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The role of the nurse in quality and patient safety essay
The role of the nurse in quality and patient safety essay
Patient safety and risk management
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Scottish Patient Safety Programme
and the Early Detection of the Deteriorating Patient
The aim of this reflection is to discuss patient safety in an acute setting according to the Scottish Patient Safety Programme. I will be using a model of reflection, Gibbs Reflective Cycle to structure my essay (Gibbs 1988 cited in Paterson and Chapman, 2013). In accordance with the Nursing and Midwifery Council identifiable information will not be written, maintaining confidentiality (NMC, 2010a).
Description
Health Improvement Scotland coordinated the Scottish Patient Safety Programme created to improve the safety of patients across Scotland (NHS Scotland, 2010a). Four groups were created to manage patient safety, one of which was established to supervise care within an acute adult setting (NHS Scotland, 2010a). During my practice learning experience a male patient was brought into the accident and emergency department following a serious assault, he had suffered severe lacerations to his head, face and hands. Prior to arriving, ambulance staff did not call to warn nursing and medical staff. As a result, the team were unprepared and the patient was brought into the wrong area within the department. The patient should have gone straight into the resuscitation area where the appropriate equipment is available, in case of patient deterioration (Brooker and Nicol, 2011).
On arrival nursing staff initiated SBAR with ambulance staff. SBAR is a communication tool which stands for situation, background, assessment and recommendation; providing a structured way to retrieve all vital information triggering a relevant response (NHS Scotland, n.d.b). An A to E assessment was commenced as soon as the patient arrived within the departme...
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...Students [online] Available: http://www.nmc-uk.org/Documents/NMC-Publications/NMC-Guidance-on-professional-conduct.pdf [Accessed: 16th April 2014]
Nursingtimes.net. (2012) Scottish Patient Safety Programme Extended., Available: ProQuest Nursing and Allied Health Source [Accessed: 14th April 2014]
Nursing Times. (2012) Call to adopt national early warning score. Vol.108 932/33) pp.7. Available: ProQuest Nursing and Allied Health Source [Accessed: 15th April 2014]
Paterson, C. and Chapman, J. (2013) Enhancing skills of critical reflection to evidence learning in professional practice. Physical Therapy in Sport Vol.14(3) pp.133-138. Available: ProQuest Nursing and Allied Health Source. [Accessed: 14th April 2014]
Wilson, W., McGrande, C and Hoyt, D. (2013) Trauma: Emergency Resuscitation, Perioperative Anesthesia, Surgical Management, Vol 1, CRC Press: New York
The purpose of this essay is to reflect upon the teamwork and communication within the multi- disciplinary environment of the theatre suite. I will follow a patient on their journey along the Patient pathway, from their arrival in the anaesthetic room, through to them being handed over to the recovery staff. The patient pathway is described by the Department of Health (2007) as a timeline, on which every event relating to treatment can be entered. Events such as consultations, diagnosis, treatment, medication, diet, assessment and discharge can be mapped on this timeline. In this essay, I will use the Johns 1994 mode of reflection. The purpose of reflection, as stated by Johns (1994) is to promote desirable practice through the practitioners understanding and learning about their lived experiences. Patient trust and confidentiality will be maintained throughout, the patient referred to as Mrs X and any details will be improvised.
There was inappropriate staffing in the Emergency Room which was a factor in the event. There was one registered nurse (RN) and one licensed practical nurse (LPN) on duty at the time of the incident. Additional staff was available and not called in. The Emergency Nurses Association holds the position there should be two registered nurses whose responsibility is to prov...
Safety is a primary concern in the health care environment, but there are still many preventable errors that occur. In fact, a study from ProPublica in 2013 found that between 210,000 and 440,000 patients each year suffer preventable harm in the hospital (Allen, 2013). Safety in the healthcare environment is not only keeping the patient safe, but also the employee. If a nurse does not follow procedure, they could bring harm to themselves, the patient, or both. Although it seems like such a simple topic with a simple solution, there are several components to what safety really entails. Health care professionals must always be cautious to prevent any mishaps to their patients, especially when using machines or lifting objects, as it has a higher
Critical incidents are snapshots of something that happens to a patient, their family or nurse. It may be something positive, or it could be a situation where someone has suffered in some way (Rich & Parker 2001). Reflection and analysis of critical incidents is widely regarded as a valuable learning tool for nurses. The practice requires us to explore our actions and feelings and examine evidence-based literature, thus bridging the gap between theory and practice (Bailey 1995). It also affords us the opportunity of changing our way of thinking or practicing, for when we reflect on an incident we can learn valuable lessons from what did and did not work. In this way we develop self-awareness and skills in critical thinking and problem solving (Rich & Parker 2001). Critical incidents ???
Patient safety is a major issue in health care, especially in the public sector. Studies show that as many as 10 patients get harmed daily as they receive care in stroke rehabilitation wards in hospitals in the United States alone. Patient safety refers to mechanisms for preventing patients from getting harmed as they receive health care services in hospitals. The issue of patient safety is usually associated with factors such as medication errors, wrong-site surgery, health care-acquired infections, falls, diagnostic errors, and readmissions. Patient safety can be improved through strategies such as improving communication within hospitals, increasing patient involvement, reporting adverse events, developing protocols and guidelines, proper management of human resources, educating health-care providers on the need for patient protection, and commitment of the leadership to the task. This paper talks about patient safety and how it can be improved in stroke rehabilitation wards of both public and private hospitals.
A key technique current and nurses in learning can use is reflection based on past experiences. This method of critical thinking enables the user to have an approach of systematic analysis for present and future scenarios with the intent of improvement. In terms of knowing, reflection has appeared to be a crucial part of learning and understanding. (Bonis, 2009).
Dougherty, L. & Lister, s. (2006) ‘The Royal Marsden Hospital manual of Clinical Nursing Procedures: Communication 6th Edition Oxford: Blackwell Publishing Ltd
Patient’s safety will be compromised because increase of patient to nurse ratio will lead to mistakes in delivering quality care. In 2007, the Agency for Healthcare Research and Quality (AHRQ) conducted a metanalysis and found that “shortage of registered nurses, in combination with increased workload, poses a potential threat to the quality of care… increases in registered nurse staffing was associated with a reduction in hospital-related mortality and failure to rescue as well as reduced length of stay.” Intense workload, stress, and dissatisfaction in one’s profession can lead to health problems. Researchers found that maintaining and improving a healthy work environment will facilitate safety, quality healthcare and promote a desirable professional avenue.
One of the most essential aspects of doing a job well, no matter what job it is, is the ability to think critically about a situation. Finn (2011) defines critical thinking as “the ability and willingness to assess claims and make objective judgments on the basis of well-supported reasons and evidence rather than emotion or anecdote”. The difference between assessing a certain situation critically and assessing it without any evidence to corroborate your claims is that when you look at something critically, you are using your ability to “come up with the alternative explanations for events, think of research findings and apply new knowledge to social and personal problems” (Finn, 2011). When you can come up with other explanations using evidence, you can also create an alternative way of enhancing the situation. Critical thinking skills are especially important to nurses in a fast-paced setting. Nursing is a very demanding and rewarding field to enter into; it becomes enjoyable when you are good at it. In order to be good at their jobs, nurses need to learn the skills required to think critically and also, relate those skills to their everyday routines. This is known as evidence-based practice. Evidence-based practice is defined as “using the best scientific evidence available to guide clinical decisions and interventions with the goals of fostering self-management skills and improving health outcomes” (Miller, 2011). This paper examines the skills required for critical thinking, how to learn these skills, and how to apply them in clinical settings. (Miller, 2011; Finn, 2011; Noonan, 2011; Lunney, 2010; Wangensteen, Johansson, Bjorkstrom & Nordstrom, 2010; Chitty & Black, 2011).
In this essay I will be describing reflection, the methods of reflecting and the benefits of reflection in clinical practise. Everyone from doctors and lawyers to shop assistants and builders reflect upon their work. Reflection can be used to learn and develop as a clinician, professional and also as a person.
Reflection has its importance in clinical practice; we always seek to be successful and that can be achieved by learning every day of our life through experiences we encounter. In that way we can reconsider and rethink our previous knowledge and add new learning to our knowledge base so as to inform our practice. Learning new skills does not stop upon qualifying; this should become second nature to thinking professionals as they continue their professional development throughout their careers (Jasper, 2006). According to Rolfe et al. (2001), reflection does not merely add to our knowledge, it also challenges the concepts and theories by which we try to make sense of that knowledge. Acquiring knowledge through reflection is modern way of learning from practice that can be traced back at least to the 1930s and the work of John Dewey, an American philosopher and educator who was the instigator of what might be called ''discovery learning'' or learning from experience. He claimed that we learn by doing and that appreciating what results from what we do leads to a process of developing knowledge, the nature and importance of which then we must seek to interpret (Rolfe et al., 2001).
The rate of errors and situations are seen as chances for improvement. A great degree of preventable adversative events and medical faults happen. They cause injury to patients and their loved ones. Events are possibly able to occur in all types of settings. Innovations and strategies have been created to identify hazards to progress patient and staff safety. Nurses are dominant to providing an atmosphere and values of safety. As an outcome, nurses are becoming safety leaders in the healthcare environment(Utrich&Kear,
The following essay is a reflective paper on an event that I encountered as a student nurse during my first clinical placement in my first year of study. The event took place in a long term facility. This reflection is about the patient whom I will call Mrs. D. to protect her confidentiality. Throughout this essay I will be using LEARN model of reflection. I have decided to reflect on the event described in this essay since I believe that it highlights the need for nurses to have effective vital signs ‘assessment skills especially when treating older patients with complex medical diagnoses.
The current patient may be experiencing a range of traumatic injuries after his accident, the injuries that the paramedic will focus on are those that are most life threatening. These injuries include: a possible tension pneumothroax or a haemothorax, hypovolemic shock, a mild or stable pelvic fracture and tibia fibula fracture.
The care that patients receive has the potential to improve in the course of reflective practice. Having a structure of reflective practice also has the potential to develop staff knowledge and to improve the application of professional standards. It offers the health care professional to make sense of complicated and difficult situations, acts as a method to learn from experiences and thus improve performance and patient care, identify educational needs, highlight barriers to development and ways of identifying improvements, and provide evidence of continuous professional development which is a prerequisite to the profession of nursing. In addition staff could become increasingly more motivated and empowered, better critical thinkers and self-directed professionals.