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Importance of quality measures

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Performance in Nursing is measured with quality standards such as set out by the National Committee for Quality Assurance (NCQA). They come up with quality standards and performance evaluations that are critical in noting weakness, opportunities and proposing improvements. The measures enhance improvement of patient care experience by avoidance of error medication and prevent patient handling. Quality care translates to reduced patients complications and mortality in the patient. Quality care takes a higher position as opposed to quickly serving patients to avoid queues as a key measure for nurses’ productivity. Performance evaluation means that nurses focus on the well-being of the entire population through preventive measures that translate to a reduction in medical care expenditure by the people (Hughes, 2008). 

Nursing requires the utilization of resources which determine of fee schedules for the nurses. The Relative Value Unit (RVU) is used as a measure of these resources (Rhodes, Bechtle, & McNett, 2015). Work RVU’s are vital in measuring time and intensity of services given to the patients which translate to the incentive given to the nurses. Workflow for the nurses is scored based on quality, satisfactory evaluation of quality measures which determines the final score. It is through performance-based pay that service is improved benefiting the institution, the nurse, and the patient.

Remuneration is fundamental for motivation and retention whether given in monetary or non-monetary. A salary ensures that nurses can cater for their day to day expenses. However, a good working condition is essential in enhancing the value of work. Incentives such as day care, working with flexible hours and opportunities to learn to attract and retain the best talent. A profit sharing model would be ideal. Nurses should be trained on efficiency to reduce costs while providing the best service (Everhart et al., 2013). The hospital would thereby have adequate resources to cater for salaries and offer a proper working environment.

Legal Implication for Standard Care

Standard care in nursing underlies the concept that the nurse should act within certain professional guidelines when handling patients. The nurse would be charged for malpractice if they do not assess, monitor, follow standards of care, communicate adequately with patients, advocate for the well-being of the patient and follow hospital protocol.  The law is strict on issues relating to negligence which could harm the client as the nurse did not advocate for the well- being of the patient and calls for the use of personal judgment in making a decision as to what is reasonable and unreasonable (Moffett & Moore 2011). Legally, none- compliance may not be taken as a defense of not taking standard care. However, in legal practice cases, the courtroom does not expect the nurses to be perfect.

In our case, we see Gwen who is evidently refusing to take tests and inconsistently takes medication despite the high blood pressure. Malpractice in nursing would imply that nurses that the nurse fails to provide quality care. Working with non-compliant clients requires taking time with the client to understand and solve existing problems (Kleinsinger, 2010). Creation of a relationship would require building a relationship with Gwen to establish how the nurse can be of assistance. It is key to critically inform Gwen on the consequences of non-compliance to ensure they are not liable on the basis that the patient was not aware of the related risks. Failure of the client to further comply would mean that the nurse followed protocol and would not be liable for harm to the client.

The State of Montana highlights that nurses are deemed unprofessional if they do not use judgment in ensuring that the safety of patients is guaranteed. They should follow all policies to safeguard patient care. It is fundamental to respect the dignity of the patients while ensuring Gwen’s is not harmed physically or psychologically (Labour and Industry, 2017).

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