Evolving Practice of Nursing and Patient Care Delivery System
Evolving Practice of Nursing and Patient Care Delivery System
Evolving Practice of Nursing and Patient Care Delivery SystemThe American healthcare system has been undergoing reforms for a number of years now, especially in the nursing sector. The nursing sector has been under sweeping economic and political review by the United States government. The purpose of this outlook is to implement steadily market competition within the healthcare industry. It is anticipated that increased market competition will reduce the costs related to nursing in healthcare. As a result, nursing has been diversified in to different categories such as hospital nursing and home care nursing among others (Wood & Haber, 2014). These reforms have corresponded with the essential changes involving budgeting, financial, and reimbursement within the American healthcare sector.
Nonetheless, the transition from supply driven to a market system through the introduction of managed competition by the government in the form of performance-based finance systems is the most important change the healthcare sector has to deal with. From an international point of view, performance-based finance systems have shown their worth. With respect to the cure sector, Diagnosis Treatment Combinations (hereafter referred to as DTCs) are the tools to achieve performance-based and demand-driven services and products in nursing. DTCs are defined as the set of interventions and activities of medical specialists and hospitals that result from the initial consultation and diagnosis in the hospital. However, the objective of the new system is not to alter the previous social position of the various organizations, but to open up the nursing sector to in order to provide healthcare to all Americans. Traditionally not-for-profit hospitals are facing a profit motive to remain afloat and continue running their business. The development of a free market structure with respect to the cure sector has occasioned an increase in the risk profiles of organizations.
Competition between businesses has acted as a mechanism of increasing nursing value to patients across the healthcare industry (Kelly, 2013). Competition ensures that better services are products are provided to customers in a manner that satisfies their needs. The healthcare costs in the U.S. endure to be an important concern for consumers. Numerous and complex challenges exist in managing such costs, as well as the provision of a better healthcare system. The Affordable Care Act together with the prospects for increased innovation and consumer choice has increased the significance of the efforts. Competition in the healthcare industry involves one or a number of elements, including quality, price, superior services or products, and convenience. Nonetheless, competition may also be based upon innovation and technology. The nursing sector has not been left behind, and it is even one of the sectors that will continue play a very important role in healthcare of this country even as it is undergoing restructuring. Under the new structure, nurses will have many roles in all sectors including hospital settings, communities, and clinics and even at medical homes (Finkelman& Kenner, 2010). Nurses will be charged with the administration of the medication while a different doctor may monitor the progress of the patient and make decisions regarding the ongoing medication regimen.
These are all very important duties, hence when the nursing personnel is insufficient, a room for many errors is created. For instance, every step in the process of prescription, administration, and monitoring has the potential for error, which can occur in several ways. Errors in prescription may include inadequate knowledge on the drug contraindications, indications, and drug interaction. Prescription errors may also result from failure to consider individual patient aspects that would change prescribing such as pregnancy, allergies, co-morbidities such as renal stultification, and the patient’s use of other medications. With respect to administration, errors may include administering drugs to the wrong patient, using the wrong method or drug, in incorrect doses, and at the incorrect time (Finkelman& Kenner, 2010). Other errors in drug administration include complete failure to give a prescribed drug and errors in documentation. For instance, medication may be administered, but not recorded as having being given. In this case, another staff member may inadvertently administer it for the second time.
Such errors result from poor communication, lapses and slips, lack of vigilance, overworking of the available yet insufficient nursing personnel, medication packaging designs, lack of procedural checks, calculation errors, and suboptimal workplace design. On the other hand, errors in monitoring include poor monitoring of side effects, failure to complete the prescribed course of medication, and the failure to cease medication use upon the completion of the prescribed course. According to my colleagues that I interviewed, these errors are some of the effects of nursing shortage in this country as well as in many other parts of the words. These errors will also result into negative effects towards the patients. They may result in disease developing complications if addressed poorly, or even result to deaths.
What the American society needs to understand the significance of sufficient nursing professionals for better health care delivery and of the best quality. The efficient and practical management of nurses in an organization plays a crucial role in a hospital environment and constitutes a sizeable portion of the operational expenses. The nurse personnel practices and policies very much affect the staff working conditions and the consequent quality of healthcare provided. The policies that govern the staffing level impacts directly on the result of the scheduling level and contrariwise. An isolated mindset commonly leads to inferior decisions that lead to mediocre outcomes of the care (Wood & Haber, 2014).Selecting a staffing model and practice that matches the needs and goals of an organization is thus critical to the success of the management. Similarly, obtaining adequate resources to help with the staffing and scheduling is very important. The performance of a nursing staffing plan and on-boarding of new graduate nurses at once is a possible solution towards reducing the expenses associated with the expensive travel and contract type nursing.
As a matter of fact, there have been programs that have already been implemented such as the Nurses Residency Programs, although their effectiveness in the ICUs during night shifts still remains to be evaluated. The nurse personnel practices and policies very much affect the staff working conditions and the consequent quality of healthcare provided, and the Nursing Residency Programs (NRP) are supposed to ensure that night shift nursing shortage in hospital settings such as the ICUs is addressed. The performance of a nursing staffing plan and on-boarding through the Nursing Residence Programs and on-boarding of new graduate nurses at once is a possible solution towards reducing the expenses associated with the expensive travel and contract type nursing (Bleich, 2012). At the same time, this also presents a real challenge to the existing nursing squad regarding the induction and education of a huge number of graduate nurses.
However, determining the effectiveness of the Nursing Residency Program remains to be a challenge. For instance, one of the primary goals of this program was to minimize graduate nurse level turnover experienced within the first year of employment. It was also supposed increase residents’ comfort with clinical skills so that that their critical thinking and communication capabilities could be enhanced with the health care team (Bleich, 2012). However, even with all these objectives, these programs need to be evaluated on a regular basis, otherwise, their effectiveness cannot be established. This is more so because most of the nurses in these programs lack sensitive skills needed to succeed in hospital environments. This means that these program can produce good bedside nurses and combat new graduate nurse turnover, but the effectiveness of these programs will primarily rely in how the needs of the populations in the ICU are met. Therefore, one can argue that Nursing Residential Programs are not a quick remedy for combating nursing turnover or skill building, although they offer new ways of addressing the needs of new graduate nurses, although they are a positive.
When I interviewed three of my colleagues, they felt that the evolvement if this practice of will be of significant help to many patients. They also felt that quality healthcare service will be accessed efficiently with the new implementation in the practice. However, they also felt that in as much as this profession is evolving, there is still so much to be done to address issues like nurses shortage that has rocked this country for a very long time. This is also not forgetting that the emergency of home care nursing services and nurses residency programs, more job vacancies for nurses have been created, but meeting the demands for nurses in the health care industry remains a significant challenge to health care delivery (Wood & Haber, 2014). Statistics show that effects of nurses’ shortage have been felt all over the United States of America. Research done in this field also show that even the average age of working nurses has shot up to 45 years in the last 10 years from 32 years.
This research also shows that currently there is a shortage of more than 126,000 nurses in the US (Wood & Haber, 2014). These positions remain unfilled to the dwindling number of college students opting to pursue nursing as a profession in college. Additionally, this research projects a shortage of more than 400,000 nurses in the United States by the year 2020 if these positions are not filled, and if college students continue to avoid pursuing nursing as their major in college. Additionally, research shows that factors such as aging nursing workforce, diminishing pipeline of nursing students in college and immense growth in population leading to high demand of health care as the causes for nurses shortages (Wood & Haber, 2014).
Our federal government has however, been trying to step up and curb this shortage through offering full and partial scholarships to all students wishing to pursue nursing as a career in college. However, this is not necessarily guaranteed by every school in the United States where they offer nursing courses. The most considered nursing students for this scholarship are the ones who may be intending to work in high need communities. These scholarships are awarded by the federal government of the United States through the infamous Nursing Scholarship Program. This program falls under the United States Department of Health and Human Services, and it seeks to awarding student looking to become nurses with monthly stipends (Kelly, 2013). This program also seeks to pay the cost of tuition for nurses in America, as well as exchange service offered in a nursing facility for two years of each student especially in cases where there may be nurses’ shortages.
It is significantly evident that the career of nursing needs to be taken very seriously in the United States of America, especially with its recent evolvement. This is especially looking at the fact that serious career-specific scholarships offered by the federal government are not offered for any other career beside nursing and education. In nursing, these scholarships are taken even more seriously bearing in mind that the federal government also takes care of monthly stipends as well as paying the would-be nurses for a period of two year, before they even graduate. In fact, the mission of this Nursing Scholarship Program is to recognize and acknowledge students with potential in the field of nursing, and they are committed to assist needy American when they graduate (Bleich, 2012). Therefore, this Nursing Program Scholarship seeks to offer these committed would-be-nurses with financial support both at the graduate and undergraduate level so that they can get the necessary skills and go out to save American lives. With this program under the Department of Health and Human Services in the United States, the government seeks to make as many nurses available to the American people so there could be enough personnel to assist them in cases of need. These scholarships are also intended to recognize the many students who show the initiative and the skills of becoming nurses who would always prioritize on saving lives. As if that was not enough, these scholarships are also intended to foster inclusion for every American who would wish to pursue this profession without having money constrains as a hurdle to their success. In a nutshell, it is the high time that Americans embraced the evolvement of the nursing practice and the patient care delivery system, if the quality and efficiency of health care were to improve in this country.
References
Bleich, M. (2012). In praise of nursing residency programs. American nurse today, 7(5), 47-49.
Finkelman, A. W., & Kenner, C. (2010). Professional nursing concepts: Competencies for quality leadership. Sudbury, Mass: Jones and Bartlett Publishers.
Kelly, P. (2013). Essentials of nursing leadership & management. S.l.: Delmar.
Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice. Elsevier Health Sciences.
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