adequate staffing
• Good nurse–physician relationships
• Autonomous nursing practice
• Nurse manager support
• Control over nursing practice
• Support for education
• A culture that values concern for patients

Healthcare service quality is associated with patient satisfaction, loyalty and healthcare organizations’ productivity and profitability. As a result, healthcare organizations throughout the world consider it as a strategic differentiator for sustaining competitive advantage. Therefore, it is very important to define measure and improve quality of healthcare services.

Quality healthcare is a subjective, complex and multi-dimensional concept. Quality healthcare is defined as “consistently delighting the patient by providing efficacious, effective and efficient healthcare services according to the latest clinical guidelines and standards, which meet the patient’s needs and satisfies providers”.

Healthcare organisations monitor patient experiences in order to evaluate and improve the quality of care. Because nurses spend a lot of time with patients, they have a major impact on patient experiences. To improve patient experiences of the quality of care, nurses need to know what factors within the nursing work environment are of influence. Patient experiences can be defined as a reflection of what actually happened during the care process and therefore provide information about the performance of healthcare workers; it refers to the process of care provision.

Effective nursing care relies on the gathering and use of nursing evidence. The pattern of empirical knowledge is founded in evidence-based research and objective experience, and has been identified as the most prevalent in nursing practice. Evidence based practice functions as the key standard for quality in nursing practice by enhancing patient satisfaction. Evidence-based quality improvement was redesigned to transform healthcare into an environment of care that is effective, safe, and efficient. Research is being used progressively as the basis for clinical decisions in many organizations. The stream of information through the increase of technology, has transformed the decision-making process for clinicians. Research authenticates, enhances and creates a scientific base for nursing practice and is facilitated and disseminated through the use of information technology and nursing informatics. The nurse's ultimate goal through the use of information technology is patient education, while providing high quality care and most importantly patient safety.

It has been observed that patient education has slowly become a major concern and that hospitals want to get involved in implementing better education for patients and their families. The importance of patient education is an example of critical study and evidence based practice by nurses that has shown that knowledge, on the part of patients and their families, can reduce re-admission rates, decrease healing time, improve mental discomfort, and produce better patient results. Today, patients are educated with the help of technology including modern televisions, I-pads and other sophisticated electronic devices where the patient can watch, learn and explore their illnesses and care. Partnership with team members and families is essential to optimal treatment. The application of individual nursing practice is based on an arrangement of the clinician and the patient. Traditional patient education relied on written material about disease processes, medication, medical management, and self-care instruction guidelines. Today, patients benefit from many forms of education and with all these forms of education nurses can provide patients with knowledge that enables them to understand the disease process and make important decisions about their health. Nursing interventions in proper patient education improves patient self-care, satisfaction, moral support, coping skills and mental stability. Addressing improvement in nursing workflow is essential to the improvement of patient stability and safety.

Healthcare outcomes including quality of life measures are the result of a multifaceted relationship between the patient, the nurse, the treatment and the information healthcare system. A strong foundation for addressing the challenges of electronic documentation is the informatics nurse's capability to understand and direct the balance of patient care with the technology systems and organizational structure that supports this balance. In order to guarantee a successful implementation of a computer system while managing patient care it is important to integrate nurses' perceptions, beliefs, and knowledge in the use of new technology and how nurses implement this technology into their daily nursing practice. Finding the right balance of information science in conjunction with nursing science is a continuing process that will rely on the forward thinking and perseverance of today's modern nurse and the support of nursing informatics specialists.