In the U.S., Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys make many healthcare organizations sweat because they're constantly struggling to maintain adequate patient satisfaction scores.
These patient surveys have brought the importance of quality and evidence-based nursing practices to the forefront.
And now that reimbursement from Medicare is no longer based just upon diagnosis and procedure codes, but also on patient satisfaction scores, healthcare organizations can't afford to experiment with ways to better care for their patients. Instead, they must use proven, evidence-based standards in their nursing practices to ensure that patients receive the quality care they deserve.
The care that patients receive is primarily delivered by nurses. If the nurses are undertrained or overworked then they're not going to deliver quality care.
Hospitals must set a standard of excellence from day one, by training nursing staff in up-to-date, evidence-based nursing practices, starting with the onboarding process and continuing with annual clinical competency assessments and certification tracking.
Focus on quality and safety from day one
Most patients aren't difficult to please. They want to be cared for by a competent and compassionate nursing staff. They want to feel safe and receive quality care. So why not give them what they want?
- On the first day of nursing orientation, healthcare organizations should set a clear standard for the importance of quality and safety in the care provided.
- Further, nurses should know the organization's mission statement and hold true to it. During the orientation and preceptor process, nurses should also learn the standards of care that the organization expects them to practice.
- Nurses come to healthcare facilities with varying levels of education, experience, and critical thinking skills. Nothing about their level of skill in patient care should be assumed. You should require a thorough clinical competency assessment of every nurse, regardless of their years of experience or how well they seem to "get it."
The knowledge nurses acquire through this training will stay with them throughout their years of service with your organization, and provide an excellent baseline to grow an exceptional nursing staff. This well-trained nursing staff can focus on quality and safety in patient care and work on process improvement.
Fostering continuous improvement
Because standards of nursing care are always changing, hospitals have to be proactive to stay ahead of the patient care curve. As new information is learned, nurses need to adopt new practices.
The effort to improve patient care is best led by the nurses who are going to deliver it. You should empower your nurses to step up and make evidence-based recommendations for the care they provide.
One great way to support this approach is by facilitating nurse-led process improvement committees that identify areas that need improvement, research the current evidence-based practice, and put plans in place to address those needs.
Yearly competency and certification tracking
Even though onboarding training is important it shouldn't be the end of a nurse's education within a health system.
The moment nurses stop learning and become complacent the care they offer their patients suffers. It's often said that a nurse who knows everything is a dangerous nurse.
So it's extremely important to review your nurses' skillsets on an annual basis, to determine their performance level. You can also use these yearly clinical competencies assessments as a time to teach new information and techniques to your nursing staff.
And even when nurses are highly skilled, if they allow their license or certifications to lapse they'll be unable to deliver quality care. So make sure you have a system in place to track clinical competency proficiency and certification, to help ensure nurses are well trained and competent to deliver patient care.
Evidence-based nursing is all about quality
The best way ensure that nurses are competent to deliver high quality care in support of patient satisfaction is through ongoing training that starts with your onboarding process and continues through yearly competency assessments and certification tracking.
You should instill a focus on quality and safety in staff on day one, and every day throughout the year. Empower your nurses to participate in process improvement initiatives to ensure that patients are receiving the most current standards in evidence-based nursing care.Your Turn: What are your thoughts on these suggestions for supporting evidence-based nursing? Any additional strategies to add?