Feb 23, 2024 Nursing Roles in Quality Improvement
Nursing Roles in Quality Improvement
Nurses promote patient safety and improve quality at my workplace by doing a few different things. Such as during the admission process we are asking the patients 100 questions, including the suicide assessment. Stroke patients are supposed to be asked the suicide assessment questions every day as part of the plan of care. Also the nurses in the ER are asking the suicide assessment questions to every patient they have coming in. These all together try to help our mod-high suicide risk patients with the resources they need to be able to get some help. The one that I feel is most repetitive is the two patient identifiers any time we give our patients medications. Name & Birth date. The patients I have seen get irritated especially if we have them for days. Saying things like you know who I am and such. I do get it but it’s in the best interest of their care. The problem with the name and birth date, we have a lot of elderly patients, confused, demented, mentally challenged, that aren’t usually able to give this information to us, or they forgot it and things like that. So I know the two patient identifiers are at good safety goal to make sure we have the right patient and the right treatment but there is that slight problem. I can’t tell you how many times patient just agree with you or answer to a different name. We do use a scanning system at our hospital that will not even let us scan the meds to confirm them before we scan the patient’s bracelet and confirm they are who they say they are. These are just a couple of the patient safety standards are implemented at the hospital. Joint Commission has a list of national patient safety goals to help identify the patients correctly, improve staff communication, use medications safely, use alarms safely, prevent infections, identify patient safety risks, and help prevent mistakes made in surgery (Hood, pg. 447).
Changes I would suggest to be made on my unit to improve non punitive culture of safety would be to bring back the intensivist program and actually run it the right way this time. That there is physicians that specialized in training in the critical care, being able to put in invasive lines that the patients need, are there 24/7. It would take critical time back for our patients being able to have a physician that is available on hand 24/7. Not paging doctor’s multiple times and waiting 20-30 minutes for them to call back. Sometimes the patients do not have that long. Prevention is key, we would love to be able to correct an issue before the patient codes, or before we have no IV access once so ever to be able to give our patients their medications. Yes we have IO available, but there is not that many kits, also that should be saved for last resorts. Injecting a needle directly into the patients bone marrow is not nice, especially if they are awake. Also they only are able to be in for 24 hours. A thing that would make a huge difference at our hospital, especially in the intensive care units, would be if the safe staffing ratios according to the Safe Patient Care Act (About the Safe Patient Care Act), were implemented hospital wide.
Resources
About the Safe Patient Care Act. (n.d.). Retrieved March 23, 2020, from https://www.misaferhospitals.org/about.html
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Hood, L. J. (2018). Leddy & Pepper’s professional nursing ninth edition. Philadelphia: Wolters Kluwer.
How do nurses promote patient safety and improve quality at your workplace? How do you report errors and near misses? What changes would you suggest be made on your unit or facility to improve a non-punitive concept
Hood, L. J. (2014). Leddy & Pepper’s conceptual bases of professional nursing (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
Chapter 19: pp. 489–519
Other Required Readings (located in Webliography):
Massachusetts Nurse of the Future Nursing Core Competencies: Slides 34–36
AACN Essentials of Baccalaureate Education : pages 13–15
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