Nursing Theories: The Base For Professional Nursing Practice (6th Edition) Downloads Torrent ((FREE))

Nursing Theories: The Base For Professional Nursing Practice (6th Edition) Downloads Torrent

..assumptionsabout the nursing contribution to care must be replaced withempirical evidenceof the nursing professions actual contributions to care.the lack of evidence to delineate the nurses contributions to care is problematic. in response to declining reimbursement and escalating quality and safety problems, stakeholders in the healthcare industry now challenge traditional assumptions across the delivery system and seek empirical evidence to guide system redesign. the goal of system redesign is encapsulated in the institute of medicine (iom) six aims for care: safe, effective, timely, equitable, patient-centered, and efficient ( iom, 2001 ). continued support is unlikely for care providers and processes that lack evidence of a meaningful contribution to these aims. therefore, assumptions about the nursing contribution to care must be replaced with empirical evidence of the nursing professions actual contributions to care. the purposes of this article are to examine the imperatives, ideals, history, and challenges related to effective outcome measurement in nursing and to identify recommendations for action.

due to the paucity of available clinical data at that time, the uhdds was based on administrative data collected primarily for billing purposes. nurse leaders were particularly concerned about the absence of information about nursing care in the uhdds, fearing that this would result in the inability to cost out nursing services and establish the profession of nursing on equal footing with medicine in terms of contributions to inpatient care. consequently, a core group of nurse leaders collaborated to develop an mds specific to nursing (nmds). an nmds with 16 elements related to nursing care (nursing diagnoses, nursing interventions, nursing outcomes, and nursing intensity), and patient demographics, and service elements (facility, medical record number, nurse identifier, encounter dates, payor source, discharge disposition, and resource consumption) was submitted to dhhs in 1987 but was not endorsed ( hobbs, 2011 ; klieb, sales, doran, mallette, & white, 2011 ).

the act of measurement makes phenomena visible and functions to elevate actual and/or potential quality problems in the consciousness of stakeholders.there are no intrinsic benefits in measuring nursing outcomes; rather, the benefits are contingent upon whether or not the act of measurement results in changes that lead to improved quality of care ( farquhar, kurtzman, & thomas, 2010 ). the act of measurement makes phenomena visible and functions to elevate actual and/or potential quality problems in the consciousness of stakeholders. regardless of intention, measure selection communicates importance and generates selective attention that ultimately drives selective improvement ( kurtzman & jennings, 2008 ). therefore, outcome measurement is best conceived as one interdependent component of the broader quality management enterprise with intentional selection of measures to drive improvement in outcomes relevant to nursing. the selection of quality measures sets is guided by conceptual models of quality, scientific standards, and the pragmatics of data collection.
the combined dependent, independent, and interdependent components of nursing practice add to this challenge ( doran, 2011 ). nurses not only diagnose and treat patient responses to health problems, they also carry out interventions prescribed by other disciplines. additionally, nurses are primarily responsible for the coordination of care activities within and across healthcare teams.
..health outcomes are rarely, if ever, the result of a singular process or provider.the complex nature of healthcare is well documented ( iom, 2004 ). patients typically receive care from teams of semiautonomous providers representing multiple disciplines and specialties working interdependently. therefore, health outcomes are rarely, if ever, the result of a singular process or provider. for example, achievement of high functional status in a patient diagnosed with a cerebrovascular accident requires diagnostic and therapeutic interventions from physicians, nurses, physical therapists, occupational therapists, and dieticians. each discipline is necessary for recovery of function, yet none is sufficient. thus, quantifying the unique contributions of each individual discipline is challenging. the combined dependent, independent, and interdependent components of nursing practice add to this challenge ( doran, 2011 ). nurses not only diagnose and treat patient responses to health problems, they also carry out interventions prescribed by other disciplines. additionally, nurses are primarily responsible for the coordination of care activities within and across healthcare teams. therefore, there are few elements of care that do not pass through the hands of nurses, and few outcomes that are not influenced in some way by nursing care.
5ec8ef588b

Deja un comentario Cancelar respuesta