Week 4: Nurse/Patient Empowerment in Practice

Introduction

As a registered nurse, you have the power to influence change in patient outcomes. An important aspect of influencing change is identifying areas that need improvement. This is done primarily through measurement of data. There are several different measures to gather data within organizations as well as on a national scale. Some of these measurements include core measures, standards, best practices, evidence-based practices, and the National Database of Nursing Quality Indicators (NDNQI). These support mechanisms have also been discussed as a means for helping nurses to deliver quality care and improve patient safety. Each measurement essentially focuses on providing care that is safe, effective, patient-centered, timely, efficient, and equitable.

Although there are several different measurements, NDNQI data is used in the process of attaining Magnet Recognition. Magnet Recognition is the highest honor a health care organization can receive for nursing excellence and high-quality patient care. The nurse-specific measures presented in the NDNQI help inform nursing staffs and their organizations of areas where nursing practices can be improved and where nursing practice efforts are producing positive clinical outcomes. Nurses must be directly involved in developing and implementing action plans based on the data presented by the NDNQI.

This week, you will explore the importance of nurse empowerment in effecting change and how action plans are created based on the results of the NDNQI as presented on a dashboard. You will also consider how nurses advocate for patients’ rights, even when that means supporting a patient whose personal choices may have negative health outcomes.

Learning Objectives

Students will:

• Evaluate strategies to empower both the nurse and the patient to improve quality of care
• Analyze the use of National Database of Nursing Quality Indictors for nurse empowerment in practice
• Analyze nurse empowerment in relation to use of quality improvement data for practice
• Analyze practice experiences for patient or nurse empowerment
• Analyze quality improvement dashboards for nursing plans

Note: The Assignment related to these Learning Objectives is introduced this week and submitted in Week 5.

Photo Credit: [Eva Katalin Kondoros]/[iStock / Getty Images Plus]/Getty Images

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Brown, D. S., Aydin, C. E., & Donaldson, N. (2008). Quartile dashboards: Translating large data sets into performance improvement priorities. Journal of Healthcare Quality, 30(6), 18–30. doi: 10.1111/j.1945-1474.2008.tb01166.x

Note: You will access this article from the Walden Library databases.

Typically, references should be within five to seven years of publication. However, this publication is considered a classical research reference pertaining to quality improvement and the use of data sets.

Cole, C., Wellard, S., & Mummery, J. (2014). Problematising autonomy and advocacy in nursing. Nursing Ethics, 21(5), 576–582. doi: 10.1177/0969733013511362

Note: You will access this article from the Walden Library databases.

Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38(1), 111–128. doi: 10.1177/019394591454281

Note: You will access this article from the Walden Library databases.

Giancarlo, C., Comparcini, D., & Simonetti, V. (2014). Workplace empowerment and nurses’ job satisfaction: A systematic literature review. Journal of Nursing Management, 22(7), 855–871. doi: 10.1111/jonm.12028

Note: You will access this article from the Walden Library databases.

Guglielmi, C. L., Stratton, M., Healy, G. B., Shapiro, D., Duffy, W. J., Dean, B. L., & Groah, L. K. (2014). The growing role of patient engagement: Relationship-based care in a changing health care system. AORN, 99(4), 517–528. doi: 10.1016/j.aorn.2014.02.007

Note: You will access this article from the Walden Library databases.

Rock, M. J., & Hoebeke, R. (2014). Informed consent: Whose duty to inform? MEDSURG Nursing, 23(3), 189–194. Retrieved from http://web.b.ebscohost.com.ezp.waldenulibrary.org/ehost/pdfviewer/pdfviewer?vid=9&sid=273f009b-d8f5-4cd8-8f01-0973c944bcf7%40sessionmgr104&hid=107

Note: You will access this article from the Walden Library databases.

American Hospital Association. (2003). The patient care partnership: Understanding expectations, rights and responsibilities. Retrieved from http://www.aha.org/content/00-10/pcp_english_030730.pdf

 

Read through this document created by the American Hospital Association. This document was created for inpatient hospital stays. However, it is applicable to other practice settings as well.

Montalvo, I. (2007). The national database of nursing quality indicators. The Online Journal of Issues in Nursing, 12(3). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Volume122007/No3Sept07/NursingQualityIndicators.html

Institute for Healthcare Improvement. (2016). Retrieved from http://www.ihi.org/Pages/default.aspx

The IHI offers numerous resources for improving nursing practice and patient care. Explore a variety of topics and examine some of the resources available.

National Quality Forum. (2016b). Retrieved from http://www.qualityforum.org/Home.aspx

 

The National Quality Forum (NQF) strives to improve patient safety and reduce medical errors. Explore the NQF’s endorsed standards and consider how they apply to nursing practice.

Document: Dashboard Directions (Word document)

Document: Sample Dashboard (Excel spreadsheet)

Required Media

Laureate Education. (Producer). (2009a). Topics in clinical nursing: Accountability and nursing practice [Video file]. Baltimore, MD: Author.

 

Note: The approximate length of this media piece is 15 minutes.

Discussion: Nurse/Patient Empowerment

As a nurse, you are the individual who has the ability to empower patients in the decision-making process pertaining to their health care. In addition, you are in a unique position to empower your nursing colleagues to improve job satisfaction and use performance indicator data from dashboards to effect social change.

In this week’s Learning Resources, you examined both the National Database of Nursing Quality Indicators (NDNQI) and the key role nurses play as advocates for patient rights. To assist nurses in being better prepared for this role, programs such as Patient Care Partnership provide guidance.

For this Discussion, you will analyze the use of quality improvement data and discuss how this data can help empower both patients and nurses. Review the Patient Care Partnership information presented in this week’s Learning Resources. In addition, reflect on the media presentation and the information shared by Ms. Manna on patients’ rights.

By Day 3

Respond to the following:

• What are the best strategies the nurse can employ to empower patients and support patients’ rights to improve quality of care? (Some considerations to keep in mind may include: providing information on effectiveness, risks, and benefits of alternative treatments.)
• In what ways can NDNQI data from dashboards or quality improvement data be used to support nurse empowerment in practice?
• How has your institution empowered the nursing staff through the use of quality improvement data?
• Provide an example of how you have personally empowered either a patient or a fellow nurse.

Support your response with references from the professional nursing literature.