THE PRACTICE ENVIRONMENT ANTICIPATING THE FUTURE 23 C H A P T E R THE PRACTICE ENVIRONMENT FOR NURSING: ANTICIPATING THE FUTURE

The Challenge for Nursing Meet new health care system needs Provide patient-centered care Function as part of a team Use evidence-based practice Focus on quality improvement

Health Care Delivery U.S. system has many problems. Provides fragmented care Focus is on illness but is shifting to health promotion.

Caring for Populations Need to eliminate disparities Focus on public health issues such as obesity Population is aging and becoming more diverse. Writing Exercise 23-1 has the students reflect upon disparities and how they affect health care delivery.

Nursing Workforce Shortage will worsen Transition to the practice doctorate (DNP) Writing Exercise 23-2 has the students reflect upon their educational experiences and how they correlate with real-world experiences.

Information Technology Integrated health information systems Smart equipment Advances in treatment technology Telehealth systems

Quality Issues Evidence-based practice Focus on safety Pay for quality Internet Exercise 23-3 guides the student through the AHRQ website to find the 30 clinical practices that should be at every health care setting.

Savvy Patients Have better outcomes Are more satisfied Can prevent errors (Figure 23-3) Case Scenario 23-1 presents a situation in which a patient speaks up about hand washing.

Five Steps to Safer Health Care: A Patient Fact Sheet Savvy Patients (cont.) Five Steps to Safer Health Care: A Patient Fact Sheet (courtesy of Agency for Healthcare Research and Quality, 2004) AHRQ Publication Number04-M005. Rockville, MD.

Healthcare Teamwork Care provided by teams is the norm Team training improves safety and quality Requires good communication among members

Design of Future Nursing Practice Safe Timely Efficient Effective Equitable Patient-centered

Appearance of Future Nursing Practice New roles and positions Enhanced IT practice environment Shaped by nursing-sensitive outcomes More diverse workforce Sought-after career