Ambulatory Care Nurse-Sensitive Indicators Series: Patient Engagement as a Nurse-Sensitive Indicator in Ambulatory Care

By Esposito, Eileen M.; Rhodes, Catherine A. et al. | Nursing Economics, November/December 2016 | Go to article overview

Ambulatory Care Nurse-Sensitive Indicators Series: Patient Engagement as a Nurse-Sensitive Indicator in Ambulatory Care


Esposito, Eileen M., Rhodes, Catherine A., Besthoff, Catherine M., Bonuel, Nena, Nursing Economics


THE AMERICAN ACADEMY of Ambulatory Care Nursing (AAACN) convened a task force to research, recommend, and/or develop ambulatory care nurse-sensitive indicators (NSI). A group was assembled to examine and develop a patient engagement NSI. Work was done to understand the intricacies of patient engagement as a core value in nursing interactions. Under the Centers for Medicare & Medicaid Services meaningful use electronic medical record program, patient engagement is associated with the utilization of electronic portals for communication with providers (Blumenthal & Tavenner, 2010). Patient engagement measured in this way reflects the percentage of people who communicate with their providers using electronic means but does not represent the patient?s engagement in their care, treatment plans, or goal setting activities (Irizarry, DeVito Dabbs, & Curran, 2015). Patient engagement is an increasingly important part of a national strategy to improve health outcomes and enhance health care quality. It is acknowledged as a key component of accountable health care as the United States health delivery system transforms to a more patient-centered approach capable of responding to patient and family needs and preferences (Carman et al., 2013). According to the Institute of Medicine (2014), patient engagement through shared decision making is linked to increased patient satisfaction, better health outcomes, and quality of decisions.

It is proposed patient engagement is a nurse-sensitive indicator given registered nurses? (RN) pivotal role in eliciting discussions with the patient and family on goals of care followed by carefully planned execution of interventions designed to increase patients? involvement in their care, creation of self-determined goals, and other detailed engagement behaviors. This column is part of a series which addresses ambulatory care NSI and proposes patient engagement as one of those measures initially identified in the AAACN Industry Report (Start, Matlock, & Mastal, 2016).

Patient Engagement

Patient engagement, inclusive of not only the patient but family/significant other(s), has been demonstrated to improve health outcomes through activation of patients? desires to become increasingly involved in their health and health care, serve as partners and decision makers in their plan of care, and become authors of self-determined goals (Hibbard & Greene, 2013; Hibbard & Mahoney, 2010). Patients who determine how they will meet the needed steps to achieve improved health outcomes are more likely to actualize those goals (Hibbard & Greene, 2013).

Patient activation is a key factor in achieving patient engagement and the term patient activation is often used interchangeably with patient engagement in the literature. Patient activation relies on self-efficacy principles and encompasses the degree to which patients are motivated and possess the skill set, knowledge, and confidence to effectively manage their health and health care (Hibbard, Stockard, Mahoney, & Tusler, 2004). The underlying construct of patient activation includes an individual's (patient, family member, significant other, etc.) self-belief and perception of self, and is associated with individual health management (Hibbard & Mahoney, 2010). These characteristics are evident in Nola Pender's mid-range nursing theory of health promotion, which incorporates the Health Promotion Model. This model outlines how an individual's behaviors and experiences influence his or her health outcome. The model draws on the work of Bandura and other social cognitive theorists who identify that people are likely to invest time and effort into goals they value and believe they can attain (Bandura, 1977; Pender, Murdaugh, & Parsons, 2015). Behavioral outcomes include the individual's commitment to a plan of action, which ultimately leads to health-promoting behaviors.

Patient engagement involves active participation by individuals in their health and health care, and can be observed as a set of behaviors by patients, family members, and health professionals working in active partnership guided by a set of organizational policies and procedures that foster collaborative partnerships with providers and provider organizations (Carman et al. …

The rest of this article is only available to active members of Questia

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

(Einhorn 25)

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Note: primary sources have slightly different requirements for citation. Please see these guidelines for more information.

Cited article

Ambulatory Care Nurse-Sensitive Indicators Series: Patient Engagement as a Nurse-Sensitive Indicator in Ambulatory Care
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen
Items saved from this article
  • Highlights & Notes
  • Citations
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Buy instant access to cite pages or passages in MLA 8, MLA 7, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    Buy instant access to save your work.

    Already a member? Log in now.

    Search by... Author
    Show... All Results Primary Sources Peer-reviewed

    Oops!

    An unknown error has occurred. Please click the button below to reload the page. If the problem persists, please try again in a little while.