Patient Outcomes
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Introduction
This concept analysis identifies characteristics of patient outcomes and provides information and understanding to health care practitioners and researchers (McEwen & Wills, 2018). Patient outcome is outcome of medical care to patients. It is the measure used to determine the effectiveness of cost sensitive, quality health care (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014). In the concept analysis journal of patient outcomes by Ying Liu, Kay Coalson Avant, Yupin Aungsuroch, Xin-Yu Zhang, and Ping Jiang, they came to a conclusion that patient outcomes is influenced by various factors which include patient experience, maintenance of patient functional status, maintenance of patient safety and patient perception of satisfaction. It also states that medical staff, nurses, and nurse managers need to be aware of and monitor these factors within the field of nursing. Patient outcomes that depend on long term or outpatient care were not included in the analysis (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
The Method of Analysis
The method of analysis used was the Walker and Avant concept analysis approach (McEwen & Wills, 2018). In this concept analysis on patient outcomes, it was restricted to measurable variables between patient admission and patient discharge (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014). The Walker and Avant concept analysis has eight steps which include selecting a concept, determining the purpose of the analysis, identify the uses of the concept, identify the defining aspects of the concept, describing a model case, describing a borderline, identifying antecedents and consequences, and definition of empirical referents (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
The Steps of Process and the Results for Each Step
Selection of a concept
The concept selected by Ying Liu, Kay Coalson Avant, Yupin Aungsuroch, Xin-Yu Zhang, and Ping Jiang was patient outcomes in the field of nursing. Patient outcome was defined as measure of the effectiveness of cost sensitive, quality health care.
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Purpose of the analysis
To analyze the concept of patient outcomes to get rid of the lack of certainty around this concept and to produce clarity about patient outcomes so that health care practitioners have the same operational definition of the concept.
Use of the concept
Patient outcome is used to measure the provision of quality health care with minimal cost
Defining aspects of the concept
Patient functional status (maintained or improved)
This was actual performance of an activity and the level or degree of performance. Measures of functional status have been developed to ascertain disability levels by measuring performance and quantifying patient outcomes. Kaplan stated that functional outcomes are measures of how well patients can do the tasks required for everyday life (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Patient safety (maintained or unharmed)
This is the avoidance of injuries or damage to patients from care to treatment provided to heal them. Indicators used to measure patient safety include decubitus ulcer, patient falls, thirty-day mortality, and nosocomial infections (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Patient satisfaction (patient reporting of pleasure or contentment)
Patient satisfaction can be measured by patient opinion on how well nursing staff managed patient pain as determined by scaled responses to a uniform series of questions designed to obtain patient views regarding specific aspects of pain management. In addition, patient opinion of nursing staff regarding their condition and care requirements as determined by scaled responses to a uniform series of questions designed to obtain patient views regarding specific aspects of patient education activities. In addition, patient opinion of the care received from nursing staff during the hospital stay as determined by scaled responses to uniform series of questions designed to obtain patient views regarding satisfaction with key elements of nursing care services (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Description of a model case
Walker and Avant described a model case defining all attributes of the concept. A 56-year-old married male with a fifteen-year history of diabetes and a five-year history of hypertension was admitted to the cardiology department. Nurses executed several procedures in addition to the administration of medications to help the patient recover promptly. They kept the ward quiet so that the patient could rest well to reduce fatigue, used a massage mat to prevent decubitus ulcers, used a bedrail to prevent falls, controlled the patient’s diet and monitored his blood glucose level, they kept a watch on patient blood pressure, measuring it frequently and carefully (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
After two weeks of treatment and nursing care, the patient was discharged. Before his discharge, nurses evaluated his health status, well-being, and self-care abilities. He was given a passing grade on all of these tests. After discharge, nurses then reviewed the patient’s satisfaction questionnaire. They found that the patient was satisfied with nursing care, pain management, and educational information. The patient did not suffer from decubitus ulcers, patient falls, medical errors, or infections during his hospitalization (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
This model case illustrates the successful achievement of all attributes of the patient outcomes concept. First, nurses were able to evaluate the patient’s health status, well-being, and ability to perform self-care. Thus, patient functional status was maintained or improved. Second, the patient satisfaction questionnaire was returned with all responses marked as satisfied. Thus, patient satisfaction was achieved. Finally, there were no decubitus ulcers, patient falls, medical errors, or infections during the patient hospitalization and therefore patient safety was maintained (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Antecedents of patient outcomes
These events or incidents must occur prior to the occurrence of the concept. The antecedents were divided into patient factors, which include the patient social background, age, gender, condition and the degree of illness or injury. Provider factors, which include type of provider, technological factors, and discipline factors. System factors include location, resources, and organizational structure (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Consequences of patient outcomes
These are events that occur as a result of the occurrence of the concept. They include the impact of patient outcomes on cost of care, the results are essential in the measurement of quality health care, and outcomes are important to stakeholders (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Empirical referents
These are the occurrences in the real world that help the clinician diagnose the concept. These will be described in terms of patient functional status, patient safety, and patient satisfaction (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
Apply the Concept to a Practice Situation
The measurement and management of health care outcomes is important in the provision of quality health care and the discovering of new tools to measure and quantify components such as quality of health care and health care outcomes (Kim, 2015). The concept of patient outcomes can be applied through accountability in medicine, information regarding outcomes of care can play an important role in decision making for health care providers and patients. The methods provided can be used to reliably provide information and analysis of patient outcomes (Kim, 2015). Through this analysis, outcomes are measured and resources for outcomes are put into practice. If information is collected through the appropriate ways, the information can facilitate the decision making process and as a result can enhance the quality of health care (Kim, 2015).
Conclusion
The provision of good nursing care to all patients is important and the main goal in the nursing profession (Kim, 2015). Patient outcomes are the results of provision of health care services to patients. This analysis provides a new perspective by helping health care practitioners to understand all the components within the concept analysis of patient outcomes. Through the analysis, the concept of patient outcomes is made up of several components that are influenced by other factors and health care practitioners must be aware of these factors and be able to monitor them. Through the improvement of patient outcomes, there will be improved quality health care (Ying, Kay, Yupin, Xin-Yu, and Ping, 2014).
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References
Kim, H. S. (2015). The essence of nursing practice: Philosophy and perspective. New York : Springer Publishing Company.
McEwen, M., ; Wills, E. M. (2018). Theoretical basis for nursing. Philadelphia, PA: Wolters Kluwer/Lippincott Williams ; Wilkins.
Ying, L., Kay C. A., Yupin, A., Xin-Yu, Z., and Ping, J. (2014). International Journal of Nursing Sciences. Patient outcomes, 1, 69 -74.
