Nursing Surveillance in the Nursing Home Setting

During the course of routine care, patients are exposed to a number of threats, including adverse events as well as technical errors. Nursing surveillance has been identified as one of effective intervention strategies to minimize adverse events while providing care to patients (Dresser, 2012). According to Henneman, Gawlinski, and Giuliano (2012), nursing surveillance can be effectively utilized to improve safety of patients in critical care units as well as acute care units. Apart from hospitals, nursing homes also provide comprehensive care to various groups of patients. The services provided include personal care, room and board, monitoring and medication, and recreational and social activities. Registered nurses provide skilled care in nursing homes. Given a wide range of services and patients that are cared for in nursing homes, nursing surveillance is also of great importance in this setting. This paper discusses importance of nursing surveillance in nursing homes and looks at how the concept can be applied in the nursing practice.

Definition of Nursing Surveillance

According to the nursing intervention classification, nursing surveillance "is the purposeful and ongoing acquisition, interpretation, and synthesis of patient data for clinical decision making" (Henneman et al., 2012). The term is sometimes used interchangeably with monitoring, but it should be noted that they differ significantly in terms of scope and purpose. Monitoring is an activity undertaken in the surveillance process and since it is one of the key activities, it cannot be used alone in carrying out surveillance effectively. Nursing surveillance has been utilized to a great extent in monitoring bedside safety of patients. Nursing surveillance in this case includes activities and processes such as interdisciplinary rounds, checklists, clinical decision support systems, and clinical information systems.

An important role that nurses play in achieving positive outcomes in the care of patients cannot be overlooked. In the nursing home setting, their presence means that well-being and safety of patients are ensured. They also respond to changes in conditions of different patients that nursing homes provide care to. They often collect information that helps them to analyze, interpret, and draw conclusions on how patients are fairing on. These activities are what nursing surveillance entails. In the nursing home setting, nurses have to monitor patients closely. They utilize surveillance to identify and respond to risks and threats that may negatively impact safety and well-being of patients. Clarke and Aiken (2003) describe nursing surveillance as a process that is hypothesized to enable patient outcomes to be forecasted. Nursing surveillance is multidimensional because it can be applied to various settings, including acute care, aged care, and general nursing care. Analyzing this concept is important for understanding of the nurses' role in patient outcomes.

Consequences of not Embedding Surveillance in Nursing Practice

Active collection of patient information is the main activity that nursing surveillance entails. This information is important in identifying threats and risks that patients are exposed to, as well as evaluating and acting on decisions that will improve general patient outcomes. In the nursing home setting, failure to incorporate nursing surveillance may result in a number of negative consequences, including increased risks and threats to which patients are exposed. Absence of nursing surveillance means that most patients will fail to take their medication as required, a factor that may lead to complications among patients. In addition to that, a failure to imbed nursing surveillance in nursing homes will make it hard for early detection and intervention of new complications among patients to be done. When new complications are not detected early enough, chances that a patient will fully recover are minimized. Absence of nursing surveillance also undermines physical safety of patients. It increases chances of patients in nursing care suffering from physical injuries as a result of the lack of proper structures and systems that enhance their physical well-being.

Nursing homes provide care to different types of patients. Some of these patients may be unstable, hence requiring constant monitoring and collection of information over a short period of time. A failure to implement nursing surveillance in such scenarios may make it hard for proper intervention practices and process to be identified and used. This in turn will worsen unstable conditions of such patients. Data collected during the nursing surveillance process is also important to decision makers within the nursing home setting. Absence of nursing surveillance will mean that the decisions made are not based on critical needs of patients. This would lead to bad decisions and eventually undermine services offered and general reputation of the nursing home.

Quick decision making is often required when providing care to patients. This occurs when a patient encounters a life threatening event or when his/her health condition worsens. Nursing surveillance makes it possible for care providers to identify short-term patterns in health conditions of each patient. This makes it possible for situational needs of different patients to be identified within a short period. Lack of this information may result in confusion as practitioners try to identify situational needs of patients. Lack of nursing surveillance makes it hard for care providers to respond accordingly to situational needs of patients.

Additionally, nursing surveillance makes it possible for individualized care to be provided. In the nursing home setting, individual needs of patients vary depending on their complications and ailments. Lack of nursing surveillance would undermine provision of individualized care, meaning that unique needs of each patient would not be catered for. In the nursing home setting, nurses care for multiple patients. Individual surveillance makes it possible for changes in the patient's condition to be quickly identified and acted upon. A failure to carry out nursing surveillance means that additional needs of patients, as well as changes in the conditions will not be identified. Additionally, it will make it impossible for referrals to be appropriately made, especially when patients' conditions worsen.

Importance of Surveillance to the Role of a Registered Nurse

Registered nurses play an important role in identifying errors and threats that put patients' safety at risk. They have to identify and correct medical as well as physical errors that undermine well-being of patients. Their primary role is to care for patients. This role requires constant monitoring of patients conditions' in order to find out how they are doing and whether their condition is improving or worsening. Registered nurses also play a crucial role in identifying new needs that may arise among patients. In this role, they have to collect information that will help them identify general patterns among different patients. It thus follows that nursing surveillance is important in ensuring that registered nurses are effective in their role. Rogers et al. (2008) point out that surveillance is particularly essential in the intensive care environment. Consequently, it allows nurses to correct drug errors in the environment where chances of potential and preventable adverse drug events occurring are twice higher than in non-ICU environments.

Nursing surveillance makes it possible for registered nurses to identify new complications that arise in patients. In addition to that, it ensures that patient records are accurate and that recommendations they make will not result in more harm to the patient. Apart from identifying medication errors, nursing surveillance enables nurses to discover other errors such as procedural errors, charting errors, and errors relating to equipment. Apart from that, it enhances their delivery of individualized care. Nurses have to attend to many patients, but surveillance makes it possible for them to have information about individual needs of each patient, thereby enhancing individualized care delivery. Surveillance also makes it possible for registered nurses to identify the most appropriate intervention strategies when conditions of patients worsen. Additionally, it enables them to make quick decisions in emergency situations.

How to Apply the Concept in My Practice Style

This paper has identified the critical role that nursing surveillance plays in the nursing home setting. Surveillance ensures that nursing practitioners are efficient and effective in their roles. It is thus important for all nurses to incorporate this concept in their practice. In my case, I would apply the concept in my practice style, ensuring that I am familiar with patients I have to attend to. Apart from their medical history and current medical condition, it would be important to know one or two more things about patients. This will help in boosting confidence patients have in me and enhancing our relationship, a fact that will enable collection of vital patient information.

In my practice style, it would be my duty to check frequently on patients to find out how they are fairing on. Having recorded information for each patient, I have to attend to them in order to ensure that their medication is appropriately monitored and that none of the patients is given wrong medication. In addition to that, frequent interaction with patients will ensure that I can identify their individual needs and cooperate with other practitioners and seniors to make sure that these needs are catered for. Apart from that, I will incorporate the concept in my practice style by ensuring that patients under my care are not exposed to objects that may physically harm them and that other forms of errors such as equipment errors are avoided.


Nursing surveillance is equally important in the nursing home setting and in hospitals. Nursing surveillance has been identified as one of the effective intervention strategies to minimize adverse events while providing care to patients. Nursing homes cater for different types of patients and surveillance makes it possible for individual needs of patients to be met. Nurses have to closely monitor patients in the nursing home setting, often collecting information that helps them analyze, interpret, and draw conclusions on how patients are fairing on. They utilize surveillance to identify and respond to risks and threats that may negatively impact safety and well-being of patients. A failure to imbed nursing surveillance in the nursing home setting may result in a failure to achieve positive outcomes in patients. It would expose patients to more threats and risks than before and at the same time undermine the role of nursing practitioners and reputation of the nursing home.


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