Dayna Week 2 Discussion

Week 2 Discussion: Nurses as Leaders in Health Care Reform
Dayna Canzone
Walden University
NURS-6050N-17, Policy & Advocacy
Research Priority
The research priority that I have chosen from the Institute of Medicine of the National
Academies (2011) is the identification of the personal and professional characteristics most
important to leaders of quality improvement initiatives in hospitals and other settings. The
ultimate goal of patient care should be to improve the health and wellbeing of our patients and to
improve their lives. Continued assessment and evaluation by the entire healthcare team is
required to maintain the most effective care for our patients.
The Institute of Medicine of the National Academies (2011) shared that private and
public funders, health care organizations, nursing education programs, and nursing associations
should expand opportunities for nurses to lead and manage collaborative efforts with physicians
and other members of the health care team to conduct research and to redesign and improve
practice environments and health systems. These entities should also provide opportunities for
nurses to diffuse successful practices. As members of the healthcare team, all parties must
collaborate to analyze the current practices that are in place and to develop strategies for
outcome improvement.
As a psychiatric nurse working in psychiatric and behavioral healthcare, I am personally
involved in the analysis and development of improvement initiatives in our facility. We often
come across several patients that are readmitted not long after their discharge from our facility.
Collaborative efforts must be established between our facility and outpatient providers, and we
must find a way to improve the outcome for each patient across the board. One of the challenges
that we frequently face is the continuously rapid patient turnaround and increased acuity that is
found within our field. No two patientcare scenarios are the same, so we must adapt ourselves to
the situation at hand in a controlled fashion. Our facility holds several team meetings each week
to analyze each patient care plan and also to review company policy and procedure. It is helpful
to know that my voice is heard by others on my team because we are able to work together to
make positive changes.
Continued research is necessary to establish which areas require improvement and to
compare those that have been used. We must work to improve the health of the individuals we
are caring for in order to improve the health of our population. Knickman and Kovner (2015)
shared that the goal of public health is to improve the health status of entire populations, not just
individuals. Nurses who advocate for continued education and active participation in decision-
making process can help make a difference in patient-care outcomes for the entire population.
Article Overview
Karami, Farokhzadian, and Foroughameri (2017) shared that professional competency is
a fundamental concept in nursing, which has a direct relationship with quality improvement of
patient care and public health. Nursing competency is a fundamental requirement for leaders of
quality improvement. Nurses must be competent in the care that is being provided, and continued
education and analysis is required for positive outcomes Commitment is required for continued
change to the nursing care that is being provided to patients.
One of the major difficulties facing behavioral health patients is the increased escalation
of behaviors that require emergent intervention. As a registered nurse that is often the first person
encountering these patients, improved care is a necessity for improved patient outcomes. An
increasing number of patients are presenting to the emergency room for care. In effort to increase
patient outcomes, hospital teams have come together to analyze the specific areas that require
improvements. The wait time that took place before patient assessment and initial medication
administration were two of the areas that required physician intervention prior to the
implementation of a standardized practice in emergency care. Although nurses are often the
primary assessment provider in patient care, emergency triage of patients with behavioral health
emergencies was not following this familiar procedure.
Winokur, Loucks, and Raup (2018) shared that use of a STP (standardized procedures) is
an effective method for the nurse to assess autonomously and immediately begin treatment of
patients who demonstrate signs of anxiety and aggression and thus reduce risk of violence.
Allowing nurses to assess and provide standardized medications for patients in crisis would
allow for quicker implementation of interventions during those patient care situations.
Implementing this standardized procedure would allow nurses to act independently which
promotes nursing responsibility and professionalism. Initiating standardized procedures allows
nurses to actively and autonomously care for their patients.
Continued Research. Continued nursing education, developing solutions to healthcare
delivery setbacks, and appropriate delegation and education to coworkers and staff are important
factors to improved patient care outcomes. Policy change begins with thorough assessment of
current measures that are in place and moves forward with active nursing advocacy and
involvement. “The committee emphasizes that the synergistic implementation of all of its
recommendations as a whole will be necessary to truly transform the nursing profession into one
that is capable of leading change to advance the nation’s health” (Institute of Medicine of the
National Academies, 2011). Nurses who are driven to be a part of this process will provide the
healthcare field with advancement and change that is needed. We must work diligently on
improving our direct patientcare as we advocate for health care reform and positive change in
our society.
References
Institute of Medicine of the National Academies (2011). The Future of Nursing: Leading
Change, Advancing Health. Copyright 2011 by the National Academies Press. Reprinted
by permission.
Karami, A., Farokhzadian, J., & Foroughameri, G. (2017). Nurses’ professional competency and
organizational commitment: Is it important for human resource management? PLoS One,
12(11) doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1371/journal.pone.0187863
Knickman, J. R., & Kovner, A. R. (Eds.). (2015). Health care delivery in the United States (10th
ed.). New York, NY: Springer Publishing.
Winokur, E. J., Loucks, J., & Raup, G. H. (2018). Use of a standardized procedure to improve
behavioral health patients’ care: A quality improvement initiative. Journal of Emergency
Nursing, 44(1), 26-32. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.jen.2017.
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Week 2 Discussion: Nurses as Leaders in Health Care Reform

NURS-6050N-17, Policy & Advocacy

required to maintain the most effective care for our patients.

make positive changes.

Continued research is necessary to establish which areas require improvement and to

Karami, Farokhzadian, and Foroughameri (2017) shared that professional competency is

change to the nursing care that is being provided to patients.

emergencies was not following this familiar procedure.

promotes nursing responsibility and professionalism. Initiating standardized procedures allows

nurses to actively and autonomously care for their patients.

Continued Research. Continued nursing education, developing solutions to healthcare

organizational commitment: Is it important for human resource management? PLoS One,

ed.). New York, NY: Springer Publishing.

behavioral health patients’ care: A quality improvement initiative. Journal of Emergency

Nursing, 44(1), 26-32. doi:http://dx.doi.org.ezp.waldenulibrary.org/10.1016/j.jen.2017.

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