Identification of Safety Changes
I experienced circumstances where the quality of health care services and patients’ safety was substantially compromised by the healthcare professionals in the clinical setting. Indeed, elevated workload, reduced nurse-to-patient ratio, and interprofessional conflicts between the healthcare teams resulted in situations that not only deteriorated the healthcare environment but also compromised the safety and wellness of the treated patients across the treatment environment. Missed referrals, incomplete lab analysis, and cancellation of pre-scheduled surgeries include some of the significant events that delayed treatment administration and elevated the health risks of patients to a considerable extent. Furthermore, delayed clearance from the healthcare specialists, incomplete patient preparation for surgery, an absence of informed consent (for treatment), and delay in medical discharge significantly impacted the clinical manifestations and wellness outcomes of the concerned patients in the healthcare facility. The absence of safety checklists in the clinical setting substantially increased the risk of patient-care adversities due to the inappropriate accomplishment of the patient care requirements. The development of surgical site abscess, nosocomial infections, bed sores, falls in the clinical settings, and other procedure-based conditions include some of the patient adversities that occurred because of significant compromises in patients’ safety measures and quality of clinical interventions.
The safety competencies and thresholds that I effectively shared during my clinical placement included the following attributes (CPSI, 2009).
- I recommended the need for establishing a patient safety culture that necessitates the re-evaluation of patients’ pre-procedural and safety requirements. The threshold of patients’ safety culture is based on at least 95% reassessment of patients’ safety attributes prior to procedural administration.
- I advocated the need for interprofessional collaboration of nurses with other healthcare specialists to effectively optimize the quality of care and patient safety across the treatment environment. The threshold for interprofessional collaboration is related to the mandatory requirement of recording the minutes of interprofessional communication while catering to the daily patient care requirements.
- I suggested the requirement of managing an optimal nurse-patient ratio in accordance with the treatment needs to the patient population. The optimized nurse-patient ratio is a measurable threshold that requires consistent monitoring to effectively stabilize the nursing workload in the context of minimizing the risk of safety events.
- I recommended the requirement of undertaking patients’ risk assessment while categorically anticipating their healthcare needs and disease predisposition factors. I advocated the need for recording patients’ medication contraindications, adverse events, falls, polypharmacy, and age-appropriate risk factors for their qualitative measurement by the healthcare professionals (Baranzini, et al., 2009).
- I also recommended the requirement of clinical documentation in the context of recording the patients’ adverse events, medication dosage, and clinical assessment to effectively track and minimize safety risks. Furthermore, I advocated the need for 100% recording of patients’ medical necessities, treatment measures, and wellness outcomes in the context of establishing the practice standards related to the recommended safety competencies. The thorough compliance with the documentation threshold is highly needed to minimize the frequency of adverse events in the clinical setting.
Identification of safety changes will be based on the evaluation of physicians’/nurses’ safety-related understanding and perceptions in the clinical setting. Indeed, the patient safety culture is based on the establishment of health-related behavior, competencies, perceptions, attitudes, and values of the stakeholders (including patients, physicians, and nurses) (Lawati, Dennis, Short, & Abdulhadi, 2018). The identification of safety culture changes in the clinical setting would require the thorough analysis of the patient safety strategies and statistical assessment of the frequency of reported adverse events across the clinical practice environment. Furthermore, the utilization of HSOPSC (Hospital Survey On Patient Safety Culture) will be highly required to determine the acquisition of the desired threshold (i.e.re-evaluation of patients’ safety parameters) related to the establishment of the patients’ safety culture (Chaneliere, et al., 2016). Furthermore, the utilization of PSCS (patient safety climate surveys) in the healthcare setting will assist in evaluating the extent of patient satisfaction and staff perceptions related to the established safety parameters and their implications across the treatment environment (Ginsburg, Tregunno, Norton, Mitchell, & Howley, 2014). Furthermore, the utilization of structured questionnaires will assist in evaluating the informed (safety) culture in the healthcare facility. The evaluation of this informed culture will assist in understanding the cooperative patient safety behavior of the healthcare teams, including inter-departmental bridging, innovation, and problem-solving (Pierre, 2013). The statistical evaluation of the patient safety culture data is also based on the important attributes including the communication openness, pre-procedural preparedness, organizational learning, and teamwork of the healthcare employees (Wagner, Smits, Sorra, & Huang, 2013). The quantitative analysis of incident reporting systems will substantially assist in measuring the rates of medication errors, inappropriate lab investigation, missed referrals, and surgery cancellation in the healthcare setting (Pham, Girard, & Pronovost, 2013).
Analysis of Patient Safety Strategies
The subjective and objective assessment of the interprofessional communication through semi-structured interviews will assist in evaluating the collaboration experience of the professional nurses across the clinical practice environment. The thorough analysis of the interprofessional conflicts, challenges, difficulty level, inadequacies in relationship pattern, uncertainty, responsibility, and decision-making capacity of the nurses and other healthcare professionals will help to determine their interprofessional collaboration level in the clinical practice environment (Hood, et al., 2017). The statistical assessment of the healthcare professionals’ unmet expectations will assist in tracking the deficits in interprofessional collaboration and their sustained impact on the process of medical decision-making. The structured interview sessions will effectively record the mutual values and shared goals of nurses and other healthcare professionals. The quantitative assessment of the interdisciplinary patient rounds and their correlation with safety events and duration of patient stay will provide greater insight of the interprofessional collaboration pattern between the nurses, physicians, clinicians, and other healthcare specialists in the clinical practice environment (Muller-Juge, et al., 2013). Furthermore, survey intervention will effectively record the interprofessional challenges experienced by the nurses, medication experts, prescribers, diagnosticians in the healthcare setting. The survey will also quantitatively determine the medical staff shortage and its impact on interprofessional communication and safety events in the clinical practice environment (Bosch & Mansell, 2015).
The quantitative assessment of the staffing ratio in the healthcare setting will assist in understanding the nursing workload and associated odds of survival (Lee, et al., 2017). The quantitative assessment of nurse staffing level and frequency of adverse events will assist in identifying the relationship pattern between the safety risk and nurse-patient ratio in the healthcare setting. The assessment of nursing staffing level and workload along with the patient care complexities will provide a rational picture of recommended staffing modification in the context of enhancing the quality practice environment in the medical facility (Rochefort, Buckeridge, & Abrahamowicz, 2015). Systematic retrieval of the average adverse event and staffing data will assist in benchmarking the nurse-patient ratio requirement in the treatment setting. Furthermore, the statistical assessment of nurses’ personal factors, workplace attributes, and community-based requirements will assist in determining their overall impact on the healthcare performance outcomes (MacLeod, et al., 2017). Eventually, these findings will radically assist in designing standardized staffing requirements, performance parameters, and task allocation strategies in the context of improving the quality of treatment procedures while concomitantly minimizing the risk of adverse patient events.
The systematic recording of patients’ risk factors including, treatment needs, polypharmacy pattern, injuries, and contraindications through the electronic health records will assist in minimizing the frequency of safety events while concomitantly improving the patient care quality (Oreskovic, Maniates, Weilburg, & Choy, 2017). The provider-centric and patient-centric clinical records’ implementation in the healthcare setting will facilitate the statistical evaluation and re-evaluation of patient reminders, computerized provider order entry, pre-surgical requirements, lab data, referrals, physician schedule, and patient appointment data (Chang & Gupta, 2015). This will not only assist in tracking the root causes of the previously reported adverse events but also ascertain the accomplishment of standardized patient safety requirements prior to treatment/procedure initiation. The assessment of electronic medical records’ interoperability will assist in determining the accessibility of nurses, physicians, and pharmacies to the individualized patient care records and safety event data in the healthcare setting. Furthermore, the quantitative assessment of nurses reporting EMR adoption will help in analyzing the frequency of patient care records utilization by the concerned nurses in the treatment facility. Indeed, enhanced access to medical records by the healthcare records will substantially improve the medical decision-making pattern and reduce the risk the risk of safety events in the clinical setting.
Evaluation of Staff Perceptions
The action plan will be based on the following measures.
- The nurses and physicians will effectively require documenting patient safety quality indicators in the context of establishing various benchmarks and standards for the administration of medical procedures.
- The nurses will require improving their interprofessional communication with physicians and other healthcare team members in the context of improving the precision and quality of medical decision-making and associated treatment interventions.
- The nurses in coordination with the healthcare teams will need to develop and promote an effective patient adverse event reporting system in the context of identifying the root causes of various adverse events in the context of devising their systematic mitigation.
- The nurses will need to promote routine safety culture measurement practices to facilitate dynamic action planning through an effective leadership in the context of improving the participation of patients, physicians, and nursing teams in various patient safety interventions (Campione, 2018).
- The systematic use of the electronic medical record will not only assist in tracking the safety incidents but also facilitate disaster planning and customization of safety alerts and product recalls.
- The plan outcomes will be systematically circulated within the healthcare teams through digital notice boards in the context of improving the knowledge and awareness of stakeholders regarding healthcare strategies that would require modification for establishing a quality practice environment in the clinical setting.
- The establishment of patient safety quality indicators and security alerts will prompt the nurses and healthcare professionals to cross-validate the safety parameters and ascertain their implementation prior to the administration of healthcare interventions. The pre-procedural assessment will not only improve the quality of procedural interventions but also elevate the wellness outcomes of the treated patients.
- Interprofessional communication will radically improve the medical decision-making process and minimize the occurrence of medication errors and polypharmacy issues in the treatment setting.
- The development of an effective adverse event reporting system will assist in identifying the frequency of patient falls, transfusion reactions, pressure ulcers, and nosocomial infections across the clinical practice environment. Eventually, modified evidence-based treatment approaches will effectively reduce the frequency of these events in the healthcare setting.
- The auditing of patient safety culture will substantially assist in determining the associated pitfalls for their earliest mitigation in the context of improving the qualitative patient care outcomes.
- Electronic medical record implementation will radically improve the precision of various treatment decisions while minimizing the risk of medication errors across the clinical practice environment.
Safety consciousness of nurses substantially minimizes the frequency of serious infusion incidence in the hospital setting. The analysis and reporting of various safety events and associated measures are highly required to effectively promote an evidence-based patient safety culture across the healthcare environment. Indeed, healthcare quality enhancement through shared decision-making reduces the risk of medication errors, surgery complications, referral issues, and inadequate laboratory outcomes. Nurses require utilizing transformational leadership strategies to facilitate the promotion of safe health care practices while establishing the desired patient care standards in the treatment facility. Categoric utilization of human factors approaches not only improves the patient care behavior of nurses but also motivate them to effectively surpass healthcare barriers and treatment challenges for establishing a quality practice environment in the hospital setting.
References
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Bosch, B., & Mansell, H. (2015). Interprofessional collaboration in health care – Lessons to be learned from competitive sports. Can Pharm J (Ott), 148(4), 176-179. doi:10.1177/1715163515588106
Campione, J. (2018). Promising Practices for Improving Hospital Patient Safety Culture. The Joint Commission Journal on Quality and Patient Safety, 23–32. Retrieved from https://www.jointcommissionjournal.com/article/S1553-7250(17)30443-9/pdf
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Chang, F., & Gupta, N. (2015). Progress in electronic medical record adoption in Canada. Can Fam Physician, 61(12), 1076–1084. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4677946/
CPSI. (2009). The Safety Competencies – Enhancing Patient Safety Across the Health Professions. Ontario: FSC. Retrieved from https://www.patientsafetyinstitute.ca/en/toolsResources/safetyCompetencies/Documents/Safety%20Competencies.pdf
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