Rx for Health Care: Nursing as a Force for Change

Already the shortage of primary care physicians is being felt, an outcome of greater demand for services by an aging population. To help fill that gap, the role of the nurse practitioner will continue to expand. Recruiting, training and then retaining enough nurses will be crucial.
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May 12, the anniversary of Florence Nightingale's birth, is celebrated around the world as International Nurses Day. According to the International Council of Nurses, this year's theme is "Nurses: A Force for Change."

Florence Nightingale found her calling by revolutionizing nursing care of wounded soldiers during the Crimean War of 1854. She dedicated her life to campaigning for change in hospital sanitation and medical care in general, making her a force for change by anyone's measure. Her book Notes on Nursing, published 155 years ago, continues to be the gold standard on nursing care for the profession.

It's a particularly timely topic given the rapidly changing health care system in the U.S. and the more than 7 million newly insured Americans. As our global population starts to age, health care as a business is growing rapidly. The rise of local clinics offering ambulatory services and new models of care, such as medical homes, is an outcome of greater demand for services by an aging population. Already the shortage of primary care physicians is being felt.

To help fill that gap, the role of the nurse practitioner will continue to expand. Recruiting, training and then retaining enough nurses will be crucial. Programs such as the Nurse Faculty Leadership Academy, a 22-month program from Sigma Theta Tau, the Nursing Honor Society, encourages nurses to remain in the profession and lead others to do the same.

Investing in continuing education for nurses is also vital if we are to ensure that they continue to provide the best patient care possible. One important facet is leveraging the tools to manage the millions of pages and terabytes of the most current research available. More importantly, health and medical professionals need their information "in the workflow" -- that is, in the most convenient, easily accessible way that improves but doesn't interfere with the ongoing treatment of the patient.

But information is one thing. Using it to its best advantage is quite another. More importantly, being able to trust the source of information is vital. Search engines are adequate enough for the casual self-diagnosis, but they fall short of the sophisticated interdisciplinary knowledge of treatments and equally sophisticated processes required to ensure quality care. There are thousands of journals publishing new research papers every day; Elsevier alone publishes about 2,200 journals! New drugs are approved while old ones are discontinued. Studies on new drug discoveries, possible interactions and new uses for existing drugs are regularly announced. And because illness and acute care does not adhere to a standard 9-to-5 workday, clinicians need access 24/7 to the very latest data.

Medical information comes in many forms: journal articles, textbook chapters and images, video demonstrations of procedures, monographs on new medications, and even the personal notes of physicians who want to pass along their firsthand experience. It is vital that content infrastructures be developed that are integrated with the advanced technologies that hospitals and providers are already using, including customized taxonomies and search algorithms, to harness all that data and make it available at the point of care -- when patients are ill and in pain and the clock is ticking.

Misdiagnosis and other errors are a cost that go right to the heart of the health care business model, but it's not just about money. In addition to the prospect of patient complications, the long-term reputation of the health care professionals and the institutions that they represent are also at stake. Patients are unique individuals with mitigating factors that can affect treatments such as allergies, family history, preexisting conditions and medication regimens. As front-line health care professionals, nurses need to be able to assist with patient diagnosis and treatment based on the most current data. With the deluge of information available, providing all of this in a user-friendly format that can be accessed on a variety of devices -- smartphones, laptops and tablets -- is fundamental to driving efficient workflows, improving quality and reducing the costs associated with risk and errors.

While every business model has to weigh cost against deliverables, in health care the equation can have serious long-term implications. Measured against the increasing cost of providing the very finest patient care possible is the worth of the "healthy patient" outcome. This matters not only to the individual but to society as a whole when you consider the value of a healthy population with the capacity for long-term productivity.

The debate over how best to provide health care is not just limited to the national conversation in the United States. Many European systems are also facing the same pressures, especially in those countries with aging populations, and it's not just about what pills to take or what operations to have. Ensuring that nurses and other medical professionals manage information to help them work smarter and more cost effectively through access to cutting-edge data will be an essential component in improving patient care and the greater societal benefit of a healthier world.

Florence Nightingale campaigned tirelessly for health care reform that we benefit from today. We at Elsevier salute the dedication of today's nursing professionals and the force for change started by the "lady with the lamp."

Jay Katzen, President of Elsevier Clinical Solutions, contributed to this blog post.

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