Balancing Act: The Vital Role of Nursing and Compliance in Healthcare

Brandy Horton, MSN, MBA
August 7, 2023 by
Simplifyance, Gina Thorne

I could never have imagined in my early years of nursing education that I would be responsible for compliance!!!  That was someone else’s job, all I had to do was take care of the patients.  Well as I look back in my career, every interaction I had with a patient, client, and/or health care organization had a direct correlation to compliance, I just did not always “see” the connection.

 When you say the words, compliance, regulations, requirements, nurses often say, all I want to do is take care of the patients, why do I have to worry about all this other stuff.  If only it was that simple!

 Compliance has many varying definitions depending on the arena you are working in.

 The ability of an object to yield elastically when a force is applied.”

“A disposition to yield to others.”

“The act or process of complying to a desire, demand, proposal, or regimen or to coercion.”

Healthcare compliance can be defined as, “Compliance is the practice of adhering to federal healthcare laws and regulations. Compliance laws are intended to help protect patients, safeguard sensitive information and help mitigate and prevent fraud, abuse and waste in the healthcare industry”.

Sounds so formal, however if you think about what a nurse is responsible for, you see compliance in many of their interactions with patients and organizations.

 Such things as:

  • The patient’s ability to follow the plan of care (medications, orders)
  • Billing rules (coding of the record as it relates to the nursing care)
  • Documentation
  • Following policies and procedures
  • State licensing requirements
  • Accreditation Rules, The Joint Commission Survey

We as nurses are always being faced with questions related to compliance:

  • Was the patient compliant in taking his/her meds?
  • Did the patient comply with the orders the doctor sent home with him/her?
  • Did the corporation comply with the standards of the accreditation body (meds being reconciled as an example)?
  • Was there a signed order?
  • Did you submit the documentation timely?

The list could go on and on…

Ultimately, healthcare compliance is about providing safe, high-quality patient care. Complying with industry standards and regulations helps healthcare organizations continue to improve the quality of care.

While it may not always be the nurse’s objective of the day (compliance), providing safe, quality patient care is always a nurse’s objective, hence maintaining compliance.

Author: 

Brandy Horton, MSN, MBA