Nursing 300: Foundations of Professional Nursing
By: Jayme Shulman, RN
0ctober 28, 2012
America’s health care system has become very complex with a rise in health costs, patients with complex medical issues, and Medicare cuts. Nurses must find a way to juggle the health care industry while maintaining positive patient outcomes. Patients will either have good or bad outcomes during or after their care based on the decisions of the nurse and the interdisciplinary team. The new goal in healthcare is for outcomes to be patient centered. This means that the patient is looked at holistically and also that the patient is equally involved in the care planning process as the nursing and medical staff. This topic allows for nurses and nursing students to apply to Goodwin College curriculum framework based on the “Wellness Model” and “QSEN”. The nurse must collaborate with the patient and other members of the medical team to help the patient achieve the highest level of wellness. If this happens, then the patient has achieved a positive outcome. Not all patients will have positive outcomes. The goal for nurses is always to help the patient achieve the highest level of health and wellness. “Healthcare aims to maintain and improve patients’ conditions with respect to disease, injury, functional status, and sense of well-being.” (Paget, et al., 2011). QSEN are competencies for quality and safety in nursing education. This model revolves around patient centered care, teamwork and collaboration, evidence based practice, quality improvement, safety, and continuing education. (Altmiller). Nurses must demonstrate knowledge, skills, and attitudes that promote not only quality, but safety in patient centered care. Patients need to be able to be a partner in decision making and have their values, needs, and preferences be respected. Quality patient outcomes are achieved by a strong team of professionals who are able to communicate effectively. Evidence based practice is used to deliver the most optimal level of care. Data collection is used to monitor the quality of patient outcomes and find ways to improve the healthcare system. Safety must always be considered to protect our patients and minimize risks. (Altmiller). The National Institute of Nursing Research (NINR) was established in 1986 to work with the National Institutes of Health (NIH) and collaborate to assist with optimal patient centered care. Its mission statement states, “The mission of NINR is to promote and improve the health of individuals, families, communities, and populations. NINR supports and conducts clinical and basic research and research training on health and illness across the lifespan. The research focus encompasses health promotion and disease prevention, quality of life, health disparities, and end-of-life. NINR seeks to extend nursing science by integrating the biological and behavioral sciences, employing new technologies to research questions, improving research methods, and developing scientists in the future.” (Blias & Hayes, 2011, p. 187). The NINR has done a lot of research on quality patient outcomes. For the past nine years, the National Institute of Health has developed a program in order to measure patient outcomes called the Patient-Reported Outcomes Measurement Information System (PROMIS) program. “One of the main objectives of PROMIS is to compile a core set of questions or measurements to assess the most common dimensions of patient-relevant outcomes for the widest possible range of chronic disorders and diseases.” (Johnson, 2012). These tools that are designed are not basic checklists, but are measurement instruments that use qualitative and quantitative methods to develop scoring algorithms. A short number of questions are put into a bank of computer adaptive tests. The goal is to focus on real world problems and developing a solution to them. “Patients and providers are asking that PROs...