Safety and quality

I believe that there are positive and negative consequences in the safety and quality affecting the delivery of healthcare today. For example, in the past patients used to be on prolonged bed rest following surgical procedures thus the promotion of atelectasis, pneumonia, thrombus formation and so on… Positively, the safety and quality has evolved by enforcing patients to ambulate early, use tri-flows, apply ted hose and sequential compression devices have eliminated the amount of these post operative complications. Also advanced technological inventions, such as laparoscopy, have lessened the extensive hospital stays. According to Dr. Porter-O’Grady, “Thirty years ago today when somebody entered the health care system for surgery, 86% of the times, they were inpatient. Today, 83% of the people who come through the health care system are outpatients. ” However, negatively, after several procedures patients are sent home in a matter of hours and many of these patients wind up in emergency rooms. This was my experience last month, after a diagnostic laparoscopy. At the hospital I felt fine. After a couple of hours when the anesthesia wore off at home, I was in an incredible amount of pain, had urinary retention, and to this day my voice after being intubated is not the same.
The staff was professional and comforting but I was disappointed that no one told me about these potential adverse effects. Also, many patients who have cesarean sections and are discharged after 2 to 3 days visit the OB/GYN triage with wound infection, wound dehiscence, and other complications. We are steered by such strict guidelines placed upon us by insurances and Medicaid that we do not have adequate time to monitor the patients for side effects from the procedures and I believe this is a negative impact on the nursing practice.
It has become a prominent concern on OB/GYN triage, due to insurance and Medicaid does not pay for re-admits, thus meaning the unit is losing money when it is bombarded with these patients. We need to remember as nurses patients expect us to be proficient and will advocate for them. “We need to hold on the fact that nurses have been leaders in the health care and society, and that is something we need to act on and emulate and leave for the next generation. ” (Mason, 2005) This issue does affect our job because the patients’ experience will be negative if they assume that they are receiving insufficient care.