Program outcome number seven focuses on delivering patient centered care utilizing the best available

Program outcome number seven focuses on delivering patient centered care utilizing the best available scientific evidence. The Institute of Medicine has defined patient-centered care as "care that is respectful of and responsive to individual patient preferences, needs, and values." (Barry & Edgman-Levitan, 2012).This definition highlights the importance of clinicians and patients working together to produce the best outcomes possible. One of the biggest lessons that I will take away from this class and clinical rotation is the importance of communication. Communication begins with listening. The OLDCART question format promotes clear communication that is tailored to the patient’s complaint and needs. For some decisions, there is one clearly superior path, and patient preferences play little or no role — a fractured hip needs repair, acute appendicitis necessitates surgery, and bacterial meningitis requires antibiotics; however, for most medical decisions there is usually more than one reasonable path (including the option of doing nothing, when appropriate), and different paths entail different combinations of possible therapeutic effects and side effects (Barry & Edgman-Levitan, 2012). A part of patient centered care is shared decision making in which both the patient and clinician share information; the clinician offers options and describes their risks and benefits, and the patient expresses his or her preferences and values (Barry & Edgman-Levitan, 2012).MSN Essential III focuses on quality improvement and safety that includes methods, tools, performance measures, and standards related to quality. Quality improvement is defined as the use of data to monitor the outcomes of care processes and use of improvement methods to design and test changes to continuously improve the quality and safety of health care systems (American Association of Colleges of Nursing [AACN], 2012). Safety is defined as a minimization of risk of harm to patients and providers through both system effectiveness and individual performance (AACN, 2012). One of the most prevalent tools used in this class and clinical was the SOAP note. Quality of outpatient clinical encounter notes relates to patient safety, medical education, medico-legal issues, and justification of reimbursement (Hanson, Stephens, Pangaro, & Gimbel, 2012). The clinical note is the primary tool used to document care, communicate plans, and provide guidance for follow-up treatment and care (Hanson, Stephens, Pangaro, & Gimbel, 2012). Gaps in the quality of clinical documentation could, therefore, adversely affect patient care and health care outcomes. The SOAP note also assists with continuity of care, which is another aspect of both quality and safety in clinical care, by providing detailed, clear, practical information about the patient, as well as needed follow-up care (Hanson, Stephens, Pangaro, & Gimbel,

2012).

Competencies are a mechanism that supports health professionals in providing high-quality, safe care (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). Incorporation of these competencies into healthcare system expectations, orientations, job descriptions, performance appraisals, and clinical ladder promotion processes could drive higher quality, reliability, and consistency of healthcare as well as reduce costs (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). Identification of competence is an essential aspect of high quality, safe and cost-effective health care, which in clinical practice reflects the day-to-day reality of patient care and the complex nature of professional practice (Meretoja & Koponen, 2012). Effective use of nursing resources and competencies are critical strategies for providing evidence-based care. The use of clinical guidelines is another take-away that I have from this class and clinical rotation. These guidelines provide summaries outlining what is known about a disease or https://www.coursehero.com/file/43517863/NR511-week-8-reflectiondocx/ This study resource was shared via CourseHero.com

condition and the best way to treat the patient (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014). This information can be referenced at the point-of-care and can keep the advanced practice nurse up-to-date on the latest evidence while refreshing clinical nursing skills (Melnyk, Gallagher-Ford, Long, & Fineout-Overholt, 2014).References American Association of Colleges of Nursing (AACN). (2012). Graduate-level QSEN competencies: Knowledge, skills, and attitudes. Retrieved from

http://www.aacn.nche.edu/faculty/qsen/competencies.pdf

Barry, M.J. & Edgman-Levitan, S. (2012). Shared decision-making: The pinnacle of patient-centered care.

New England Journal of Medicine, 366, 780-781. DOI: 10.1056/NEJMp1109283

Hanson, J.L., Stephens, M.B., Pangaro, L.N., & Gimbel, R.W. (2012). Quality of outpatient clinical notes: A stakeholder definition derived through qualitative research. BMC Health Services Research, 12(407).

DOI: 10.1186/1472-6963-12-407

Melnyk, B.M., Gallagher-Ford, L., Long, L.E., & Fineout-Overholt, E. (2014). The establishment of evidence-based practice competencies for practicing registered nurses and advanced practice nurses in real-world clinical settings: Proficiencies to improve healthcare quality, reliability, patient outcomes, and costs. Worldviews on Evidence-Based Nursing, 11(1), 5-15. DOI: 10.1111/wvn.12021 Meretoja, R., & Koponen, L. (2012). A systematic model to compare nurses' optimal and actual competencies in the clinical setting. Journal of Advanced Nursing, 68(2), 414-422.doi:10.1111/j.1365-2648.2011.05754.x https://www.coursehero.com/file/43517863/NR511-week-8-reflectiondocx/ This study resource was shared via CourseHero.com