Advocating For the Nursing Role in Program Design and Implementation
Below is a transcript of an interview I had with regard to advocating for a collaborative role of the nurse in the design and implementation of a program focused on improving elderly patient safety.
Interviewer: Tell us about a healthcare program within your practice. What are the costs and projected outcomes of this program?
K.S.: Thank you for giving me this opportunity. My practice is majorly focused on geriatric care. An issue with geriatric care is a single patient with multiple health conditions. Such multimorbid conditions impair the sensory and cognitive functions of the elderly patients we care for. Evidence shows that such multimorbid conditions affecting the sensory and cognitive functions of the elderly are responsible for multiple safety issues in geriatric care, including falls, fractures, lacerations, bedsores, and medication errors (Huh & Shin, 2021). To counter these safety issues, er develop a safety program focused on improving the safety of geriatric patients under nursing care. The program includes education of nurses on caring for frail elderly patients, installing monitoring gadgets, and walking assist rails. The costs of this program will include costs related to educating the nurses on safe geriatric care, purchase of the monitoring gadgets and guard rails, and installation of the monitoring gadgets and guard rails at the geriatric ward. This program is expected to reduce the number of falls and related safety issues, including fractures. This will improve the experiences of the nurses and elderly patients as well as injury-related increases in the length of stay.
Interviewer: Who is your target population?
K.S.: The safety program targets geriatric elderly patients at risk of falls and geriatric care nurses.
Interviewer: What is the nurse’s role in providing input for the design of this healthcare program? Can you provide examples?
K.S.: Nurses have a firsthand experience with safety issues within geriatric care. Nurses are uniquely qualified to inform health policies and program planning due to their educational qualifications, rich communication skills, leadership role in healthcare, association with healthcare business, and nature of practice settings (Milstead & Short, 2019). Their proximity to the patient makes nurses the source of the most valuable insights that can help design the program. For instance, Betty. T. is a geriatric nurse who has been in service at the geriatric ward for the last 13 years. She has enough experience with all safety issues that occur. She can point out the at-risk patients and help design the safety measures based on the observed individual patient behaviors and preferences. Another example is that all of the nurses in the unit understand the needs of each patient and can help implement the program in a more targeted way for each patient to help avoid instances of trial and error, which can be costly.
Interviewer: What is your role as an advocate for your target population for this healthcare program? Do you have input into design decisions? How else do you impact design?
K.S.: As per the American Nurses Association (ANA) (n.d.), advocacy, whether legislative or political, is at the core of nursing. The advocacy role in nursing is not about positions or titles but is a part of being a nurse. As the nurse leader and an advocate for nurses’ inclusion in the design, development, and implementation of the patient safety program for geriatric patients, I want to ensure that the program is patient- and person-centered with regards to the elderly patients’ and geriatric nurses’ preferences. I have a role in pushing for the inclusion of the nurses in the program as they can effectively voice the needs of the patients, their concerns, and their preferences with regard to the program. I have input into the design decisions as I am a nurse and have a better understanding of the state of geriatric patient safety and the current needs of each patient. I believe I can further influence the program’s design by encouraging other nurses to provide input in the safety program’s development.
Interviewer: What is the role of the nurse in healthcare program implementation? How does this role vary between the design and implementation of healthcare programs? Can you provide examples?
K.S.: The roles in healthcare program implementation include translating the program from theory to practice. As they are in direct contact with the patients, nurses also report on the response of the patients to the program. They also play the role of educating the patients on the program and what it entails. And most importantly, nurses manage organizational change when implementing new practices (Ham-Baloyi, 2022). Their role, however, varies between the design and implementation of healthcare programs. For example, during the program’s design, their role is to inform the program’s design to ensure it aligns with the patient’s needs, patient numbers, and preferences. On the other hand, during implementation, they are accountable for the success or failure of the program.
Interviewer: Who are the members of a healthcare team that you believe are most needed to implement a program? Can you explain why?
K.S.: I believe everyone working in the geriatric wards and from the hospital’s administration is an essential healthcare team member who can help the program succeed. Specifically, the healthcare team will include the geriatric care nurses, other nurses for the geriatric ward, physicians, a pharmacist, the finance officer, the health information manager, and a bedside nurse. Both geriatric care and nurses in general work directly with the patient and will help the team gain insights into the patient’s risks and needs. The physicians and the pharmacist will both provide expert insights on the medical care of elderly patients and the prescription of medications that may increase the risk of falls, respectively. On the other hand, although not necessarily healthcare professionals, the finance officer, and the health information offices help ensure the correct amount is allocated to the program and the necessary information is needed for making the program’s decisions, respectively. A collaborative team approach can improve interdisciplinary fall risk communication with an impact on reducing the number of falls in elderly care (Lavareda Baixinho Rua dos Matos et al., 2019). Therefore, each healthcare team member is expected to provide their input for the success of the program.
References
American Nurses Association (ANA). (n.d.). Legislative and Political Advocacy for Nurses. Retrieved June 27, 2023, from https://www.nursingworld.org/practice-policy/advocacy/
Ham-Baloyi, W. Ten. (2022). Nurses’ roles in changing practice through implementing best practices: A systematic review. Health SA = SA Gesondheid, 27. https://doi.org/10.4102/HSAG.V27I0.1776
Huh, A., & Shin, J. H. (2021). Person-Centered Care Practice, Patient Safety Competence, and Patient Safety Nursing Activities of Nurses Working in Geriatric Hospitals. International Journal of Environmental Research and Public Health 2021, Vol. 18, Page 5169, 18(10), 5169. https://doi.org/10.3390/IJERPH18105169
Lavareda Baixinho Rua dos Matos, C., dos Velhos, S., Lavareda Baixinho, C., Adriana Henriques, M., & convidado WCQR, A. (2019). Preventing falls in hospitalized elderly: design and validation of a team intervention. Revista Da Escola de Enfermagem Da USP, 53, e3479. https://doi.org/10.1590/S1980-220X2018031803479
Milstead, J. A., & Short, N. M. (2019). Health Policy and Politics: A Nurse’s Guide (6th ed.). Jones & Bartlett Publishers.
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Advocating for the Nursing Role in Program Design and Implementation
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textbook: Communication in the Real World: An Introduction to Communication Studies is adapted from a work produced and distributed under a Creative Commons license (CC BY-NC-SA) in 2013 by a publisher who has requested that they and the original author does not receive attribution. This adapted edition is produced by the University of Minnesota Libraries Publishing through the eLearning Support Initiative.
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