152 unit 2 | Working Within the Organization
your impact. (1) Write a letter to your represen-
tative (local, state, federal), ANA leadership or
state-level delegate, the editor of your local
newspaper, or to the editor of your favorite
nursing journal/magazine. (2) Attend a meeting
where your topic will be addressed in a public
forum or at a professional gathering. Meet the
people who are influential, and share your ideas
or learn from others. (3) Vote for candidates and
officers in your professional organizations and
within the government. (4) Visit your represen-
tative (local, state, federal) or ANA leadership
or state-level delegate to share your ideas.
(5) Volunteer. Ask what you can do to help.
(6) Testify before decision-making bodies.Conclusion
Pressure from quality organizations, consumers,
payers, and providers has caused the focus in the
health-care system to shift from patient care to
issues of cost and quality. Experts indicate that
quality promotes decreased costs and increased sat-
isfaction. This is an opportunity for nurses to
become more professional and empowered to
organize and manage patient care so that it is safe,
efficient, and of the highest quality. Begin early in
your career to participate actively in QI initiatives.
Regardless of the care model used or the indicators
selected, focus attention on the following in patient
care delivery (Hansten & Washburn, 2001, p. 24D):
1.Think critically.Use your creative, intuitive,
logical, and analytical processes continually in
working with patients.
2.Plan and report outcomes.Emphasizing results
is a necessary part of managing resources in
today’s cost-conscious environment. Focusing
on the outcomes moves the nurse out of the
mindset of focusing just on tasks.
3.Make introductory rounds.Begin each shift
with the health-care team members introduc-
ing themselves, describing their roles, and pro-
viding patients updates.- Plan in partnership with the patient.In conjunc-
tion with the introductory rounds, spend a few
minutes early in the shift with each patient,
discussing shift objectives and long-term goals.
This event becomes the center of the nursing
process for the shift and ensures that the patient
and nurse are working toward the same outcomes.
5.Communicate the plan.Avoid confusion
among members of the team by communicat-
ing the intended outcomes and the important
role that each member plays in the plan.
6.Evaluate progress.Schedule time during the
shift quickly to evaluate outcomes and the
progress of the plan and to make revisions as
necessary.
Study Questions1.How have historical, social, political, and economic trends affected your practice? Give specific
examples and their implications.
2.What problems have you identified during your clinical experiences that could be considered issues
to be addressed using CQI?
3.What SCMs have you seen implemented in practice? Which ones might you use to assist you in
planning care? If you have not seen any, ask the nurse manager what is used on the unit.
4.Review the section in this chapter on risk management. In what areas of risk do you feel you are
the most vulnerable? How will you work on correcting your risk?
5.Discuss the role of the nurse in CQI and risk management.
6. Based on patient safety goals for the current year, what will you do to ensure adherence to these goals?
7.What are evidence-based practices that promote quality and safety within the health-care system?
8.Describe how regulatory agencies and accrediting agencies affect patient care and outcomes at the
bedside.