Practice Environment in Healthcare

NB: We do not resell your papers. Upon ordering, we do an original paper exclusively for you.

NB: All your data is kept safe from the public.

Table of Contents

Introduction
Leadership Accountability
Professional Obligation and Accountability
Conclusions and Recommendations
References

Introduction

Frontline Staff and Patients/Families

The practice environment (an intensive care unit in a hospital) is a complex clinical setting. Team and staff-leader communication is imperative to deliver coordinated and quality care. From my observations and unit reports, nurses and patients/families are not adequately empowered to be effective in their roles. There is limited structural empowerment, which refers to institutional strategies supporting shared governance and information sharing (1). RNs feel that leaders do not prioritize clinical advancement and support creativity and ideas at the bedside. They are not empowered to develop and disseminate impactful, innovative solutions that could lead to quality care.

Leadership Accountability

Another key communication risk in this practice setting is error reporting to managers, patients, and families. Self-reporting often attracts disciplinary actions, which forces nurses to conceal near misses or medication errors. System vulnerabilities are a barrier to accountable reporting and can potentially harm patient safety and clinical outcomes (2). The practice environment must promote non-punitive self-reporting of errors to mitigate their effects. The greatest communication challenge in this respect is that the definition of errors and near-miss events are unstandardized, and changes to improve safety are not provided after an incident.

Interdisciplinary team meetings to review safety or communication lapses are rare in this setting. Safety huddles, which are brief sessions (10-15 minutes) or safety briefings held by health care teams to assess safety issues each day (3). In my opinion, such briefings can help nurses share key information and identify concerns that will then be escalated to hospital leaders for further action. Since safety huddles are lacking, poor error reporting and dysfunctional teams hamper care at the unit. The quality committee found blaming and limited collaboration as the key risks affecting optimal patient care and outcomes.

Professional Obligation and Accountability

Relevant laws and codes support mandatory reporting of medication errors. The American Nurses Association [ANA] prescribes principles for electronic health record documentation (concise, accessible, and readable), training of nurses in reporting procedures, and using standardized terminologies (4). The goal is to enhance professional communication and accountability within teams and individuals involved in quality and regulation. ANA’s ninth Standard of Practice requires RNs to communicate effectively as a professional competency.

Specific laws cover the reporting of errors or sentinel events by nurses and physicians. The Patient Safety and Quality Improvement Act promotes confidential disclosure of medical errors to avoid lawsuits (5). Individual states have laws that require adverse events to be communicated to hospital leaders and regulators. An example is Pennsylvania’s Medical Care Availability and Reduction of Error Act. In my view, nurses have an ethical responsibility to communicate patient safety issues, as concealing them will only exacerbate the problem. They can report such events verbally before preparing a written report.

Conclusions and Recommendations

The likelihood of miscommunication in the busy intensive care unit is high. In my practice setting, three communication risks are noted: inadequate RN empowerment, a weak error reporting system, and limited safety huddles. They have consequences and implications for patient outcomes – length of stay, hospital-acquired outcomes, and satisfaction. Professional codes and various laws require health professionals to communicate medical errors and issues to hospital managers and regulators for intervention. On this basis, the following two recommendations are made:

Provide communication training programs are needed at the unit to promote collaboration.
Implement standardized tools and error reporting terminologies to improve information exchange.

References

Brennan D, Wendt L. Increasing quality and patient outcomes with staff engagement and shared governance. Online J. Issues Nurs; 26(2): 1-10.

Eltaybani S, Mohamed N, Abdelwareth M. Nature of nursing errors and their contributing factors in intensive care units. Nurs Crit Care. 2019;24(1): 47-54.

Stapley E, Sharples E, Lachman P, Lakhanpaul M, Wolpert M, Deighton J. Factors to consider in the introduction of huddles on clinical wards: Perceptions of staff on the SAFE programme. Int J Qual Health Care. 2018;30(1): 44-49.

Urquhart C, Currell R, Grant MJ, Hardiker NR. Nursing record systems: Effects on nursing practice and healthcare outcomes. Cochrane Database Syst Rev. 2018;5: 1-12.

Vaismoradi M, Tella S, Logan PA, Khakurel J, Vizcaya-Moreno F. Nurses’ adherence to patient safety principles: A systematic review. Int J Environ Res Pub Health. 2020;17(6): 1-15.

Click Here To Order Now!

Practice Environment in Healthcare

Do you need this or any other assignment done for you from scratch?

We have qualified writers to help you.

We assure you a quality paper that is 100% free from plagiarism and AI.

You can choose either format of your choice ( Apa, Mla, Havard, Chicago, or any other)