Jacqueline Fowler Byers

Demonstrating the Value of the Advanced Practice Nurse: An Evaluation Model

Advanced practice nurses are challenged to assess comprehensively the value of their role and the impact of their practice. Value is defined as quality divided by cost. The correlations among the structure, strategies of care (process), and their objectives (outcome) are key to the assessment of the quality of care and the impact of the advanced practice nurses role. Advanced practice nurses are challenged to provide high quality care for a competitive or decreased cost. For the profession of nursing, outcomes are the result of interventions based on the nurses clinical judgment and theoretical, practical, or scientific knowledge. An evaluation model is presented that comprehensively measures the impact of advanced practice nurses on patients and families, and an example is presented. Using the model will give credibility and validity to the APNs positive impact on the quality and financial outcomes of care for each patient and for entire patient populations.

The relationship between continuous quality improvement and research.

&NA; The adoption of new care processes can take years despite high‐quality research findings that support the change in clinical practice. Healthcare quality professionals, with their leadership and continuous quality improvement (CQI) skills, are critical champions in accelerating and supporting the change toward evidence‐based practice. Heightened attention to the relationship between CQI, research, and research utilization is vital. This article addresses CQI strategies and research activities that can help organizations advance quality of care and patient outcomes. By broadening their repertoire of CQI methods, healthcare quality professionals can provide more value to their organizations and expand the complex problems and projects that CQI teams can manage.

Holistic Acute Care Units: Partnerships to Meet the Needs of the Chronically I11 and Their Families

The traditional acute care health care environment does not meet the needs of chronically ill patients and their families. The classic paternalistic approach encourages dependence on the health care team. This report reviews several innovative types of patient care delivery models, including patient-focused care, family-centered care, cooperative care, and Program Planetree. The core concepts of these various models are described and compared. Related research is presented. A synthesis of these existing models to meet the needs of chronically ill medical patients holistically is proposed. The implementation of the holistic model with chronically ill patients and their families is depicted.

Managed care and patient safety: risks and opportunities.

Objective: Patient safety practices have primarily focused on providers, such as hospitals and ambulatory or long-term care. Based on the premise that most medical errors and patient safety problems arise from system issues, and that managed care constitutes the largest, most integrated system in health care, the authors examine the role of managed care in making patient care safer. Study design: Review of the literature and analysis of the role of managed care in patient safety. Results: Authors find that although much has been written regarding managed care and quality, there is little research on managed cares relationship to patient safety. Research shows that managed care is not significantly different from indemnity insurance in terms of quality of care. However, managed care contracting, reimbursement, and management practices result in health care utilization changes that could pose potential risks for patient safety. Although managed care may pose possible risks to patient safety, practices can be monitored and adjusted to maintain quality and safety. At the same time, managed care provides opportunities for promoting patient safety at an integrated system level. Managed care organizations are in a unique position to influence patient safety by using safety strategies in selective contracting, financial incentives for performance, quality improvement programs, consumer education, and management and integration of care delivery. Our literature review reveals that health plans are starting to implement some of these strategies, but the practice is not widespread. Conclusions: Authors conclude with a framework and recommendations for patient safety.

CORE Characteristics for Survival in Patient Care Redesign

As patient care delivery systems evolve and facility redesign occurs, innovative models of care delivery require clinicians to possess certain qualities for successful implementation of redesign efforts. Certain specific CORE abilities are key for all clinicians. They are: C: the ability to think critically, communicate, and collaborate with patients, families, and other health care team members. O: the need to be outcome-oriented, that is, striving to optimize patient and family outcomes along the continuum. R: realization of the value of research and the ability to use research resources to develop and evidence-based practice. E: the ability to keep abreast of a wide variety of clinical and other health care-related topics. Demonstration of these CORE abilities will increase a clinicians opportunity to achieve professional success into the 21st century.

CE Credit: How to Manage Diuretic Therapy

All diuretics are not created equal. How they act, where they act, and how they interact with other drugs can make a big difference. Here are the ins and outs of diuretic therapy--and the crucial assessments you need to make.