Insight, The Journal of ASORN ASORN Insight 2018 Q3 - Page 6

4 VI E W POI N T Spotlight on Ambulatory Care – Opportunities for Ophthalmic Nurses these were eye operations (Hall, Schwartz- populations and individuals (AAACN, 2017). the health care landscape that impact oph- man, Zhang, & Liu, 2017). During this same Nurses, including ophthalmic nurses, must thalmic nurses, especially those in ambula- year, approximately 55 million visits were also partake in meaningful development, tory care. These include payment reform made to office-based ophthalmologists for utilization, and benchmarking of ambulatory and a shift toward value, the digital transfor- a variety of acute, chronic, and preventive care nurse sensitive data to quantify their mation and ever-growing use of technol- ophthalmic care needs (Centers for Disease value. A summary report, with exemplars, ogy, an increasingly aged and diverse Control, 2010). These are among sites outlines some of the important ambulatory population, and health care delivery that is and opportunities for ophthalmic nursing care nurse sensitive structure, process, moving from hospitals to the ambulatory practice leadership and innovation. and outcome measures (Start, Matlock, ENORMOUS CHANGES ARE OCCURRING in care environment. While there is evidence of nurse value in the acute care settings, there is a paucity of metrics for ambulatory care nurse sensitive measurement (Mastal, Matlock & Start, 2016). Among the public there is continually high trust of nurses yet many don’t understand what nurses do (Buresh & Gordon, 2013). For ophthalmic nurses specifically, clinicians and nurses of other specialties don’t fully understand ophthalmic nursing practice (Marsden, 2014; Clouse, 2015). Without a clear understanding of the scope, capabilities, and outcomes of registered nurses work, their role and value in innovative future care models will be limited. In their call-to-action report, the National Academies of Sciences, Engineering, and Medicine (2016) describe the critical impact eyesight has on individual’s health and well-being in daily communication, data exist on the number of people affected practice to the full extent of their educa- by all causes of vision issues but estimate tion and training, and to be full partners 6.42 million have uncorrectable impairment. with physicians in the re-designing health The consequences of vision impairment in care in the United States. Despite the trend adults include falls, injuries, social isolation, toward ambulatory care, the RN work- depression and impacts to other chronic force has declined in the ambulatory care conditions while children experience devel- opmental, social and education challenges. and enhancement of the health and func- ambulatory care (Bureau of Labor Statistics, tioning of those with vision impairments are 2016). Ambulatory care nursing is a com- among report recommendations. Ophthal- plex and multifaceted specialty of nurses mic RNs in the outpatient arena often serve who work independently and collaboratively as the primary contact with and advocate in the design and provision of care across for patients, families and communities and multiple settings that include clinics, offices, can bring great value in these areas. performed in the United States and 16% of ASORN INSIGHT Summer 2018 continued on page 36 Public awareness to the importance of tion of problems and access to quality care, million ambulatory surgery procedures were outcomes, and readmissions. Nursing report (2010) called for nurses to the United States. Of these, 18% work in Nursing [AAACN], 2017). In 2010, 48.3 certification), ambulatory surgery adverse The Institute of Medicine (IOM) Future of serve as the foundation of health care in (American Academy of Ambulatory Care follow-up, RN demographics (degrees and independence. They indicate no reliable good eye and vision health, early identifica- service environments, and patients’ homes staffing and skill mix, pain assessment and education, employment, and personal Over 3 million registered nurses (RNs) ambulatory care surgery centers, telehealth & Mastal, 2016). Metric examples include Implications for ambulatory care nurses, such as ophthalmic nurses practicing in the outpatient arena, include the need for lead- ers to understand ambulatory care nursing, support top of license nurse practice, and ensure effective, safe, and efficient care for Kathleen Mertens, DNP, MPH, RN