In the last two decades, a growing body of research has confirmed what most patients and medical professionals suspected anecdotally – nurse-provided care plays a critical role in affecting patient outcomes. As the largest direct provider of care, nurses provide service that results in shorter hospital stays, lower rates of infections and fewer pressure ulcers.
The National Institutes of Health and the National Library of Medicine’s journal, PMC, highlights the impact of nursing care and improved patient outcomes, from lowered rates of postoperative pneumonia, cardiac arrest and failure to rescue to prevention of pressure ulcers and falls. The latter requires professional nursing skills spanning nutrition, risk assessment, appropriate medication administration and supervision.
It is this level of nursing expertise that drives more positive patient outcomes and helps improve healthcare quality within organizations.
Improving Hospital Safety and Quality
While a nurse’s strongest contribution to hospital safety may be the difference they can make between a patient’s life and death, at a system level, nurses drive overall care coordination, provide medication and introduce new practices.
The online journal, Health Affairs, notes three essential areas nurses support that help improve safety and quality, while decreasing costs.
- Continuous patient monitoring allows nurses to intervene, attend to complications or mitigate risks
- Nurses coordinate care provided by others
- When nurses discharge patients, they educate patients and their support system regarding ongoing care
In-the-moment intervention as a result of continuous monitoring typically results in faster patient discharge, which results in reduced hospital costs, and often fewer patient readmissions.
How the Nursing Shortage Affects Patient Care
As the Baby Boomer generation ages and requires more care, the demand for qualified registered nurses continues to surge. New policies open the door to the health care system for massive numbers of new patients. Patients feel the effects of the nursing shortage when overworked nurses, who are more prone to fatigue and injury, make medical errors, or when dissatisfied nurses become demotivated to perform their daily duties.
According to a California-based study regarding the implications of nurse staff mandates, researchers found a 7% increase in patient mortality from the addition of only a single patient to a nurse’s case load; doubling that case load from four patients to eight increased patient mortality risk by 31%.
Best Practices for Improvement
One large healthcare delivery system turned to technological innovation to improve nursing care and eliminate superfluous tasks. With a massive private electronic health record (EHR) at its disposal, the organization set a strategic vision to incorporate health IT into routine practice, aimed at meeting three goals nurse executives established.
The strategic goals were to:
- Streamline the nurse’s route
- Equip nurses with information
- Reduce superfluous tasks
With input from leadership, the organization established technology priorities that supported nurses, including rapid sign-on to the EHR, dashboards with clinical knowledge, situational alerts and mobility. One immediate practice application aimed at reducing hospital associated pressure ulcers (HAPUs). The system offered nurses a best practice alert with real-time reminders (for example, when patients should to be turned to prevent ulcers), and equipped nurses with intervention information directly to their electronic file.
Every hospital in the region that implemented the alerts reported statistically significant improvements in both documenting and reducing the occurrence of HAPUs.
Massive health data sets also offer the ability for health organizations to leverage predictive analytics to predict patient outcomes and highlight risks. The organization incorporated these indicators into a dashboard alerting nurses to risk for fall, ulcers and infections, and offering reminders for vaccine and pain medication. This real-time data supports the bedside nurse, while providing immediate information to the charge nurse or nurse manager, who is responsible for patient care across the unit.
With evidence that nursing drives positive patient outcomes and a growing industry demand, healthcare organizations should continue partnering with nurses to adopt innovative approaches that support them in their critical work.