Introduction
The competitiveness of nurses is essential in order to provide quality and safe care. The Quality and Safety Education for Nurses or QSEN provides a framework, which aims to emphasize the essence of different competencies, from which the Patient-Centered Care in included. It is important that nurses understand the significance of focusing on patient’s needs towards the provision of better health outcome and overall quality care. The purpose of this paper is to discuss the Patient-Centered Care competency and how it affects the delivery of care. Additionally, this paper will discuss how the evidence-based practice in nursing relates to nursing education, nursing practice, and nursing research. Thus, this paper will offer insights as to how such competency can improve the working environment.
Patient-Centered Care – Definition
Knowledge
When it comes to the discussion of quality health care delivery, Patient-centered care serves as one of the most essential topics that must be understood by nurse practitioners. This competency is defined as the quality of professional, personal, and organizational relationships (Epstein & Street Jr., 2011). That is why; nurses must be equipped with adequate knowledge when it comes to promoting patient-centered care through consideration of patient-centeredness of the patients and their families as well as the overall health care system. According to QSEN (2014), this competency is the integration of understanding of different dimensions, such as the patient, their families, and the community preferences; the examination of common barriers to enable patients in their personal health care process, and the demonstration of knowledge of concepts of suffering and pain. “Picker Institute identified eight domains: respect for patient preferences and values; emotional support; physical comfort; information, communication and education; continuity and transition; co-ordination of care; involvement of the family and friends and access to care” (Luxford, Safran, & DelBanco, 2011). Nurses must be able to promote self-care to their patients regardless of identified barriers, such as culture, religion, or ethnicity of the patient.
Skills
The skills in patient-centered care pertain to the nurses’ capacity to apply the knowledge and awareness about the context of this competency. It aims to develop patient values, needs, and preferences as part of the clinical interview (QSEN, 2014). It is also important that nurses are able to implement the care plan as well as the care evaluation. Thus, the identified needs and preferences of the patients must also be communicated to the rest of the team accordingly. This will ensure that the patient-centered care context will be applied with respect to the patient’s values. Respecting the diversity of different human experiences is a good representation of this competency. Additionally, understanding the potential barriers of quality and safe care may not be enough if there will be no efforts to remove such challenges. QSEN (2014) also shows that the facilitation of informed patient care is part of the patient-centered care skills.
Attitudes
Across all competencies, it is important that nurses have positive attitude towards providing safe and quality care. The positive attitudes encompassing the patient-centered care suggest that the nurses must focus their attention what their patients need in order to achieve better health outcomes. The skills in patient-centered care is defines as the value looking at the health care situations “through patients’ eye” (QSEN, 2014).
Implications of Patient-Centered Care Competency in Nursing Education, Practice, and Research
Nursing Education
Patient-centered care is one of the core competencies that health care professionals need, specifically nurse practitioners (Greiner & Knebel, 2013). Thus, nursing education must provide adequate information with regards to the promotion of this competency. In order to prepare the health care work force, the patient-centered competency is being included in the nursing course, so as to emphasize the benefits of its application to real-life situations towards better health outcomes of the patients. Since part of this competency is the promotion of the patients’ self-care, the nursing education may have educational programs that will elevate the value of self-care among patients.
Nursing Practice
An improved patient-centered care delivery will also improve the overall competitiveness of the nurse practitioners. The inter-professional collaboration or the collaborative patient-centered care is an approach that involves different members of the health care team. QSEN’s aim to provide quality and safe care will help the nurses in applying their knowledge into actual practice of patient care (Bridges et al., 2011). Once this area of competency has been constantly applied by nurse practitioners, it will improve the delivery of care and increase both the safety and quality of related actions. Therefore, there could be an overall improvement on the nursing practice, as it was developed through effective inter-professional collaboration of the health care team members.
Nursing Research
This competency impacts the nursing research in many ways. One of which is the researchers’ perception about the effectiveness of this patient-centered care when it comes to achieving quality and safe health care delivery. Moreover, the competency enabled the development of new approach when it comes to providing care. In fact, the IOM report in 2001 about safer health care system emphasized the need to redesign the structure of care delivery in order to serve the patients better, from which the research led to the QSEN in 2005 (Dolansky & Moore, 2013).
How Patient-Centered Care Improves the Working Environment
Improving the work environment
The application and practice of patient-centered competence holds various advantages to the working environment. Nurses who observed their work environment as patient-centered become more satisfied with their jobs as compared to practitioners who do not have the same perception. In relation, a better perception towards the work environment and job satisfaction will reduce the occurrence of medical error, hence, increase the quality and safety of health care delivery. Additionally, an improved work environment may provide more comfortable reporting of minor errors from the staff members without the fear of losing their jobs. Therefore, transparency and accountability in the work units become part of the daily practice.
Relevance to QSEN’s goal
The transformation of working environment through patient-centered care will further enhance the knowledge, skills, and even the attitude of the health care professionals, specifically the nurses. The competency will serve as one of the major reasons as to why the work unit or the overall working environment will be effective with their jobs. The efficiency of the working environment will also improve the nursing practice. Since there will also be an improvement on patient safety and work satisfaction, it is possible that the patient-centered approach will result in employee, patient, and even organizational outcomes.
Safety, Satisfaction, and cost
The patient-centered care may provide positive outcomes and implications to safety, satisfaction, and cost. The competency will ensure that the safety of patients is based on what they needs and preferences. Thus, using safety as a vital component, the competency will ensure the nurses’ focus on their patients through effective and realistic way. On the other hand, understanding, acknowledging, and focusing on the patients’ needs and preference will increase the patients’ satisfaction. In return the nurses will increase their job satisfaction. When it comes to cost, an efficient focus on the patients’ needs through quality and safe health care delivery will reduce the risk of readmission, as the practice of care help in the full recovery of the patient.
Conclusion
Understanding the patient-centered care is one of the core competences that every nurse must hold. It aims to provide better health outcomes through quality and safe delivery of care. The knowledge, skills, and attitude of the nurse practitioners on the competency suggest that it can influence the nursing education, practice, and research through various ways. It is essential that the competence of every nurse must be used towards the improvement of working environment for the benefits of both the patients and the employees themselves.
References
Bridges, D. R., Davidson, R. A., Soule Odegard, P., Maki, I. V., & Tomkowiak, J. (2011). Interprofessional collaboration: three best practice models of interprofessional education. Medical Education Online, 16(0). doi:10.3402/meo.v16i0.6035
Dolansky, M. A., & Moore, S. N. (2013). Quality and Safety Education for Nurses (QSEN).Online Journal Issues Nursing, 18(3). Retrieved from http://www.medscape.com/viewarticle/822706
Epstein, R. M., & Street, R. L. (2011). The Values and Value of Patient-Centered Care. The Annals of Family Medicine, 9(2), 100-103. doi:10.1370/afm.1239
Greiner, A. C., & Knebel, E. (2013). Institute of Medicine (US) Committee on the Health Professions Education Summit. Retrieved from http://www.ncbi.nlm.nih.gov/books/NBK221519/
Luxford, K., Safran, D. G., & Delbanco, T. (2011). Promoting patient-centered care: a qualitative study of facilitators and barriers in healthcare organizations with a reputation for improving the patient experience. International Journal for Quality in Health Care,23(5), 510-515. doi:10.1093/intqhc/mzr024
Quality and Safety Education for Nurses. (2014). Pre-Licensure KSAs. Retrieved from qsen.org/competencies/pre-licensure-ksas/#patient-centered_care
