NURSING

Critical Issues in Nursing

 Delivering excellent care:

o Build effective nursing and interdisciplinary teams to deliver individualized, patient
centered care.
o Plan, deliver, and evaluate care that is safe, effective, and evidence based.
o Provide training and logistic needs.
o Measure and improve nursing team performance.
 Communicating for comprehensive patient care:
o Ensure full transfer of knowledge between nurses, physicians, and other team members.
o Use team huddles for patient safety and quality.
o Use the electronic health record to integrate care from direct and indirect care
providers.
 Educating patients, families, and communities:
o Use the patient–HCO encounter to address preventive and continuing needs.
o Consider cultural and linguistic competence.
o Support community health initiatives.
 Sustaining the supply of nurses:
o Ensure healthy work environments.
o Promote nursing as a career choice in elementary, middle, and high school.
o Provide learning and advancement opportunities for nursing personnel.
o Reach out to groups previously underrepresented in nursing

Nursing and the Goals of Excellent Care

 Safe
o Eliminate biological, physical, human, and psychological risks in both the inpatient and
home environments
o Maintain safety of diagnosis and treatment
 Effective
o Monitor the care process and provide the early warning for any deviation from the plan
o Evaluate patient progress toward comprehensive recovery
 Patient-centered
o Identify each patient’s unique characteristics and adapt protocols to accommodate
them
 Timely
o Minimize the duration of the patient’s disability
 Efficient
o Minimize the total cost of care and disability
 Equitable
o Ensure that care is equally available without regard to ethnicity, culture, gender, or
sexual orientation
 o Ensure patient’s rights are respected including the right to refuse treatment

Types of Nurses

 Registered Nurses
 Nurse Anesthetist
 Nurse Practitioner
 Nurse Midwife
 Clinical Nurse Specialist
 Public Health Nurse
 Nurse Manager/Leader
 Clinical Nurse Leader
 Nurse Doctorate (Certification required if Doctor of Nursing Practice (DNP) is an advanced
practice role; PhD is research focused)

Nursing Practice Specialties in HCO’s

 Acute Hospital
o Operating Rooms
 Collaborate with surgical team
o Birthing Suite
 Pre and Post-Partum care; assist with delivery
o Intensive care and post-anesthesia care
 Demanding technically complex bedside care (surgical, cardiovascular, and
neonatal)
o Intermediate Care
 Less demanding bedside care, patient instruction, and emotional support
o Emergency Care
o Ambulatory (outpatient) Care
 Direct care, patient instruction, and emotional support
 Primary Care Office
o Screening, case management, patient instruction, and limited direct care
 Rehabilitation
o Direct care, patient instruction, and emotional support
 Long-Term Care Facility
o Bedside Care, emotional support
 Home Care
o Bedside care, emotional, and family support
 End-of-Life Care
o Hospice
o Palliative Care

Nursing Performance Measures

 Demand
 Costs
 o Nursing Hours per patient day, medical supplies
 Human Resources
o Skills mix, education, and certification
 Output/Productivity
o Discharges, cost/discharge
 Outcomes Quality
 Process Quality
 Patient Satisfaction
 Physician Satisfaction