Nursing Practice Transformation to meet the Unique Needs of Patients

This article discusses the importance of nursing practice transformation in meeting the unique needs of patients. It explores the redesigned roles for nurses and the challenges they face in the changing healthcare landscape. The article also highlights the importance of quality care and the impact of nurses on patient outcomes.

Running head: NURSING PRACTICE TRANSFORMATION
Nursing Practice Transformation to meet the Unique Needs of Patients
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Introduction
In every clinical setting, patients deserve the quality of care centered on the unique needs
of their health conditions and not only a service that is most convenient for the healthcare
professionals giving the service. Hood (2017) denotes that this goal is only possible when a
transformed healthcare is adopted, an aspect that requires the adoption of a transformed
healthcare system with fundamental rethinking of the responsibilities of various healthcare
professionalism such as nurses. In the course, global healthcare systems have adopted various
healthcare strategies aimed at improving the level and quality of care afforded to patients. These
policies vary from state to state and are aimed at addressing different healthcare concerns. This
paper examines the need for full practice to the extent of training and education by nurses
resulting to the adoption of the Affordable Care Act of 2010. The policy outlines new healthcare
strategies and structures that in turn results to new roles and opportunities for nurses in both local
and global clinical environment.
The Importance of Nursing Practice Transformation
According to Chalmers, and Langhorne, (2016), the changing landscape of the global
healthcare environment coupled with the changing profile of the global population in terms of
health calls for the system to undergo a fundamental shift. The goal is achieving patient-centered
care that is primarily delivered in contrary to specialty care, focus on more community care
delivery, other than acute care setting, and enable different healthcare practitioners to adopt full
care to the extent of their competencies, education, and training while fostering inter-professional
collaboration. When such a shift is achieved, the health care system will be able to provide
quality care, increase health safety, and reduce medical errors. Burns, Hyde, and Killett (2016)

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also support the assertion since providing healthcare that covers the above areas helps in tapping
the traditional strength of the nursing profession. Nurses also have the responsibility of
addressing the patient needs through their scientific knowledge, adaptive capacity, and virtue of
their numbers. Therefore, there is a need of the healthcare system to use their nurses’
contribution while assuming re-conceptualized and enhanced roles.
Identification of the Problem
In a systematic study, Mobley, Leigh, and Malinin (2017) denote that nursing is among
the most versatile professions within the workforce of health care. With the advancements and
changes that are taking place, the modern nursing industry has reinvented itself severally since
the development of trained care-givers personnel for the ill, a strategy that was advocated for by
Nightingale Florence. The outcome is the emergence of new career paths for nurses evolution
that entices broadly talented and larger pool of applicants, an aspect that has led to scope
expansion in responsibilities and practices for nurses. As a result, nurses have become a great
assembling force driving a great change in the healthcare in various dimensions as pointed out by
Reese, Duncan, Kodet, and Brown (2018).
With the many innovations that adaptive, versatile, and well-educated nurses have, they
have achieved high technology evolution within the hospital setting, national development of
principal care dimensions, and better-quality care obtainability for the unfortunate and
countryside inhabitants, palliative and respite care, and reduced the length of stay in hospitals.
There is also the reduction of nurse-work hours for the resident practitioners for improving
patient safety, improved care coordination for the elderly and those with chronic conditions, and
focused consultation and greater access to specialty care. Therefore, nurses have become

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increasingly integral part of healthcare service with every passing decade, an aspect that limits
envisioning the future without nurses.
Nurses and Quality of Care
Quality of care has been defined in different ways by several health organizations and
establishments. From numerous meanings in the literature, the WHO definition of quality of
concern is the degree to which health care services delivered to persons and patient populaces
recover wanted health effects (Fortier, Fountain, & Swan, 2016). To achieve this, health care
ought to be benign, operative, apt, effectual, reasonable and persons-centered.” Nurses play a
fundamental role in inpatient hospital care. Alongside giving straight patient care, nurses add to
the good and extraordinary quality patient care by overseeing another nursing workforce,
observing the health state of patients, harmonizing and cooperating with multi-professional
health care workforces, and offering edification and backing for equally patients and patients’
relatives. This lets nurses have an excellent outlook of the patient care practice, setting them at
the “severe end” of patient well-being, and compelling their aptitude to make knowledgeable
valuations of care quality and patient well-being in their place of work.
The quality of nursing care re-counts to the proper implementation of valuations and
involvements proposed to enhance patient aftermaths and avoid adversarial happenings
(Lammers & McLaughlin, 2017). For instance, the degree to which nurses evaluate the threat of
reductions in hospice patients upon admittance, device, proof-founded fall-aversion conventions,
and uphold such precautionary intrusions could each be established into scales of nursing care
quality. The quality of nursing care likewise comprises responsiveness to safety concerns, for
instance, the precision of suppository administration. Safe care similarly involves steady

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observing personalized to patients’ illnesses to ensure timely realization of a patient worsening
and, if glitches are recognized, the benefit from a prompt, proper interdisciplinary team reaction
to these matters.
Quality of care by nurses can be improved through community engagement. The outlooks
of patients, their relations and societies, on the variety of services affect their resolutions to seek
out care (Chokshi, Rugge, & Shah, 2017). Involvement of nurses with the communities they
attend to– so that they can recognize their anticipations, foster trust and engross them in the
course of healthcare service delivery – is an indispensable element for generating plea for and
access to quality medical services and care.
Quality delivery of care for patients in health-care amenities necessitates proficient and
inspired health-care nurses and the convenience of valuable physical assets, such as sterile water,
necessary medications, paraphernalia, and materials. Additionally, evidence-based observes for
routine, and crisis care necessitates practical referral schemes amid levels of care, as well as info
schemes that allow analysis and review to take place. The practice of quality care necessitates
active communication—patients ought to feel that they recognize what is happening to them and
what to expect at every level of treatment, and know their civil liberties and rights (Chokshi,
Rugge, & Shah, 2015). All patients have to be given care with reverence and self-worth, and a
patient and their kinfolks must have access to the emotive and social provision of their
preference.
The quality of care that nurses deliver is inclined to discrete nurse features such as
acquaintance and familiarity, together with human aspects such as tiredness (Fathi, Modin, &
Scott, 2017). The quality of care is likewise inclined to the schemes’ nurses operate in, which

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include not only workforce levels, but also the wants of all the patients a nurse or nursing team is
accountable for. Likewise, the convenience and union of other workforce and maintenance
services, and the environment and philosophy shaped by front-runners in that situation. The same
nurse might provide care of opposing quality to patients with comparable wants in variable
workforce settings and, unlike work environs.
Examples of Redesigned Roles for Nurses
The health care scheme is experiencing rapid changes that place new prominence on
populace well-being, quality of care, and the worth of the services provided. These changes avail
both prospects and dare to approximately 2.9 million registered nurses (RNs) working in the
United States (Wexler, Hefner, Welker, & McAlearney, 2016). There are about four times as
numerous nurses in the health labor force than there are doctors; nurses, by absolute figures, will
hold a significant position in this change, and will themselves be changed in the course. Since
instantaneous alarms about RN deficiencies have declined, there is a prospect to shift
consideration and assets away from escalating the educational channel to redesigning the scheme
to supporting nursing experience in a changed health care scheme.
Community health nurses have long held a position in evolving, executing, and checking
plans to improve the health of people through health elevation and disease inhibition (Sutherland
Cornett, & McNeilly, 2018). Currently, there is a mounting acknowledgment that numerous
individual health complications have backgrounds in the community, and can be barred through
enhanced populace health plans. In attending to their patients and societies, nurses and other
health caregivers should comprehend and navigate the public, administrative, and financial
aspects that affect individual and populace health. For nurses to be operative in care managing

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and organization duties, also in primary care in common, they will have to look into how the
community impacts every patient, and how interpolations at a broader level—either for a patient
board or communal—can advance specific aftermaths. This outlook demands superior
acquaintance of sociology, epidemiology, and shared bases of health.
The speedily increasing populace of older Americans will mandate supplementary health
care services in common, also extra long-term care. A budding portion of long-standing care is
being provided in home-based as well as society-based backgrounds, through household health,
grown-up daycare, and other care services (Sutherland, Cornett, & McNeilly, 2018). Through the
Medicaid platform, CMS has offered enticements to states to inspire better usage of public
services. Subsequently, several pioneering state-led transformations in the providing of long-
standing services and cares are being tried. In addition to delivering valued medical care to older
grown-ups, the nursing personnel will be fundamental to meeting this budding necessity in the
following methods: (i) By evaluating the long-standing requirements of persons with bodily and
mental deficiencies, evolving modified care strategies, organizing care crosswise givers and
situations, and supervising the sufficiency of services. Conventional and emergent plans for older
grown-ups and long-standing care populaces are leveraging nurses to advance care evolutions,
averting physical and mental deterioration while guaranteeing that older adults can live in the
community. (ii) By engaging household caregivers, mostly distinct from embracing kinsfolks,
neighbors, and associates in the enactment of older grown-ups’ strategies of care. Looking into
the exceptional wants of this “unseen personnel” will be a main dare in the changed health care
scheme.

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Care synchronization encompasses working with patients to help consolidate the services
they are given, guarantee that their preferences and desires are met, share info crosswise health
caregivers, and expedite the proper provision of health care services (Rae 2015). Novel fiscal
enticements have arisen; for instance, as of January 2015, Medicare is reimbursing $42.60 every
month for care administration of patients with binary or added chronic illnesses, like heart illness
and diabetes.
Challenges facing the Redesigned Roles for Nurses
As unique roles verbose through the health care scheme, nurse instructors and working
nurses requisite to emphasize on building the abilities to meet patient prerequisites in a speedily
shifting and growing worth-centered care setting (Jeffers & Astroth, 2017). To achieve this,
nurses will have to ascertain and advocate for the education and regulatory modifications to
upkeep the nursing personnel as they change occupation environments and take on new roles.
One of the significant hurdles in preparation of the nursing personnel is the nonexistence of
facility and preceptors who are conversant with the novel roles necessitated of nurses in original
prototypes of care. Whereas nurses have conventionally occupied care administration and
synchronization roles in critical situations, the extent to which the abilities and proficiencies
learned in dangerous situations will transform into the characters’ nurses will hold in ambulatory
conditions is uncertain.
Educational curriculums might face challenges in ascertaining facility and preceptors
who can impart vital abilities crosswise a selection of care situations. Educational curriculums
likewise will meet the dare of ongoing role uncertainty. The redesign of health care
establishments is happening quickly, and numerous roles might be phased out whereas new ones

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arise (Sutherland Cornett, & McNeilly, 2018). Instructors will have to navigate changing parts
and amend proficiencies obligatory conferring to the difficulty and analyses of patients and
situations in which nurses will perform. Another hurdle faced by educational institutes is the
absence of community-based practices in which to allocate nursing scholars. A majority of the
nurses still get the bulk of their clinical education in in-patient situations. However, for nurses to
learn to practice in novel prototypes of care, clinical cycles ought to comprise acquaintance to
high-performing workforces in mobile environments, and offer longitudinal involvements with
patients and household caregivers.
Regulatory and strategy changes are obligatory to support nurses performing in new roles
to the complete scope of their learning (Jeffers & Astroth, 2017). The IOM sturdily suggested
that regulatory hurdles be done away with if they inhibit nurses from exploiting their abilities to
the chief advantage of patients. Insurance compensation rubrics likewise can deter nurses from
providing excellent services. Every state defines its specific Medicaid reimbursement ratio for
cutting-edge practice nurses, and private insurance firms institute their rubrics. In the Medicare
platform, nursing practitioners should pursue a doctor’s consent for home-based health services
for their patients. Political principles forbid nursing practitioners from claiming home-based
health services for Medicare beneficiaries. However, several states have approved this action
through law or directive to advance access for patients who are insured by other financiers, as
well as Medicaid. The ACA added an extra obligation that doctors confirm receivers’ entitlement
for these services and long-lasting therapeutic paraphernalia. This incompetence can lessen the
quantity of time nursing practitioners spend with their patients and outcome in care delays,
particularly in remote or inaccessible environments.

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The state nurse certifying panels control the content of nursing improvement and might
have to adjust guidelines overriding entry-level nursing courses to guarantee that graduates have
the new expertise and proficiencies necessary (Scott, 2017). They too must contemplate
regulating necessities concerning clinical practices of pre-licensure scholars, to comprise
additional ambulatory practices. This will possibly necessitate novel principles concerning
facility-to-scholar quotients in mobile environments and the credentials of preceptors. Non-
nurses may ascertain to be competent preceptors for certain curricular constituents, such as
populace health managing and informatics.
Implications for adopting the Policy
The Affordable Care Act (ACA) since its adoption in 2010 has placed many demands on
the healthcare while offering more opportunities for creating a system that is focused on centered
patient care. According to Reese, Duncan, Kodet, and Brown (2018), this legislation has begun a
process to shift the focus of the New Zealand healthcare system away from specialty and acute
care. The shift is adopted with respect to an urgent need for response to health complications
such as increasing chronic conditions and need for improved primary transitional care prevention
and population wellness. For instance, the increasing aging population calls for long-term and
palliative care. Fisher, Hay, and Reistetter (2016) also denote that there is a high number of
insured populations, high numbers of ethnic minority have faced several challenges and
obstacles to access of quality healthcare. Therefore, there was a need for redefining health care to
cater for the needs of the culturally and socially diverse population in New Zealand and other
developed countries. With these complications, adopting the policy was a better way for
enabling nurses to adopt and practice the full extent of their training and education was a major

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step to meet the needs of above mentioned challenges. Adopting the policy has and will not only
improve nursing care, but has also increased the value of service they offer to patients.
According to Fisher, Hay, and Reistetter (2018), the adoption of the strategy has essentially
transformed the ways in which healthcare services are documented, delivered, and clinically
reviewed. For instance, there has been a great improvement in the way of reviewing or obtaining
diagnostic information, patient and family communication with the healthcare providers,
improved decision-making in the clinical setting, and the manner in which clinical interventions
are adopted. The Act comes in a full package of resources aimed at improving different areas
within health care. These include;
 Opportunities through the technological adoptions
According to Angood (2017), there has been no greater prospect for practice change than via
technology not only in the health industry, but also in other fields globally. The same study
denotes that the technology has for a long time been adopted in supporting payments and billing
systems, but has grown to be increasingly essential in healthcare provision for its aid in decision-
making and health documentation. For instance, it has led to the development of monitoring and
diagnostic machines that are essential in the treatment of chronic complications such as heart
disease, cancer, diabetes, and many other health complications. For instance, the policy
recommends the use of a new healthcare system called Crossing the Quality Chasm that is
functioning as a growing evidence that automated entry of order in health systems is achievable.
The system has reduced errors in dosage and drug prescription, has improved timeliness using
internet-based communications such as telemedicine and e-visit platforms. The resulting impact

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is immediate access to diagnostic access, treatment results, and clinical information irrespective
of the location and health condition of the patient.
Technology has thus enabled the expanded use of online communication through tele-health
services without limits to treatment and diagnosis, but includes health-follow-ups, promotions,
and care coordination (Angood, 2017). However, the service effectiveness faces challenges from
state regulations.
 Implication on the Time and Place of care
With enhanced expertise, care is now reinforced by various digital networks that have
budged the significance of place and time for effective healthcare provision. Therefore, the
patient should not always be in the same location and the carer must interact with the patient at
all times. Avgar, Givan, and Mingwei Liu (2015) denote that the help of computerized data
access schemes, pharmacies, test center outcomes, and imaging schemes are all connected within
a similar network enabling the provision of many types of care without regarding the location
since the care grid is available anytime and anywhere.
Remove patient monitoring is also exponentially adopted, an array of biometric device that can
effectively collect, report, monitor and store patient information in real time, either in the clinical
setting, or at the patient residents. Such devices provide direct and digitally mediated care such
as implantable defibrillators and automated insulin pump.
Recommendations for Policy Adoption towards the unique needs of patients

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As opposed to the traditional way of service delivery focused on the desire of
practitioners, Burns, Hyde, and Killett (2016) denote that the current nursing systems need to
customize and reflect on the values, choices, and needs of patients. This principle helps in
recognizing that every patient has their unique needs and preferences, an aspect that calls for a
customized planning for every patient. Such a plan will help in making the environment
comfortable for patients hence giving them the freedom to share their health issues essential for
the complete component of care.
In a patient-centered environment, all members of the care team should be aware of the
care plan and patient physiques. Therefore, such policies will stimulate the dissemination of
information and expertise between carers and patients for improved decision-making and speedy
recovery. Kirby (2016) labels such a setting as a supportive, peaceful and comfortable healing
environment for patients. Similarly, there is need for transparency as the nurses need to be honest
and upfront with the health information that can help the patient to adopt informed decisions.
Conclusion
Even though medical practitioners possess skills, knowledge and scientific qualification
to help patients, there is a need for them to focus on the specific needs of the patients. With the
vast and quick transformation of the healthcare industry, focus should be given to strategies,
regulations and policies that will ensure the care provided to patients target their specific needs.
As a result, nurses needs to focus more on the safety of patients, practice transparency, involve
the relevant stakeholders like families, and ensure they provide a unique nut comfortable
environment for effective patient-centered care.

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