Unformatted text preview: Nursing in the New Millennium
Phyllis M. Connolly PhD, APRN, BC, CS Nursing's responsibility is awesome--in patient care and also in creating a new society (Nyberg, 1998, p. 209) 3 Assumptions Life at warp speed New type of change, age of unreason Constant change, permanent white water Changing Work Environment Technology Demographics Managed Care Purchaser's Influence Health Insurance Industry Changing Health Systems Report Card: Managed Care Access Quality/Appropriateness Promotion/Prevention Outcomes General health improved Quality of life improved Treatment reduces psychological stress More productive & independent ANA Initiatives Improve Quality of Health Care 1994 Nursing's Safety and Quality Inititive 1996 Nursing-Sensitive Quality Indicators for Acute Care Settings 1997 National Data Base of Nursing Indicators (NDQI) CalNOC largest ongoing nursing quality measurement data set in nation IOM (2001)Crossing The Quality Chasm: Changes Needed Safe Effective Patient-centered Timely Efficient equitable IOM Rules for Redesign (2001) Care is based on continuous healing relationships Care is customized according to patient needs & values The patient is the source of control Knowledge is shared & information flows freely Decision making is evidence-based IOM (2003) Keeping Patients Safe: Transforming the Work Environment of Nurses Address management practices Workforce capability Work Design Organizational safety culture Impact of Nursing Studies Patient Outcomes hrs Needleman et al.(2002) 1997 data
care/day RNs medical pts. LOS, rates of UTI, UGI bleeding, pneumonia, shock or cardiac arrest & "failure to rescue" hrs. care/day RNs surgical pts. UTI, "failure to rescue" Aiken et al.(2003) 10% 5% risk of patient death & "failure to rescue" in proportion of BSN Strategies & Skills For Future Ability to understand systems Critical thinking, analysis and problem solving Reframing Personal growth & mastery, ability to tolerate ambiguity & take risks Emotional intelligence; selfrestraint (impulse control) & compassion Strategies & Skills For Future Cont. "can do" spirit Business leadership & intelligence Ability to manage change Group management skills, negotiating & conflict resolution Stewardship Collaborative leadership skills AACN: Role New Clinical Nurse Leader (Summary draft 2003) Clinician: Leadership in care of sick across all environments Outcomes manager Client Advocate Educator AACN Clinical Nurse Leader Role Cont. Information manager Systems analyst/Risk Anticipator Team Manager Member of Profession "To be active participants in shaping the health care system, nurses must learn new skills" Alderman (2001, p. 50) ...
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- IOM, Clinical Nurse Leader, Nursing Studies Patient Outcomes