Appropriate Prioritization In Nursing

You have received your patient assignment for your 12 hours shift and have completed bedside report with the outgoing nurse. How would you go about determining your priorities for patient care? How would you decide which patient to assess first? Prioritization is a critical aspect of nursing, and is a skill that must be developed to ensure patient safety and high quality care. In fact, according to Doucette (2016), “safety must supersede everything we do to create highly reliable processes that reduce or eliminate variation and deliver the best possible outcomes”. Appropriate prioritization requires nurses to use careful critical-reasoning, excellent assessment skills and astuteness of patients’ present and potential needs and complications.

Personally, I always want to give the absolute best care I possibly can to all of my patients, which focuses on their physiological as well as psychosocial needs. However, this can be increasingly difficult due to the high acuity level of patient assignments and nurse-patient ratios. According to Doucette (2016), nurses are being forced to “ration care” more and more lately, due to the overwhelming aforementioned factors. “Bedside rationing in nursing care refers to withholding or failure to carry out certain aspects of care because of limited resources such as time, staffing or skill mix” (Doucette, 2016). Unfortunately, rationing of care has been noted to result in increased patient falls, hospital acquired infections and low patient satisfaction levels (Doucette, 2016). Care rationing not only affects patients, but nurses as well, as nurses who feel they are expected to ration care, in order complete important tasks throughout their shift, experience low job and occupational satisfaction (Doucette, 2016). Nonetheless, nurses can combat the pressures to ration care at the bedside, by utilization of prioritization and

What are some examples of quality improvement projects that you have seen in your partnerships? How could (or have) these projects led to an improvement in patient care? It is critical for all nurses to understand the influence they have and their ability to advocate for change for themselves and their patients. In order to utilize their full potential, nurses must become involved in quality improvement, and lead the change they hope to see as leadership has been noted to be the foundation of quality care (Ekström & Idvall (2015). However, nurses often refrain from involvement in quality improvement projects and processes, due to their lack of comfort and familiarity with their roles. According to Tschannen, Aebersold, Kocan, Lundy and Potempa (2015), nurses’ lack of involvement in quality improvement processes is often partially due to their lack of exposure and involvement throughout their education. Tschannen, Aebersold, Kocan, Lundy and Potempa (2015), also found that incorporation of quality improvement processes within nursing curriculum improved nurses’ competency, leadership skills and ability to become involved with such projects. Therefore, in order to learn how to lead effectively, and act as active members in quality improvement processes and projects, nurses must be given tools and exposure early