Defining the value of nursing
AS PART OF OUR NURSING PRACTICE, we engage in critical thinking, prioritize patient needs, communicate with other members of the interprofessional healthcare team, and coordinate and document patient care. All of this day-to-day activity to keep patients safe may be invisible to patients, their families, and the communities around us because, as one nurse told me, “When good nursing care is practiced, bad things don’t happen.”
Although the link between nursing and patient safety has been studied for years, illuminating the attributes of good nursing care through hard data has been a challenge. In 2004, I cochaired the National Quality Forum’s Core Measures for Nursing Care Performance Committee with the University of Pennsylvania’s Mary Naylor, PhD, RN, FAAN, a well-known nurse researcher. Even then our committee struggled to determine how to measure the positive work of nurses, rather than simply examining negative outcomes such as pressure injuries or falls. Although a credible body of research showing how nurses prevent negative outcomes now exists, questions about the value of what nurses do are still raised every day, especially at budget time.
Fortunately, nurses have a new resource that highlights our value by discussing our role in patient safety. The third edition of Front Line of Defense: The Role of Nurses in Preventing Sentinel Events, which was jointly produced by The Joint Commission and the American Nurses Association (the two organizations’ first copublication), clearly shows the value of nursing. The Joint Commission’s Nursing Advisory Council recommended this update because so much has changed in healthcare. When the second edition was published in 2007, health information technology and electronic health records were less prevalent, and the imperatives of the Affordable Care Act didn’t exist.
Every chapter in the third edition has been updated to reflect the current issues in healthcare, including the most up-to-date sentinel event data reported to The Joint Commission. Most important, every chapter describes the nurse’s role in preventing harm and error related to perioperative errors, medication errors, falls, suicide, maternal and perinatal injury and death, criminal events, and infections. Nurses accomplish this by using best practices, practical strategies, and tools. Safer care is better care. Mark G. Pelletier, MS, RN, The Joint Commission’s Chief Operating Officer and Chief Nursing Executive said, “After 30 years’ experience in hospital operations, performance and quality improvement, process redesign, and program development— and in my newest role as chief nursing executive with The Joint Commission— I continue to ask myself: What can we as healthcare professionals do to improve the quality of care? What is the nurse’s role in providing patient-centered care that leads to the best possible outcomes? How do we nurses respond to, mitigate, and ideally prevent sentinel events and near misses? And how do we care for and support our colleagues when critical errors are made? Front Line of Defense was written to give nurses the support, knowledge, and practical tips to answer these questions and more.”
Pelletier adds a message for nurses, “I hope that this book gives you the tools and the knowledge to safely impact your patients’ lives. Your patients and their families will be grateful.”
I couldn’t agree more.
Lillee Gelinas, MSN, RN, CPPS, FAAN
Front Line of Defense: The Role of Nurses in Preventing Sentinel Events. 3rd ed. Oak Brook, IL: Joint Commission Resources; 2019. jcrinc.com/front-line-of-defense-third-edition