When the end of life makes its inevitable appearance, people should be able to expect reliable, humane, and effective caregiving. Yet too many dying people suffer unnecessarily. While an "overtreated" dying is feared, untreated pain or emotional abandonment are equally frightening. Approaching Death reflects a wide-ranging effort to understand what we know about care at the end of life, what we have yet to learn, and what we know but do not adequately apply. It seeks to build understanding of what constitutes good care for the dying and offers recommendations to decisionmakers that address specific barriers to achieving good care. This volume offers a profile of when, where, and how Americans die. It examines the dimensions of caring at the end of life: Determining diagnosis and prognosis and communicating these to patient and family. Establishing clinical and personal goals. Matching physical, psychological, spiritual, and practical care strategies to the patient's values and circumstances. Approaching Death considers the dying experience in hospitals, nursing homes, and other settings and the role of interdisciplinary teams and managed care. It offers perspectives on quality measurement and improvement, the role of practice guidelines, cost concerns, and legal issues such as assisted suicide. The book proposes how health professionals can become better prepared to care well for those who are dying and to understand that these are not patients for whom "nothing can be done."

"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/

First Edition named an AJN Book of the Year! ìJoanne Duffy makes a compelling argument in this book that relationships have been marginalized and no longer serve as the central organizing principle of health servicesÖThis book resonates with a virtual groundswell of findings regarding the importance of relationships for organizational performance and for human wellbeing.î -Jody Hoffer Gittell Professor of Management, Brandeis University This edition stresses the proven need for a return to the patient-centered care neglected through our health systemís emphasis on procedures, protocols, diagnostic testing, technology, and costs. It addresses the significant challenges to quality care posed by the upcoming changes in our health care system, and focuses on health systems, the role of nursing within them, and the interprofessional health team as the key to change ensuring high quality care. The book responds to the Patient Protection and Affordable Care Actís focus on accountable care organizations, the recent IOMís Future of Nursing Report, the call for radical transformation of nursing education, and current evidence on patient safety and quality of care. This text explores the Quality-Caring Model©, which honors nursingís most deeply felt value, and can be applied to clinical, educational, and leadership practice to advance our nationís health system. Among the bookís strengths are its translation of theoretical knowledge to practical applications that can be used for clinical interventions and resolution of professional issues. Chapters include key terms, case studies along with practical exercises and references, and ìCalls to Actionî offering inspiration and guidance for implementing change. New to the Second Edition: Focuses on current challenges to quality care posed by upcoming changes to our health system Addresses health systems, the interprofessional health team, and the role of nursing within them Combines theoretical foundations for practice with clinical, leadership, and educational applications Examines the powerful role of relationships in promoting nursing excellence, improving patient satisfaction, and patient outcomes Serves as a key guide for graduate nurse educators and students, nurse leaders, and hospital leadership seeking Magnet certification Incorporates recommendations of the Affordable Care Actís focus on accountable care organizations, the IOMís Future of Nursing Report, educational transformation, and current research on safety and quality of care

In a joint effort between the National Academy of Engineering and the Institute of Medicine, this books attempts to bridge the knowledge/awareness divide separating health care professionals from their potential partners in systems engineering and related disciplines. The goal of this partnership is to transform the U.S. health care sector from an underperforming conglomerate of independent entities (individual practitioners, small group practices, clinics, hospitals, pharmacies, community health centers et. al.) into a high performance "system" in which every participating unit recognizes its dependence and influence on every other unit. By providing both a framework and action plan for a systems approach to health care delivery based on a partnership between engineers and health care professionals, Building a Better Delivery System describes opportunities and challenges to harness the power of systems-engineering tools, information technologies and complementary knowledge in social sciences, cognitive sciences and business/management to advance the U.S. health care system.

"As in the first edition, the author has done a magnificent job compiling these instruments and providing important information that the reader can use to evaluate their usefulness." --Ora Lea Strickland, RN, PhD, FAAN (From the Foreword) This book provides all the essential research tools for assessing and measuring caring for those in the caring professions. Watson's text is the only comprehensive and accessible collection of instruments for care measurement in clinical and educational nursing research. The measurements address quality of care, patient, client, and nurse perceptions of caring, and caring behaviors, abilities, and efficacy. Newly updated, this edition also contains three new chapters, which document the most effective caring language and provide innovative methods of selecting appropriate tools for measurement based on validity and reliability. Key features of new edition: A chapter providing a comprehensive literature review of the research and measurement of caring A chapter entitled "Caring Factor Survey," which presents a new scale based on Watson's original theory of human caring Chapters outlining instruments for care measurement, including Holistic Caring Inventory, Peer Group Caring Interaction Scale, and many more New instruments focused on assessing caring at the administrative-relational caring level An updated section dedicated to challenges and future directions of the measurement of caring

Second in a series of publications from the Institute of Medicine's Quality of Health Care in America project Today's health care providers have more research findings and more technology available to them than ever before. Yet recent reports have raised serious doubts about the quality of health care in America. Crossing the Quality Chasm makes an urgent call for fundamental change to close the quality gap. This book recommends a sweeping redesign of the American health care system and provides overarching principles for specific direction for policymakers, health care leaders, clinicians, regulators, purchasers, and others. In this comprehensive volume the committee offers: A set of performance expectations for the 21st century health care system. A set of 10 new rules to guide patient-clinician relationships. A suggested organizing framework to better align the incentives inherent in payment and accountability with improvements in quality. Key steps to promote evidence-based practice and strengthen clinical information systems. Analyzing health care organizations as complex systems, Crossing the Quality Chasm also documents the causes of the quality gap, identifies current practices that impede quality care, and explores how systems approaches can be used to implement change.

"The authors' approach to creating a transforming culture through use of foundations laid in the theoretical development of "Nursing As Caring" offers a solid foundation upon which to recalibrate and reconfigure toward a caring organizational health system." -Tim Porter-O'Grady, DM, EdD, APRN, FAAN, FACCWS Associate Professor, Leadership Scholar, College of Nursing and Healthcare Innovation, Arizona State University Clinical Professor, Leadership Scholar, College of Nursing, The Ohio State University This is a time-tested, practical guide for nurses and other healthcare professionals who wish to transform their healthcare systems based on caring values and the promotion of intra- and inter-professional dialogue among stakeholders. It describes a theoretically grounded model created by nurses for transforming the culture of healthcare systems at all levels, and features tested strategies that facilitate accessibility, efficiency, effectiveness, and enhanced outcomes. At its most basic level, this model, the Dance of Caring Persons, expresses the fundamental beliefs and attitudes that each person in the healthcare system lives caring meaningfully in unique and valuable ways, and the contributions of each person to the whole of the enterprise have a significant place within it. The book features successful examples of how various units of the healthcare system can apply specific strategies to their inter- and intra-professional work, and how to engage and sustain authentic dialogue among and between stakeholders. Chapters feature information from a great variety of health professionals that represent a broad range of participants in healthcare. Detailed information is presented in a variety of formats ranging from formal written responses to chapter contents to transcriptions of small group conversations relating to the topic at hand. The book reflects the interests of such major stakeholders as patients and families, nurses, physicians and other primary and adjunctive care providers, ancillary service providers, administrators and managers, and all other individuals involved in the many aspects of organizational models and delivery of health care and human resource functions and outcomes. Each chapter includes questions to consider and suggested resources to help with implementation of strategies. The text incorporates professional standards and essentials from the Joint Commission, ANCC, and AACN (DNP). Key Features: Presents a theoretically grounded, proven caring-based model for healthcare system change for all stakeholders across the continuum of care Provides practical strategies for transformation in all aspects of a healthcare system applicable across the range of health services Describes how healthcare system change happens, who initiates it, and how to sustain it through caring science Includes success stories from patients and their families, nurses, physicians, ancillary service providers, healthcare administrators, and others Promotes inter- and intra-professional dialogue and collaboration