Needs Assessment and Target Market

Nurses are the heart of the healthcare system. In virtually every care setting, it is the nurse who provides the care and compassion that a patient and family needs. This vital role is even more important in the challenges of the modern managed care environment of the twenty-first century. Perhaps the most pressing foundational challenge is functioning as a patient advocate. Advocacy–holding the patient’s best interests, upholding patient rights, and assuring patient understanding of their health and plan of care–is vital to the professional nurse’s role.

Numerous ethical practice dilemmas confront nurses today. The complex healthcare climate poses challenges for staff nurses, managers, supervisors, case managers, advanced practice nurse practitioners, and other nursing roles. Several factors and trends that impact nursing practice and patient care also lead to an environment ripe for ethical challenges and questions about ethical choices.

Significant trends today include:

·        The impact of managed care systems

·        Changing models of care delivery, and staffing issues

·        An aging society and resultant healthcare issues

·        Cultural shifts and challenges in patient-focused care

·        A more well-informed patient and family, in part due to the World Wide Web and other media

·        Increased consumer use of complementary and alternative medical therapies, and the medical communities’ response to this trend 

A discussion of patient advocacy and ethical challenges must include discussion of standards of nursing practice, the underpinnings of the nursing profession’s accountability and responsibility to patients. The trends previously mentioned also impact the importance of professional practice standards. The added twist is the ongoing focus upon defining healthcare practice (nursing, medical, and other providers of care) in a measurable way, and to articulate how these roles and practices contribute to patient outcomes.  

Healthcare providers are seeking to define outcomes of care, as are federal, state, and private healthcare agencies. Leaders within the nursing profession continue to monitor the changes and trends in both the external environment and the healthcare scene, to analyze the need to revise existing practice standards or to develop new ones. Standards of ethical nursing practice are defined by the American Nurses’ Association for the general nursing population, as are standards of ethical practice for advanced practice nurses such as case managers.  

Course Objectives

 Upon completion of this home-study course, you will be able to:

 Contents

This course introduces the essence of patient advocacy today as applied to important patient choices such as: patient's right to privacy, protection from abuse and other safety issues such as healthcare errors, end of life decisions, complementary and alternative medical therapy choices; and issues in healthcare such as healthcare fraud, and ethical nursing practice related to each of these topics.

The course is presented in seven chapters that discuss patient advocacy and patient choice concerns important in modern healthcare. The text begins with an overview of ethical nursing practice and patient advocacy within the underlying framework of professional practice standards and the ANA Code of Ethics. In addition, the nurse is given the opportunity to review and analyze the basis of ethical decision-making in healthcare. The seven chapters are presented as listed below.

Unique Features to Facilitate Learning

Key Questions 

Within each chapter key questions are presented to spur further thought and analysis for nursing practice implications. These key questions are suggested as tools for individual learning and thought, as well as tools for group discussion in work or academic settings.

 Patient Case Scenarios 

In addition, patient case scenarios pertinent to the ethical topic discussed, are included within the chapters to provide opportunity to apply the concepts and issues presented. Within any learning context, it is vital to integrate application of learned concepts to better enhance taking the knowledge and skills with you to your professional role. 

Links and Resources

To encourage ongoing learning and competency in patient advocacy and ethical nursing practice, the author has provided links to Web sites and other media. These resources are intended to keep the nurse current in ethical issues, ethical nursing practice, and patient advocacy.

About the Author

Cynthia A. Parkman, RN, PHN, MSN is an instructor at California State University in Sacramento, where she teaches nursing leadership and management, managed care, and case management. She is also co-developer and faculty in the first Case Management Certificate Program for CSU’s Regional & Continuing Education which began January 2000. She has 20 years experience in nursing and publishing, and is also a healthcare consultant for State of California health projects, case management, alternative therapies, and legal and ethical issues.  She is a member of the American Nurses’ Association, the Case Management Society of America, the American Holistic Nurses' Association, and Sigma Theta Tau International.  Ms. Parkman is also listed in many  "Who’s Who” biographies since the 1990s.