Patient Outcomes Review Assignment
Patient Outcomes Review Assignment
Patient Outcomes Review Assignment
Week 5 discussion Patient Outcomes Review the story at the link below before posting to the discussion: Rau, J. (2015). Half of nation’s hospitals fail again to escape Medicare’s readmission penalties. Kaiser Health News. Retrieved from http://khn.org/news/half-of-nations-hospitals-fail-again-to-escape-medicares-readmission-penalties/ (Links to an external site.)Links to an external site. After you have finished, consider how you would respond to the following situation: Your local hospital has received notice from CMS (Centers for Medicare and Medicaid) regarding their readmission rates. As a BSN prepared nurse, you have been asked to serve as a consultant to suggest a new Quality (Performance) Improvement process for ONE of the areas of deficiency. Write some brief steps (suggestions) for improvement as you contemplate accepting the consulting opportunity. Share practice improvements utilized from your own clinical nursing experiences that have led to enhanced patient outcomes.
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AIMS AND OBJECTIVES:
Systematic review of the impact of missed nursing care on outcomes in adults, on acute hospital wards and in nursing homes.
BACKGROUND:
A considerable body of evidence supports the hypothesis that lower levels of registered nurses on duty increase the likelihood of patients dying on hospital wards, and the risk of many aspects of care being either delayed or left undone (missed). However, the direct consequence of missed care remains unclear.
DESIGN:
Systematic review.
METHODS:
We searched Medline (via Ovid), CINAHL (EBSCOhost) and Scopus for studies examining the association of missed nursing care and at least one patient outcome. Studies regarding registered nurses, healthcare assistants/support workers/nurses’ aides were retained. Only adult settings were included. Because of the nature of the review, qualitative studies, editorials, letters and commentaries were excluded. PRISMA guidelines were followed in reporting the review.
RESULTS:
Fourteen studies reported associations between missed care and patient outcomes. Some studies were secondary analyses of a large parent study. Most of the studies used nurse or patient reports to capture outcomes, with some using administrative data. Four studies found significantly decreased patient satisfaction associated with missed care. Seven studies reported associations with one or more patient outcomes including medication errors, urinary tract infections, patient falls, pressure ulcers, critical incidents, quality of care and patient readmissions. Three studies investigated whether there was a link between missed care and mortality and from these results no clear associations emerged.
CONCLUSIONS:
The review shows the modest evidence base of studies exploring missed care and patient outcomes generated mostly from nurse and patient self-reported data. To support the assertion that nurse staffing levels and skill mix are associated with adverse outcomes as a result of missed care, more research that uses objective staffing and outcome measures is required.
RELEVANCE TO CLINICAL PRACTICE:
Although nurses may exercise judgements in rationing care in the face of pressure, there are nonetheless adverse consequences for patients (ranging from poor experience of care to increased risk of infection, readmissions and complications due to critical incidents from undetected physiological deterioration). Hospitals should pay attention to nurses’ reports of missed care and consider routine monitoring as a quality and safety indicator.
© 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.
KEYWORDS:
care left undone; missed care; nurse staff; patient outcomes; safe staffing levels; unfinished care
