Literature review

The quality improvement opportunity chosen for the project is patient advocacy in hospitals. In nursing, there are times and instances when the nurses of the patients need to advocate for their patients (Nsiah, Siakwa & Ninnoni, 2019). According to studies, the lack of patient advocacy has detrimental implications. Moreover, patient advocacy tends to play an important role in hospital settings because it helps in improving the quality of the healthcare system (Choi, 2015). Additionally, it is directly related to the competencies of QSEN which states that the overall goal of QSEN is to meet the challenges regarding preparing the upcoming nurses who will have skills, knowledge, and attitude to improve the safety and quality of the hospital settings within which they work (Hunt, 2012). The paper will discuss patient advocacy in clinical settings as well as the guidelines for patient advocacy and how such guidelines contribute to better patient outcomes. It will also focus on providing recommendations for nursing practice or nursing education.

According to the literature of Nsiah et al, (2019), Advocacy is a notion that has been extensively accepted in fields other than nursing. For example, the legal firm defines advocacy as arguing a client’s case in court, whereas supporting and safeguarding the interests and freedom of the ordinary person in a community entail advocating in legislation. Advocacy in healthcare in the clinical arena, as per the researchers, is distinct from other professions in that it aims to give one’s whole (the nurse) to a person (the patient). Within a clinical environment, patient advocacy emphasizes health issues, healthcare systems, needs of the patient, as well as public needs. Nevertheless, the research varies in its view of what nurses consider to be advocacy. Patient advocacy within the hospital setting is defined by Abbaszadeh, Borhani, and MotamedJahromi (2019) as an activity made to achieve objectives on account of oneself or patients. MotamedJahromi, Abbaszadeh, Borhani, and Zaher (2019), on either hand, saw advocacy as a fundamental concept within the healthcare profession. MotamedJahromi et al. (2019) went on to say that the notion of advocacy is ingrained in nursing practice. As a result, nurses’ ethical code requires them to intervene in favor of patients in moral dilemmas in the therapeutic setting. To define the notions of advocacy within a therapeutic setting, Bu and Jezewski (2019) came up with three essential features. These qualities included protecting patients’ rights, acting on their behalf, and advocating for social equality in the delivery of healthcare services. These characteristics support the idea that advocacy improves patient safety as well as the quality of care (Nsiah, Siakwa & Ninnoni, 2019).

Advocacy in healthcare

According to another study by Water, et al (2016), patient advocacy had already become an integral part of nursing practice over the last 4 decades. Advocacy actions are implicitly and explicitly included in the standards of conduct as well as ethics of healthcare governmental and academic organizations. The International Council of Nurses (ICN) considers advocacy to be critical to nurses’ commitment to the building of strong and determined medical systems, and thus to the achievement of the Un Sustainable Development Goals (SDG). Nurses must speak for the people they serve, particularly those who are most disadvantaged as well as at-risk; fight for the establishment of a positive nursing profession; as well as participate in the formulation of legislation that promotes SDG 3: guaranteeing productive lives as well as encouraging well-being for everyone. Other areas in which advocacy is important to include pain treatment, cultural sensitivity, psychological health, end-of-life treatment, as well as patient participation. Nurses are taught the significance of serving as a patient advocate as an element of their nursing curriculum, and research shows that several nurses consider patient advocacy to be one of their key responsibilities.

In support of this, the study in regards to the textbook given by Hughes, et al (2021), states that working for the patients’ advocacy is an ethical responsibility. According to the writers, having an ethical responsibility entail being obligated to engage as an advocate. This is not a choice. The American Nurses Association’s (ANA) Code of Ethics (2001) outlines ethical responsibilities that stem from nursing’s concept of its social responsibility. Advocacy comes from the Latin term advocatus, which means “one who is called to assist another.” The word “advocate” can be used as both a verb and a noun. An individual who talks on behalf of another or acts as an intermediary is known as an advocate; to endorse is to write and speak for others or a purpose. The term “advocacy” is a noun that is employed in current literature to denote the activity of advocating for a cause. Mallik (1997) looked at the nursing curriculum on advocacy and came up with the following themes: Nursing has a long history of advocacy; clinicians are in the ideal condition on the health professionals to advocate; staff knows how to endorse, and nursing staff may work together to advocate. Recognize that other members of the medical team are indeed advocates for the patients, so working together can help to ease the strain. Furthermore, the American Nurses Association (ANA) has a code of ethics that instructs nurses to fight for their clients and serve as a clinical practice guideline for them. “A brief description of the moral obligations as well as responsibilities of every person who embraces the nursing profession,” according to the Code of Ethics for Nurses (p. 5). The code contains 9 provisions, the third of which deals with advocacy. “The nurse encourages, fights for, and works to defend the patient’s condition, safety, as well as rights,” it says (p. 12). Nurses are encouraged to advocate towards an atmosphere that allows for physical as well as sound privacy while addressing personal matters in the explanatory comments for this third clause. Other difficulties addressed in the regulation include maintaining client privacy and safeguarding study participants. This section also outlines the nurse’s responsibilities for implementing and maintaining professional nursing standards of practice. Many of the interpretation assertions in the other eight provisions imply advocacy.

Advocacy in nursing practice

After going through the research, it has been found from the American Nurses Association that the nurses in their code of ethics tend to promote, protect and advocate the rights, safety, and health of the patients. However, for future nurses, it can be recommended that they can educate the patients by teaching them about their injury, condition, or illness including the setbacks or any improvement along with how to manage them. The two main recommendations for the education of Registered nurses include:

• Educating the patient: Teach the client regarding their injury, disease, or condition, as well as any progress or setbacks, including how to deal with them. When discussing sophisticated medical terms, use simple language as well as ask the client if they have any questions once you are completed. The greater a patient comprehends the better equipped they are to advocate for themselves (Temkin, et al, 2022).
• Double-checking the documentation: By being meticulous with all paperwork, documentation, recordkeeping, as well as for instructions, nurses may advocate for patients. For avoiding any errors, conflicting instructions, misinformation, or omissions, review all prescriptions thoroughly as well as double-check with physicians, doctors, pharmacists, as well as other medical workers. If the issue is found early enough, it may not be a major problem (Abbasinia, Ahmadi & Kazemnejad, 2020).

Conclusion

From the above paper, it can be concluded that patient advocacy in hospital settings is known to be an important element. It was observed that nurses tend to support the best interests of the patients while respecting the role of the family. They work as patient advocates by attending a team meeting of healthcare along with the patient and family to clarify any problems related to communication and further ensure the information from the healthcare team is correct and complete. It was observed that various authors have different views of the issue of patient advocacy. Moreover, there exist various codes of ethics that work as clinical guidelines for the practice of nurses. The paper concluded by raising various recommendations for the registered nurses to practice patient advocacy in an efficient manner which included educating the patient and double-checking the documentation.

References

Abbasinia, M., Ahmadi, F., & Kazemnejad, A. (2020). Patient advocacy in nursing: A concept analysis. Nursing ethics, 27(1), 141-151.

Choi, P. P. (2015). Patient advocacy: the role of the nurse. Nursing Standard (2014+), 29(41), 52.

Hughes, R. M., Vadas Jr, R. L., Michael Jr, J. H., Law, B. E., Knutson Jr, A. C., DellaSala, D. A., … & Beecher, H. (2021). Why advocate—and how?. In Conservation Science and Advocacy for a Planet in Peril (pp. 177-197). Elsevier.

Hunt, D. (2012). QSEN competencies: A bridge to practice. Nursing made incredibly easy, 10(5), 1-3.

Nsiah, C., Siakwa, M., & Ninnoni, J. (2019). Registered Nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124-1132. https://doi.org/10.1002/nop2.307

Nsiah, C., Siakwa, M., & Ninnoni, J. P. (2019). Registered nurses’ description of patient advocacy in the clinical setting. Nursing Open, 6(3), 1124-1132.

Temkin, S. M., Smeltzer, M. P., Dawkins, M. D., Boehmer, L. M., Senter, L., Black, D. R., … & Thaker, P. H. (2022). Improving the quality of care for patients with advanced epithelial ovarian cancer: Program components, implementation barriers, and recommendations. Cancer, 128(4), 654-664.

Water, T., Ford, K., Spence, D., & Rasmussen, S. (2016). Patient advocacy by nurses – past, present and future. Contemporary Nurse, 52(6), 696-709. https://doi.org/10.1080/10376178.2016.1235981