skills and expertise at representing their specialty, letting those in the specialty organization know of topical expertise.
Engage in leadership roles within their preferred professional national nursing association.
Actively participate on Expert Panels and Committees of the American Academy of Nursing and the American Nurses Association (ANA).
Attend the national Hill day sponsored by ANA or another professional association.
Take action to contact members of Congress or senators regarding passage of bills that affect their state and community.
Share stories with their representatives that highlight the need for changes in health care.
Work with their institutions to invite a member of Congress or senator to walk a day in the shoes of a nurse, in order to better understand the challenges of short staffing, limited resources, or other needs of the community.
Summary
The improvement of nursing and health care quality is the responsibility of every nurse. It can and needs to occur at every level, from the direct one‐on‐one interaction with a patient or family to the advocacy for changes in rules or regulations at every level of government, within an institution or in the local community. It takes many forms, but at its most basic level, it requires being unwilling to accept the status quo, and taking the risk to challenge practice behavior. It requires moral courage to stand up to nursing peers or physician colleagues and dissent when something begins to occur that violates basic principles of quality and safety. Even though many are working on the national level to effect policy change, at the end of the day all health care is local. It comes back to the individual nurse providing care and living in a community to articulate when a policy is being crafted, and how its implementation will improve or hinder quality of care or the safety of patients. It comes back to each nurse understanding the intent of that policy and implementing it on behalf of patients. Only then, when every patient of every race and ethnicity and gender is provided the same care we would want for our parent, or sister, or best friend, or child, will high‐quality health care be achieved.
References
1 Blumenthal, D., Abrams, M., and Nuzum, R. (2015) The Affordable Care Act at 5 Years. New England Journal of Medicine, 372, 2451–2458.
2 Cronenwett, L., Sherwood, G., Barnsteiner, J., et al. (2007) Quality and safety education for nurses. Nursing Outlook, 55(3), 122–131.
3 Cronenwett, L., Sherwood, G., Pohl, J., et al. (2009) Quality and safety education for advanced practice nursing practice. Nursing Outlook, 57(6), 338–348.
4 Deming, W.E. (1986) Out of the Crisis. Cambridge, MA: MIT Press.
5 Institute for Healthcare Improvement. (2020) Safer Together: A National Action Plan to Advance Patient Safety. Retrieved June 18, 2021 from http://www.ihi.org/Engage/Initiatives/National‐Steering‐Committee‐Patient‐Safety/Pages/default.aspx.
6 Institute of Medicine. (2000) To Err Is Human: Building a Safer Health System. Washington, DC: National Academies Press.
7 Institute of Medicine. (2001) Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academies Press.
8 Juran, J.M. (1998) Juran’s Quality Handbook. New York: McGraw‐Hill.
9 Kingdon, J.W. (2003) Agendas, Alternatives and Public Policies, 2nd Ed. New York: Addison‐Wesley.
10 Long, S., Karpman, M., Shartzer, A., et al. (2014) Taking Stock: Health Insurance Coverage under the Affordable Care Act as of September 2014. Washington, DC: Urban Institute.
11 Montalvo, I., and Dunton, N. (2007) Transforming Nursing Data into Quality Care: Profiles of Quality Improvement in US Healthcare Facilities. Silver Spring, MD: Nursebooks.org.
12 Planetree International (2020). Guidelines for Increasing Family Presence in Challenging Times. 2000 Retrieved 1.8.21 from: https://planetree.org/wp‐content/uploads/2020/08/Planetree‐Gold‐Statement‐on‐Preserving‐Family‐Presence‐During‐a‐Pandemic.pdf
13 Simon, H. (1966) Political research: the decision‐making framework. In D. Easton (Ed.), Varieties of Political Theory. Englewood Cliffs, NJ: Prentice‐Hall, 19.
14 Sofaer, S., and Schumann, M.J. (2013) Nursing’s Critical Role in Fostering Patient and Family Engagement. White Paper. Silver Spring, MD: Nursing Alliance for Quality Care.
15 Stone, D. (2012) Policy Paradox, 3rd Ed. New York: W.W. Norton.
Resources
1 Centers for Medicare and Medicaid Services: www.cms.gov
2 Hospital Quality Alliance: www.hospitalqualityalliance.org
3 Institute for Healthcare Improvement: www.ihi.org
4 National Database of Nursing Quality Indicators: https://www.pressganey.com/solutions/clinical‐excellence
5 National Governors Association: www.nga.org
6 National Partnership for Women & Families: www.nationalpartnership.org
7 National Priorities Partnership: www.nationalprioritiespartnership.org
8 National Quality Forum: www.qualityforum.org
9 National Quality Partners: http://www.qualityforum.org/National_Quality_Partners.aspx
10 Patient and Family Centered Care Partners: https://pfccpartners.com
11 Project Patient Care: www.projectpatientcare.org
12 Stand for Quality in Health Care: www.standforquality.org
3 A National Initiative: Quality and Safety Education for Nurses
Linda R. Cronenwett, PhD, RN, FAAN, and Jane Barnsteiner, PhD, RN, FAAN
As
