The U.S. and other highly advanced countries have long recognized that nursing quality is of enormous importance to outcomes. But it may be even more important in Chile, where patients in rural areas may not get to see a physician at all, instead depending entirely on nurses for their care. That means nursing education is a critical component of healthcare improvement in the region.
One Chilean hospital is trying to create a model for how to raise the education level of nurses. Clínica Universidad de los Andes — a 100-bed hospital with plans to expand to 300 beds — is subsidizing the cost of advanced education for its nurses. The goals of the initiative are to increase the number of Master’s-level nurse coordinators, get nurses in specialty units to achieve formal certification, and improve nurses’ knowledge of quality assurance and evidence-based practices. “Nursing education not only improves quality of care but also nursing job satisfaction and retention,” says Marta Simonetti, who formerly served as chief nurse at the hospital. Simonetti is now a fellow and PhD candidate at the University of Pennsylvania’s School of Nursing — but she is currently in Chile, working on a study of how nursing investments improve healthcare outcomes.
Unfortunately, other hospitals in Chile might struggle to duplicate Clínica Universidad de los Andes’ program. The hospital is a private institution with greater resources than most of the public institutions that dominate healthcare in the country. “There’s a big, big gap,” says Ana Isabel Larraín, director of care and patient services at the hospital.
Education isn’t the only aspect of nursing that needs addressing in Chile and much of Latin America. Clínica Santa Isabel offers its nurses interest-free loans of up to US$616 (2,000 soles) to pay for education and degrees, and throws in raises and bonuses to nurses who complete programs. But nurses also need more sway in administrative decision-making, insists Miguel Ramirez, chief executive officer of Clínica Santa Isabel, a women’s and children’s healthcare facility, in Lima, Peru. He says his hospital made strides in that regard when it went through a demanding accreditation process with the global arm of the U.S.-based Accreditation Association for Ambulatory Health Care — only the second hospital in Peru to receive that accreditation. “When you start the accreditation process, you need to know what’s happening on the floors, and you’re not going to get that information from the physicians,” he says. “It’s the nurses.” Now the hospital has placed a nurse in charge of quality.
Bringing that sort of recognition of the critical role of nursing to more hospitals in Latin America is an important step to improving healthcare systems there, argues Clínica Universidad de los Andes’ Larraín. “We have to convince administrators that what we do makes a big difference in patient results,” she says. “We’re just becoming aware of that here.”
— Megan Margulies
Megan Margulies is a freelance writer based in Newton, Massachusetts.