Acommon theme in today's healthcare environment is the delivery of quality care. As defined by Webster's, quality is "a degree of excellence." Because of its intangible nature, measuring quality is difficult, but steps are being taken to provide some data for patients as they navigate the healthcare system in determining at which hospital they want to be treated.
Surveys taken by hospitals and the government ask patients about their treatment by the professional healthcare staff. Because nurses are on the front lines of the healthcare system, spending much more time with patients than any other healthcare professional, a patient's hospital experience is greatly influenced by the care they receive from the nursing staff.
The federal government recognizes the importance of nurses' roles in the hospital setting.
In an attempt to help consumers choose the best and most appropriate hospital for their healthcare needs, the federal government has created a number of patient surveys. One of the most significant surveys, including questions about nursing care, is close to being implemented nationally. The Hospital Consumer Assessment of Health Providers and Systems Survey (HCAHPS), created by the Centers for Medicare and Medicare Services (CMS) together with the Agency for Healthcare Research and Quality (AHRQ), will allow consumers public access to information about patients' hospital satisfaction.
The HCAHPS is the first national survey to collect uniform patient feedback on hospital care. The 27-question survey asks patients short, direct questions about their nursing care, physician attention, and environment. Although the survey seems to acknowledge the importance of nursing care by placing those questions first, it does have, in INS's opinion, a glaring omission. Even though more than 85% of hospital patients receive infusion therapy, the survey did not have a single question about IV care.
INS took advantage of the request for public comment on the survey before its final implementation. We presented to CMS 3 basic points to make our case:
1. Infusion therapy is a common experience among nearly all hospital patients, and intravascular delivery of pharmacological agents is expanding.
2. Successful intravascular line placement, usage, and maintenance reduce costs and frequent complications.
3. The therapeutic success of every infusion therapy is dependent in part on patient cooperation, participation, and response.
Using these statements as a basis, we proposed questions which, if included in the survey, will allow patients to choose a hospital based on, among other things, the competence of its infusion professionals. After all, who wants to be the recipient of repeated venipunctures?
National Quality Forum Nursing Standards
In 2004, the National Quality Forum (NQF), a private, not-for-profit organization whose goal is the improvement of healthcare in the United States through endorsement of national standards for measurement and public reporting of healthcare performance data, endorsed 15 national voluntary consensus standards for nursing-sensitive care.
The standards consist of a collection of patient outcomes (eg, catheter-related bloodstream infections, falls, death); nursing interventions (smoking cessation counseling); and system-level indicators (eg, skill mix, nursing care hours per patient day). These standards make it possible for hospital patients to assess the quality of care they receive and they will help providers identify areas for improvement in their nursing staffs.
This growing movement for quality improvement in healthcare services also offers an opportunity for infusion nursing professionals to educate our colleagues about our specialty and to take advantage of the interdisciplinary aspects of infusion therapy and broaden perspectives about infusion therapy.
I am optimistic that this trend toward quality will lead to better-educated healthcare consumers, better "customer service" at healthcare institutions, and higher levels of certified nurses, along with an increased awareness of the importance of infusion nurses.
Mary Alexander