Bold Voices - July 2016 - (Page 20)
AT THE BEDSIDE
Building Trust With Patients
Through Genuine Connection
Sometimes patients just need their
nurses to be emotionally present and
acknowledge the situation.
he best emotional support a nurse
can provide a patient or family
member is sometimes giving them
permission to experience their emotions
in a nonjudgmental atmosphere.
"This builds trust. This builds conﬁdence. This is care," says Kati Kleber on
her blog, www.NurseEyeRoll.com. She
offers the following example:
"It was a typical neuro ICU kind of day. I had two patients
in rooms next to each other. They both were pretty sick but
in very different ways. I didn't say anything profound all day. I
didn't put together the pieces of some intricate clinical picture,
call the doctor and suggest the perfect thing to improve their
outcome. I didn't manage my time perfectly."
Not trying to ﬁx the emotional pain of
the two patients and their family members,
assessing their needs and just being there
was the best she could do for them that
day. And the results were positive.
"Sometimes they just need a little extra
explanation and reassurance. Sometimes
they need to see you prove to them that
you know what you're doing and that
they or their loved one is important to
you because they are important to them. Sometimes they just
need you to be emotionally present and acknowledge the
situation," she reﬂects.
New Recommendations to Enhance Patient Safety
20 Better data, valid metrics
lthough there is an increased focus on patient safety and reducing medical
errors, safety can be compromised due to the lack of standard measures in U.S.
and greater transparency
a Safer Health Care System: The Critical Need to Improve
represent the best formula
Measurement," a commentary in JAMA: The Journal of the American Medical Association,
to make the U.S. a world Ashish Jha (Harvard T.H. Chan School of Public Health, Boston) and Peter Pronovost
(Johns Hopkins Medicine, Baltimore) criticize the administrative data used to deterleader in patient safety.
mine the number of medical errors and recommend federal action to improve metrics.
"Without standards of accuracy or timeliness," they write, "some rating programs will label some of the best
clinicians and hospitals as unsafe and some of the neglectful ones as safe, which has the potential to do more harm
The authors recommend the Centers for Medicare & Medicaid Services develop "a standardized set of validated
metrics" based on clinical data to encourage patient safety rather than coding. Reliable metrics with deﬁned standards would ensure that the healthcare industry, journalists and government share accurate data.
The only adverse events that are tracked well, the authors contend, are hospital-acquired infections, which have
been reduced. The Centers for Disease Control and Prevention should use clinical data from electronic health records
in creating mathematical models to detect other adverse events, they add.
The authors also propose that Congress invest in system funding, because large cost savings can come from
simple changes, such as the checklist intervention to reduce central line infections. "Without these measures, the
key ingredient in these efforts is missing: systematic, real-time data on adverse events with timely feedback to clinicians and health care organizations. Without effective measurement and reporting, progress in patient safety will be
arduous and slow."
The Healthcare Association of New York State published a similar call to action, "Measures That Matter," seeking
to reduce costly reporting to various entities, often with disparate requirements. "This lack of alignment and coordination ... has created an environment of measure madness - displacing and redirecting resources from meaningful
improvement efforts," the report notes.
"Better data, valid metrics, and greater transparency represent the best formula for making the United States a
world leader in patient safety," the commentary adds.
REFERENCE: Jha A, Pronovost P. Toward a safer health care system: the critical need to improve measurement. JAMA. 2016;315(17):1831-1832.
Table of Contents for the Digital Edition of Bold Voices - July 2016
Pres Note Front Teaser
We Welcome New Board Members, Thank Those Who Completed Their Service
Progressive Care? Stepdown? Intermediate Care? It’s All About the Patient
Drug-loaded ‘Backpacks’ Take Aim at Disease Sites
Elimination of Pain Should Not Be the Goal
New Blood Analysis May Detect Sepsis
Hospital Guidelines Can Decrease Opioid Overdoses
Hospitals’ Solutions Ease Opioid Overdose Crisis
Aspirin Linked to Lower Risk for Most Cancers
Wearable Defibrillators Provide Another Option
Positive Emotional Stress Can Trigger Broken Heart Syndrome
AACN Scholarships: Expand your Knowledge and Skills
The Power of Compassion
Are Stethoscopes Ready for Retirement?
Safe Practice Recommendations for Copy and Paste
NTI 2016: It Matters
AACN’s Facebook Community Weighs in About NTI
New Recommendations to Enhance Patient Safety
Building Trust With Patients Through Genuine Connection
In Our Journals
Bold Voices - July 2016