Category: Patient Safety

TeamSTEPPS strategies and tools are designed to enhance team performance and patients safety across the healthcare system. Some elements of the TeamSTEPPS are used on a daily basis, like brief and debrief meetings, mutual support with the task assistance, and providing feedback to team members to improve team performance. The other useful TeamSTEPPS tools that could be effective on a daily basis are the SBAR technique, Call-Out strategy, and Check-Back tool (Buljac-Samardzic et al., 2020). The SBAR technique focuses the immediate attention on concerns about the patients condition in the aspects of the situation, background, assessment, and recommendations. The Call-Out strategy helps with communicating several teammates simultaneously on the emergent situation while providing important information. The Check-back tool helps with the effectiveness of the communication between the teammates by double-checking that the receiver understands the information. The SBAR technique, Call-Out strategy, and the Check-back tool provide effectiveness in making the information clear and concise and ensuring that the information is heard and understood.

If I were a manager, I would keep using the TeamSTEPPS method as it includes simple and concise instructions available for everyone to understand, memorize, and use effectively in various urgent cases. The use of principle-based training provides great opportunities for team interventions in the context of improving team functioning and patients safety (Buljac-Samardzic et al., 2020). The study conducted in 2020 showed that the use of the TeamSTEPPS helps with the improvement of teamwork behaviors, communications, and leadership (Buljac-Samardzic et al., 2020). The TeamSTEPPS-based interactive workshops helped with the improvement of situation awareness, mutual support, and decrease of communication-related errors. The TeamSTEPPS method could be helpful to the manager as it makes the communication among the team more effective, and that is, in my opinion, one of the key aspects in the effectiveness of the team.

Reference

Buljac-Samardzic M., Doekhie, K. & van Wijngaarden, J. (2020). Interventions to improve team effectiveness within health care: A systematic review of the past decade. Human Resources for Health, 18. Web.

Introduction

Understaffing is widely considered a primary nursing issue globally, with many nursing leaders and scholars claiming it to be detrimental to patient outcomes. However, in this context, it is not considered that there are many other professional factors at play that lead to poor results in inpatient care. Low levels of nursing are not strongly associated with the actual quality of care since the latter depends on nurses competence, nurse-patient communication, and the available resources to a much greater degree.

Context

While low staffing levels are continuously mentioned in the clinical and administrative aspects of nursing, it is vital to consider that nursing consists of a complex system and predetermined set of tasks, most of which are fulfilled no matter the staffing level. An alternate viewpoint on the issue suggests examining the perspective of efficiency and competency. It is argued that staffing causes nurses to be unable to fulfill their duties efficiently and significantly shortens the time spent with patients. However, if methods of multitasking and communication amongst the nursing team and with patients are improved, then patient outcomes could be improved within the realities of the healthcare system.

1^st Con-Point

A decrease in the quantity and quality of communication strongly affects the quality of care. Within the staffing structure of modern hospitals, Portoghese, Galletta, Battistelli, and Leite (2015) argue that nurses are unable to build effective communication that will appropriately divide the workload and optimize key processes, which would significantly improve healthcare delivery. Nursing education is a contributing factor, as the quality of nursing benefits with an increased focus on communication strategies in education processes rather than issues such as understaffing. Effective communication elements should be naturally built into nursing protocols for the optimal result. Therefore, with properly structured communication and training processes, nurses would be able to meet the diverse needs of patients even in low-staff environments.

2^nd Con-Point

Undoubtedly, the nurse-to-patient ratio (NPR) can be low at certain times. However, it is not a primary factor for the drop in service quality, but rather the unavailability of resources. According to the theories of Kahouei, Farrokhi, Abadi, and Karimi (2016), nursing consists not only of human resources but also informational, infrastructural, and technological resources as well among others. For example, services such as patient education can be delivered through digital technology and appropriate databases of information that do not require a nursing presence. Furthermore, infrastructure for the effective provision of care and patient communication is often lacking. Therefore, it can be argued that for as long as other supporting resources are lacking, there will be limited effects.

3^rd Con-Point

The communication between nurses and patients, which has a profound impact on outcomes both while patients are hospitalized and after discharge, does not directly depend on NPR. When dismantling communication efficacy, Stalpers, de Brouwer, Kaljouw, and Schuurmans (2015) suggest that it consists of various aspects such as culture, language, and personal demeanor. Management of patient needs and overall communication can be enhanced through digital tools and improved communication training, which limits redundancies and allows to quickly establish a clear dialogue with the patient. In turn, this leads to an improved quality of life and service for patients by nurses, relatively unaffected by staffing levels. This should be considered in implementing administrative interventions and conducting nursing education.

Conclusion

It is evident that the complexity of nursing care and its effect on patient outcomes depends on numerous factors. While staffing levels unarguably could be improved, they are not the primary cause of such issues as adverse patient outcomes and poor service quality. Improved education, communication efficacy, and additional resources could have profound impacts that would allow even a skeleton staff to efficiently fulfill all duties and establish a rapport with the patients.

References

Kahouei, M., Farrokhi, M., Abadi, Z. N., & Karimi, A. (2016). Concerns and hopes about outsourcing decisions regarding health information management services at two teaching hospitals in Semnan, Iran. Health Information Management Journal, 45(1), 36-44. Web.

Portoghese, I., Galletta, M., Battistelli, A., & Leiter, M. P. (2015). A multilevel investigation on nursing turnover intention: The crosslevel role of leadermember exchange. Journal of Nursing Management, 23(6), 754-764. Web.

Stalpers, D., de Brouwer, B. J., Kaljouw, M. J., & Schuurmans, M. J. (2015). Associations between characteristics of the nurse work environment and five nurse-sensitive patient outcomes in hospitals: A systematic review of literature. International Journal of Nursing Studies, 52(4), 817-835. Web.

Introduction

Risky medical practices are the root cause of avoidable exposure to patient risk in the global healthcare system. A large portion of these risks occurs during medication administration. Consider the case of Peter, a 75-year-old male with a history of arrhythmia. The doctor of Rythmol 150 mg gives Peter a written prescription after his routine visit to the clinic. The nurse in pharmacist fills his medication, and the patient uses his usual medication as per the right dosage. Peter starts experiencing nausea, sweating, and irregular heartbeats. After consultation with his physician, it was determined that the dispensing nurse gave Peter the wrong medication. The nurse blames the mistake on the doctors sloppy handwriting in the prescription document. The case above demonstrates a good scenario of a medication administration error that poses a risk to the patient. Therefore, this study looks at the error made during peters medicine prescription and use evidence-based solution to identify how the risk would have been avoided and the role of nurses in increasing patient safety.

The Evidence-Based Solution to Reduce the Medical Administration Error

Any avoidable incident that could result in improper medication use or patient damage when the medicine is under the healthcare professionals control is referred to as a medication error. Medication errors are inevitable; some adverse drug reactions are unavoidable and unpredictable (Flavin, 2018). Correspondingly, side effects are part of the accepted risks of treatments and are known and reduced by careful prescriptions to patients. Medical administration errors, patient compliance, dispensing, and compliance errors are some of the most common notable errors nurses perform, which pose a risk to patients. According to the Institute of Medicine (n.d.), dispensing errors can be reduced by actively improving communication between physicians and nurses, improving drug labeling, and providing patient information during prescriptions. In the case of Peter, there was an error in the dispensing of his prescription, which the lapse in communication between the prescribing nurse and the doctor may have caused.

The pharmacy setting is often intense and fast-paced, with high volumes of prescriptions, demanding patients, and insufficient staffing. The nurses must double-check patients prescriptions and seek clarification if there is doubt (Institute of Medicine, n.d.). In the case of Peter, the prescribing nurse did not clarify the prescription after discovering a slop in the handwriting in the prescription. Considering that Peter was in his routine visits to the clinic, the nurse should be conversant with the medication the patients use. If the nurse had noted a change in the patient intervention, the nurse should have consulted with the doctor to confirm. Since over 70% of all medical errors result from poor communication and are preventable, it has been demonstrated that effective communication impacts patient safety (Flavin, 2018). Nurses need to comprehend the idea of professional collaboration in todays workplace to function well as a team. The ability to function successfully with nursing and interprofessional teams, promoting open communication, mutual respect, and shared decision-making to provide quality patient care (Institute of Medicine, n.d.).

Role of Nurses in Increasing Patient Safety with Medication Administration and Cost Reduction

Patient safety and accuracy in medication administration encompasses five rights medicine administration dose, drug route, time, and right patient in making sure that there are no errors made that can pose a risk to patients (University of Southern Indiana, 2019). The nurses can help reduce medication administration safety risks by advocating for computerized entry of medicine prescriptions, single-use drug packages, safety alert medications, and patient barcoding. A perfect example is the barcode drug administration, which removes the wrong patient medication, and dose errors. Caregivers and patients admiration of the home setup causes the highest percentage of administration errors (University of Southern Indiana, 2019). Nurses can play an important role in educating patients and caregivers on how to take medicines at home and advising them to consult their physicians when unsure of drug administration. Therefore, nurses play a very vital role in increasing patient safety during medication administration since they are the primary contact person with the patients.

Stakeholders in the Medication Administration

The safety of patients is a vital component of quality nursing care. Nevertheless, the healthcare system is predisposed to errors that are detrimental to the safety of patients and medication administration (Ricciardi & Cascini, 2020). According to Doyle & McCutcheon (2019), nurses and other stakeholders, such as patients, government and legislative bodies, doctors, professional associations, caregivers, and accredited medical agencies, are responsible for ensuring medical administration and patient safety. The medical stakeholders can actively develop laws that oversee medicine administration, nurses employment, and education and develop new strategies and technology that reduce medical administration risks (Doyle & McCutcheon, 2019). The campaign to promote safe care involves nurses and will continue to involve them. The support network of healthcare continues to be heavily reliant on nurses.

Conclusion

In conclusion, patient safety is cautious when dispensing drugs to reduce the risks associated with mistakes made by nurses and ensure quality care is provided to patients. Nurses are encouraged to adhere to guidelines during administration and drug dispensing, creating a conducive patient environment. Nurses play a key role in making sure that the patient is getting the right medication, the right amounts, and the right ways of administration followed. In this case, the nurses are encouraged to form a dynamic communication behavior with the doctors to avoid confusion during dispensing of drugs.

References

Doyle, G. R., & McCutcheon, J. A. (2019). 6.2 safe medication administration  clinical procedures for safer patient care. Opentextbc.ca. Web.

Flavin, B. (2018). What are QSEN competencies, and why are they important for nurses? | Rasmussen College. Rasmussen.edu. Web.

Institute of Medicine. (n.d.). Read Informing the Future: Critical Issues in Health, Fifth Edition at NAP.edu. In nap.nationalacademies.org. Web.

Ricciardi, W., & Cascini, F. (2020). Guidelines and Safety Practices for Improving Patient Safety. Textbook of Patient Safety and Clinical Risk Management, 318. Web.

The University of Southern Indiana. (2019). What Nurses Need to Know About Care Coordination. The University of Southern Indiana. Web.

Introduction

People make errors that result in accidents, adverse health outcomes, and mortality. For a long time, the healthcare system has been organized in a manner that errors in the health organizations are blamed on the individuals (Marx, 2001). As a result, a healthcare practitioner is held accountable and punished for mistakes that happen in the areas of duty. The punitive approach has not solved the errors in healthcare institutions. The approach does not take into consideration the systematic issues that may have contributed to a medical error. Kohn, Corrigan, and Donaldson (2000) noted that an individual may be responsible for the error but many times, the leadership of the health organization overlooks the faults within the system. The consequence is punishing the individual without changing the system. The failure to increase the safety of patients by changing the system does guarantee the reduction of errors. The following paper analyzes the concept of just culture.

Just Culture

The development of the just culture concept dates back to 1997 when John Reason pointed out that just culture is essential in the creation of an environment that enhances trust. Trust within the healthcare setting helps in the provision of information that touches on safety. In the healthcare setting, the term just culture was first incorporated in a health report in 2001. The aim of just culture is to address the punitive approach in the health care system and to determine whether the punitive system solves human errors or it hurts the safety of health efforts. The concept of just culture acknowledges that punitive measures result in hindering the information that is needed to solve the faulty systems (Marx, 2001). The system that does not encourage just culture prevents healthcare practitioners from correcting their mistakes. Thus, just culture is based on the fact that health caregivers should not be held responsible for mistakes that result due to system failures. However, this does not tolerate the conscious disregard of risks that are clear.

In the U.S, the Institute of Medicine (IOM) stated that patients should not be harmed by the health care system that is supposed to heal them (Kohn et al., 2000). This led to the acknowledgment of an approach to remedy the medical errors in the health system. In the analysis of the medical errors, it was found that most medical errors do not occur due to personal negligence but are caused by faults in the healthcare system. Therefore, common mistakes in healthcare can be prevented by designing a safer health system. This should be carried out at the various levels of health care in order to make it easier for health professionals to do the right thing. A safer healthcare system encourages information sharing and prevents people from repeating the same errors.

Transformational Leadership

Studies have shown that medical errors are few in hospitals that have embraced a culture of safety that is based on inclusive leadership (McFadden, Henagan & Gowen, 2009). Nurses operate in an environment that has been changing drastically. Due to the changes, there is a need for a leadership model that responds to the changes. The transformational model provides a platform that encourages adaptive and flexible leadership in which nurses and other health practitioners can share information. Transformational leadership creates a working environment of shared responsibilities that motivates people to have higher ideals and moral values. In the transformational leadership model, the leader encourages a participatory approach to solve healthcare issues instead of imposing responsibility on individuals.

The transformational leadership model is designed on the basis of idealized influence and individual consideration; hence, the creation of a just culture. This is achieved by encouraging a sense of advocacy in which the leaders support staff and patients. The leadership model makes nurses be at ease when reporting problems. It also enhances the sense of accountability for the improvement of the system as there is a platform for sharing ideas.

Classes of Human Behavior

Human behaviors have an effect on the healthcare system. According to Congress on Nursing Practice and Economics (2010), the behaviors adopted by nurses can increase or reduce medical errors. The common classes of human behavior include accountability, intimidation, and disruptive behaviors. Accountability behavior creates a sense of belonging to the system and thus promotes the adoption of safer healthy practices. On the other hand, Congress on Nursing Practice and Economics (2010) noted that intimidation and disruptive behaviors increase medical errors. The disruptive behaviors do not encourage professional work environments. In order to promote a just culture, healthcare organizations must create environments that encourage positive work behaviors.

Incident

The intimidation behaviors discourage teamwork and hinder effective communication among the health workers. As a result, the expected teamwork is negated. Marx (2001) noted that the safety and quality of patient care are influenced by collaboration between the staff members and the leadership. An example of an incident that I experienced related to intimidation behavior. It involved a trainee nurse who accidentally bathed a newborn with very hot water that burned the infant. After the error, the management of the hospital did not take responsibility but blamed the nurse for not being careful. The nurse was suspended, and the management of the hospital did not take time to investigate what led to the error.

I felt unsatisfied with how the case was handled. This is because the blame was purely placed on the nurse. The management failed to investigate the systematic errors that led to the nurse bathing the baby using the water above the normal temperatures. In reality, if there were checks in the system to ensure that water for bathing the newborns was tested for the right temperature before entering the wards it could avoid future errors. In a just culture approach, the management could have taken time to investigate the issues that led to the error. This could also encourage the trainee nurse to provide information on what happened. The result would have resulted in a clear analysis of the systems and identification of measures that can be taken to avoid a repeat of such an error. The issue was not solved amicably, and it is bound to happen again.

References

Congress on Nursing Practice and Economics. (2010). Just culture. Silver Spring: American Nurses Association.

Kohn, L. T., Corrigan, J. M., & Donaldson, M. S. (2000). To err is human: building a Safer Health System. Washington, DC: National Academies Press.

Marx, D. (2001). Patient Safety and the Just Culture: A Primer for Health Care Executives. New York, NY: Columbia University.

McFadden, K., Henagan, S., & Gowen, C. (2009).The patient safety chain: Transformational leaderships effect on patient safety culture, initiatives, and outcomes. Journal of Operations Management, 27 (1), 390-404.

Introduction

There are many ways of how to improve clinical performance and promote patient safety. Team Strategies & Tools to Enhance Performance and Patient Safety (Team STEPPS) is one of the methods with five main principles and skills in the spheres of communication, team-building, leadership, situation monitoring, and mutual support (Agency for Healthcare Research and Quality, 2020). In the video Successful Outcomes Using TeamSTEPPS Techniques, the staff demonstrates how to cooperate, make decisions, achieve the best results, and avoid mistakes. The analysis of the techniques, experiences, and the situation will be developed to encourage a good future of a masters-prepared nurse.

Lessons and Techniques for Nurses

The leading team technique is a crucial aspect of health care. As soon as the team and a plan of work are established, the members should monitor events, make adjustments, encourage each other, and review performance. In the video, all these steps have been properly taken. To become a professional nurse, I would like to follow their examples and understand how to create a perfect team. All members should communicate and share their opinions freely to identify their weaknesses and strengths. If there are some questions or recommendations, they cannot be neglected or misunderstood. In this labor and delivery situation, the cooperation of nurses, doctors, and an anesthesiologist plays a key role to identify the details of the patients condition, recent changes, and reactions to interventions.

Issues for Concern

After reviewing the video, I was concerned about two experiences about a situation. In communication between doctors and a nurse, Dr. Dean mentioned a mistaken dosage of Misoprostol, and the overdose of this drug could lead to convulsions, abdominal pain, and hypotension, which is dangerous for a woman in labor. The decision of Dr. Pharm to correct his teacher immediately was appropriate, and, what is more important, the reaction of Dr. Dean was professional enough.

He admits that he makes a mistake, praises a colleague, and accepts the right option to a treatment plan. On the one hand, I was concerned that doctors could make mistakes in such simple situations and challenge a future process of work. On the other hand, the team professionally addresses this problem, demonstrating what solutions could be possible in this situation.

Another questionable experience was demonstrated by a nurse, Jean, who admitted that she was in a hurry during her communication with another nurse, Dana. The period of shift change is a critical moment in any hospital because medical workers should share their knowledge about current patients and describe situations clearly bur brief. Although some personal issues or problems occur, they should never prevent a working process. Therefore, when Jean started talking about the necessity to pick up her kids, I was worried that she could miss some information. Still, she was able to mention all the important facts and clarify the situation with the patient in a very informative way.

Positive and Negative Outcomes

In my situation, I experienced positive outcomes as well because this plan seems to be one of the most professional ways of work. When medical employees understand the worth of communication and collaboration, they increase their chances to protect patients and create healthy and favorable environments. There are no independently made decisions, assaults, or omissions, but respect for each others opinions is present. Negative outcomes like a breakdown in a team process could happen if some doctors or nurses were not able to accept critiques or recommendations. Human overreacting or the desire to be an unconditional leader may spoil the quality of health care offered to patients.

Conclusion

In general, patient safety and collaboration of the medical team are the major elements of successful health care. When nurses and doctors are ready to cooperate and communicate, they are able to recognize their mistakes at an early stage and predict serious negative outcomes. Therefore, the leading team technique, as well as other parts of TeamSTEPPS, cannot be ignored and must be properly developed by a masters prepared nurse.

References

Agency for Healthcare Research and Quality. (2020). Pocket guide: TeamSTEPPS. AHRQ. Web.

AHRQ Patient Safety. (2017). Labor and delivery: Successful outcome using teamSTEPPS techniques [Video]. YouTube. Web.

Introduction

Patients safety has become a global concern in the past two decades. This is mainly due to the rampant cases of medical errors that have led to many deaths within the health service facilities. Medical errors have caused death, serious disability disorders, and in some cases permanent pain to the patients. However, the transformation of our healthcare system is the responsibility of every person. We need to ensure that every person plays his or her role.

A Summary of the National Patient Safety Goals for Hospitals

Several goals have been set in the effort to enhance the safety of patients and increase the effectiveness of healthcare services. These goals include identifying patients, improving staff communication, safe use of medication, preventing infection, among others (TheJointCommission, 2012). The correct identification of a patient ensures that he/she receives the right medication, which is meant for him/her. This reduces the risk of patients receiving the wrong medication hence reducing room for error (TheJointCommission, 2012).

Communications implications for patients safety

Most of the medical errors experienced in the health sector are mainly due to poor communication in healthcare centers. Research has proven that most of the poor patients outcomes are more prevalent in hospitals where the level of communication is dismal (TheJointCommission, 2012). In most healthcare facilities, nurses are required to work for long hours and this creates room for error. An effective channel of passing information to the right person in health care is vital for the safety of patients. Effective communication minimizes mistakes in surgery to ensure the right surgery is performed on the right patient (TheJointCommission, 2012).

How does communication make the patient safer?

Getting the right test results for the right patient is very important to ensure their safety. This is based on the quality of communication between the nurses and the doctors (Karen, 2010). Doctors need to receive the right test results for the right patients in order to reduce medical errors. Therefore, nurses must be careful to ensure the right information for the right patients is communicated. Safe use of medication is enhanced through proper labeling (Karen, 2010).

When a patient is visiting a doctor, he or she must always carry the current list of medicine that he/she has been taking to avoid confusion (Karen, 2010). This helps the nurse to confirm that the patient has been taking the right prescription and if not the prescription is changed and corrective measures are taken before it is too late.

Conclusion

This essay provides a summary of the National Patient Safety Goals for Hospitals. These are globally accepted goals meant to ensure a safer patients experience and to reduce the possibility of errors. Communication has been identified as the most important goal in the effort to ensure safe procedures are followed within the health sector. The paper gives a clear insight into the implications of ineffective communication on patients safety. This paper clearly shows how patient safety can be enhanced to improve and enhance better health outcomes.

References

Karen, S. (2010). Improving Quality and Patient Safety by Retaining Nursing Expertise. 15(3), 3-10. 

TheJointCommission: National Patient Safety Goals. (2012). 

Health equity is the foundation of patient safety, quality of care, and improved health outcomes for vulnerable populations. A Triple Aim is an approach for optimizing the performance of healthcare systems offered by the Institute for Healthcare Improvement (IHI). The initiative was developed to enhance the patient experience, improve the health of populations, and reduce healthcare costs. (Institute for Healthcare Improvement, 2018). The Affordable Care Act (ACA) successfully addresses financial issues via cost-effective mechanisms of government spending cuts and taxation. The policy aims at improving health equity for populations via value-based insurance coverage and deals with the problem of affordable quality care for patients with preexisting conditions and previously uninsured individuals. The goals of safety, quality, and improved outcomes for all individuals are explicitly described in the policy, as its 2016 rule was issued to enhance the understanding of the needs of minority and LGBTQ patients.

The ACA promoted multiple measures to provide safety and quality of healthcare for vulnerable, medically underserved populations, or low-income populations via affordable insurance coverage. For example, the policy improved health outcomes for LGBTQ patients by decreasing the number of uninsured LGBTQ individuals and providing them with access to safe and quality healthcare. However, the main problem that undermines the effectiveness of the ACA is the lack of financial support and the introduction of penalties for safety-net providers. Despite the ACA efforts, millions of vulnerable Americans cannot afford healthcare insurance, so they have to rely on safety-net hospitals managing the populations with a significant risk of poor health outcomes. For instance, low-income individuals without insurance do not receive Medicaid coverage in 19 states (Shin & Regenstein, 2016). The introduction of the Hospital Readmission Reduction Programme (HRRP) and the Hospital Value-Based Purchasing (HVBP) resulted in penalties for safety-net providers despite their success in the prevention of 30-day mortality (Gaffney & McCormick, 2017). Therefore, while the ACA increased the number of insured LGBTQ adults, it negatively affected the access to safe and quality care for uninsured and vulnerable populations.

The implementation of the ACA impacted the nursing practice by expanding the responsibilities of healthcare professionals. Namely, the pay-for-value approach of the ACA urged hospitals to depend on the nurses competency, patient-focused practice, and communication to support other healthcare professionals (Mason et al., 2021). According to Standard 14 by the American Nurses Association (2015), the registered nurse should provide safe, effective, and patient-centered care, recommend improvement strategies, monitor the quality of care, and participate in interprofessional teams. The changes introduced by the policy allowed the nurses, who traditionally play a crucial role as care providers, to have opportunities for decision-making and evaluation of safety and quality of care (Stimpfel et al., 2019). Additionally, the policy recommends care providers, including nurses, consider the needs of LGBTQ patients but does not require them to treat diverse patients with respect or avoid judgmental attitudes.

My position is that the ACA is a positive contribution to US healthcare, but it should be amended as it ignores the needs of uninsured or low-income populations who rely heavily on safety-net hospitals. Based on the assessment of the ACA, it might be concluded that the policy is a generally favorable initiative as it decreased the number of uninsured adults and addressed the issues of the LGBTQ community. However, some elements of the policy should be changed to achieve safety and quality of care. The policy should require medical professionals and staff to adopt equity as a guiding framework and treat diverse patients, including LGBTQ, with respect, as it considerably affects health outcomes (Wilkinson et al., 2017). The transgender patients case from my nursing practice demonstrated how judgmental attitudes and incompetency of medical professionals could lead to unsatisfactory experience, inadequate treatment, and health complications in LGBTQ patients. The HRRP and the HVBP programs penalize safety-net hospitals with 6% of Medicare reimbursements for readmissions, cause adverse outcomes, and exacerbate health inequity towards the disadvantaged Americans (Gaffney & McCormick, 2017). Therefore, readmission penalties on safety-net hospitals should be abolished as they damage the financial stability of well-performing facilities providing care for underserved and vulnerable populations.

References

American Nurses Association. (2015). Nursing: Scope and standards of practice (3^rd ed.). Silver Spring.

Institute for Healthcare Improvement. (2018). The IHI Triple Aim. IHI  Institute for Healthcare Improvement. Web.

Mason, D. J., Dickinson, E. L., Perez, A., & McLemore, M. R. (Eds.). (2021). Policy & politics in nursing and health care (8^th ed.). Elsevier.

Shin, P., & Regenstein, M. (2016). After the Affordable Care Act: Health reform and the safety net. The Journal of Law, Medicine & Ethics, 44, 585588. Web.

Stimpfel, A. W., Djukic, M., Brewer, C. S., & Kovner, C. T. (2019). Common predictors of nurse-reported quality of care and patient safety. Health Care Management Review, 44(1), 5766. Web.

Wilkinson, G. W., Sager, A., Selig, S., Antonelli, R., Morton, S., Hirsch, G., Lee, C. R., Ortiz, A., Fox, D., Lupi, M. V., Acuff, C., & Wachman, M. (2017). No equity, no triple aim: Strategic proposals to advance health equity in a volatile policy environment. American Journal of Public Health, 107. Web.

TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) was developed in order to provide healthcare employees with the opportunities to advance patient safety, as well as to make work in teams smoother and more consistent. It should be emphasized that TeamSTEPPS is founded on the four core competencies  leading teams, mutual support, situation monitoring, and communication (Zerwekh & Garneau, 2021). In conjunction, the mentioned competencies contribute to a healthy working environment and to coherent interactions between healthcare professionals who are involved in teamwork continuously. It seems apparent that if they communicate efficiently and provide mutual support to each other, the critical errors are not likely to occur, which leads, again, to significant patient safety and overall performance.

There are a plethora of useful tools that TeamSTEPPS offers  starting from the two-challenge rule and ending with cross-monitoring. However, I should state that there is one that I tend to utilize on a daily basis  DESC Script. The latter may be defined as a constructive method that might help in resolving various conflicts. It includes the following: D  description of the situation or behavior; E  expression of how I feel about the situation; S  suggestion of alternatives; C  consequences that are to be analyzed within the scope of influence on the teams goals (Zerwekh & Garneau, 2021).

If I were a manager, I would continue to use the described approach. Given the fact that my work is characterized by the presence of many daily tasks and issues, there are many contradictory opinions on them, which may evolve into conflicts at times. DESC script allows me to assess such situations reasonably and consistently  this averts unnecessary escalations constantly. It seems rational to state that such a healthy nursing working environment  without inner, interpersonal struggles  results in great teammates interactions, which, in turn, is a foundation for quality and safe patient care as we focus on appropriate things.

Reference

Zerwekh, J., & Garneau, A. (2021). Nursing today: Transition and trends (10th ed.). Elsevier.

Introduction

In a medical institution, poor quality of services could be a threat to the patients safety since it would lower the output and reputation of a hospital. In this regard, the hospitals management has to prioritise quality improvement measures to enhance the standards of healthcare that the facility offers.¹ Therefore, this proposal highlights and justifies the problem of poor service delivery that the hospital faces, it outlines the objectives of the study, and describes the methodology to be used. Finally, it provides the anticipated outcome that the health facility will realise as it seeks to reduce the challenges it might experience while improving the patients safety.

Justification of Choice of Area; Statement of the Problem

As a result of growth, the hospital will experience various structural and administrative challenges, which could jeopardise the entire provision of healthcare services for the patients if not adequately dealt with early. The number of patients visiting hospitals will steadily grow, thereby, necessitating administrating changes to improve the quality of service delivery. Moreover, this trend could be coupled with continuous and systematic quality development initiatives to promote growth.² In this case, quality improvement initiatives should focus on particular patients to facilitate service delivery. Moreover, the support that the healthcare service providers offer to the patients should promote optimum outcome for those in need. This practice will also make sure that the process adheres to the business practice in terms of its effectiveness.³ The challenges the hospital is facing due to its growth and development could be effectively dealt with through a number of initiatives. For example, the hospital will have to carry out clinical outcome review, performance appraisal, peer review, and variance analysis because they are the best techniques for quality improvement.

Research Aims and Objectives

First, the research aims at creating a suitable and healing setup where allied healthcare professionals, physicians and subordinate staff work in harmony to provide the much needed medical support at a personalised level.⁴ Second, it seeks to advance healthcare schedules and improve the available healthcare and human resources to meet the basic Medicare needs of the patients in the area of coverage. Third, the research intends to help the hospital carry out its duties in a fiscally responsible and ethical manner without ignoring the patients rights and needs.

Methodology and/or Academic Approach

In this study, descriptive research methodology will be implemented. The researcher will specifically use approaches such as surveys, questionnaires and interviews to obtain data for analysis. The survey will be administered to a predetermined number of participants drawn from the target population.⁵ The participants will be expected to fill the survey forms and send them back to the researcher for analysis. The questionnaire will contain questions, which elicit answers directly related to the topic under study.⁶ The questionnaires will contain both structured and semi-structured questions. Participants of the study will fill in questionnaires. They will answer questions during one on one interviews with research assistants. In this case, the assistants will use both the structured and semi-structured questions as interview guides.⁷ In all cases, the researcher will compile the data and analyse them using statistical software such as SPSS.

Conclusion

The anticipated outcome of this research is that it will provide quality improvement measures such as efficiency, effectiveness, equity, timeliness, safety, and patient centered service delivery. This means that non-competent physicians would not have the opportunity to serve in the hospital. The Medicare providers have to devote more time, ideas and interests to achieve the hospital goals.⁸ The patients will also be required to cooperate with the healthcare providers and physicians.

Reference List

Archbold L. Four steps to planning, mapping, implementing, and controlling improvements in all types of healthcare environments. Michigan: MCS Media Inc; 2009.

Bergh D, Ketchen, D. Research methodology in strategy and management. London: Sage Publications; 2009.

Besterfield D. Quality improvement (9^th Ed.). New York, NY: Prentice Hall; 2012.

Blessing L. DRM, a design research methodology. New York, NY: McGraw-Hill; 2009.

Kenney C. Transforming healthcare: Virginia mason medical centers pursuit of the perfect patient experience. London: CRC Press; 2010.

Shaw P. Quality and performance improvement in healthcare. Texas: AHIMA Press; 2009.

Sollecito W, Johnson J. Mclaughlin and Kaluznys continuous quality improvement in healthcare. Burlington: Jones & Bartlett Learning; 2011.

Zhu J. Quantitative models for performance evaluation and benchmarking. New York, NY: Springer; 2008.

Footnotes

1. Archbold L. Four steps to planning, mapping, implementing, and controlling improvements in all types of healthcare environments. Michigan: MCS Media Inc; 2009.
2. Besterfield D. Quality improvement (9^th Ed.). New York, NY: Prentice Hall; 2012.
3. Shaw P. Quality and performance improvement in healthcare. Texas: AHIMA Press; 2009.
4. Kenney C. Transforming healthcare: Virginia mason medical centers pursuit of the perfect patient experience. London: CRC Press; 2010.
5. Bergh D, Ketchen, D. Research methodology in strategy and management. London: Sage Publications; 2009.
6. Blessing L. DRM, a design research methodology. New York, NY: McGraw-Hill; 2009.
7. Zhu J. Quantitative models for performance evaluation and benchmarking. New York, NY: Springer; 2008.
8. Sollecito W, Johnson J. Mclaughlin and Kaluznys continuous quality improvement in healthcare. Burlington: Jones & Bartlett Learning; 2011.

Introduction

Patient safety is the core concept of healthcare, and the rising use of technology can be explained by healthcare establishments need to provide patients with a more comfortable and safe environment (Carayon et al., 2014). Such innovations as the Electronic Health Record (EHR) already make some hospitals information systems more reliable than before, allowing them to access information and store it securely.

However, the presence of human errors can still lead to adverse effects on human health. For this reason, the incorporation of an electronic prescribing (e-prescribing) system may contribute to the hospitals level of innovation, reduce human error, and increase the quality of care (Porterfield, Engelbert, & Coustasse, 2014). However, while the implementation of this technology may positively impact patient safety, one should account for such factors as resistance to change and find ways to communicate the need for it to avoid problems.

Technology

The proposed change lies in the implementation of e-prescribing. It is a system that can be used in collaboration with the EHR or separately (Motulsky et al., 2015). E-prescribing allows physicians and nurses to send patients prescriptions directly to pharmacies electronically (Porterfield et al., 2014). During this process, the need for paper-based approaches becomes non-existent, eliminating the use of handwritten notes and the reliance on patients understanding of the process. Moreover, as this technology can be used together with an EHR system, patients information becomes even more centralized, including all health records and prescriptions and the communication with the pharmacy.

Impact

Some positive outcomes can be expected as a result of introducing e-prescribing to a hospital. First of all, the possibility of human errors can be significantly reduced (Porterfield et al., 2014). While handwritten notes may be lost, changed, or difficult to read, electronic messages are easy to interpret and impossible to change without having permission from the system. Thus, human interaction with these notes is highly limited, which makes these prescriptions safer for patients. Moreover, the centralized system of storing peoples prescription history can help the hospitals staff to be always informed about patients needs and conditions. E-prescribing can reduce the rate of miscommunication and disinformation among personnel and provide medical workers with a reliable system of data storage. Thus, patient safety is increased by eliminating human errors.

Issues

One of the main problems that can influence the process of implementation is the existence of such human factors as resistance to change, the lack of competency, and human error. For instance, physicians may adversely view the introduction of new technology due to the existence of habits and reliance on old experiences (Motulsky et al., 2015). Furthermore, a limited understanding of technology as a whole may also become a barrier to implementation. Such a cognitive burden may affect workers job satisfaction and also impact their relationship with the hospital, patients, and other employees (Rosenbaum, 2015). These challenges can be overcome with education for people who work with e-prescription. By helping employees understand why this technology is essential and how it works, the hospital can introduce the new system and have workers who are confident enough to use it without making mistakes.

Measuring the Impact and Implementation

The impact of this change can be measured using the Systems Engineering Initiative for Patient Safety (SEIPS) (Carayon et al., 2014). This system uses a human factors approach to assessing the use of new technology to increase patient safety. The SEIPS model applies a more complicated process of evaluating outcomes and advances in the process than other approaches (Carayon et al., 2014). For example, it can be used to estimate the change in the rate of incorrect or not used prescriptions and see whether patient satisfaction and safety are higher than before. If the proportion of errors is lower with the use of this new technology than it was with older methods, then the implementation may be considered successful.

The implementation of this system would require some preparations. First, employees who are going to work with e-prescribing should be trained to use this system. Next, the hospital should acquire hardware necessary for the technology and install software that is fit for the establishment according to its size and number of users and patients. Furthermore, a period of adjustment should be established to allow users to shift from a traditional paper-based prescription process to a new system.

Finally, the assessment of the new technologys efficiency should be included to make some additional changes and see whether it is working as planned. Communication with workers and patients is a significant part of every mentioned step because it may help employees to overcome their resistance to change and patients to understand the necessity of the new technology. Moreover, the continuous interaction may help uncover some issues with the implementation in their early stages.

Conclusion

The need for new technology arises because of hospitals need to provide patients with a safe environment and high-quality care. As patient safety often depends on human factors, the use of such technology as e-prescribing can significantly benefit patients and employees as well. With successful implementation, e-prescribing can reduce human errors, store patients data in a secure place and create a more reliable way of communicating with pharmacies. Resistance to change and other human factors can be overcome with training and communication.

References

Carayon, P., Wetterneck, T. B., Rivera-Rodriguez, A. J., Hundt, A. S., Hoonakker, P., Holden, R., & Gurses, A. P. (2014). Human factors systems approach to healthcare quality and patient safety. Applied Ergonomics, 45(1), 14-25.

Motulsky, A., Sicotte, C., Gagnon, M. P., Payne-Gagnon, J., Langué-Dubé, J. A., Rochefort, C. M., & Tamblyn, R. (2015). Challenges to the implementation of a nationwide electronic prescribing network in primary care: A qualitative study of users perceptions. Journal of the American Medical Informatics Association, 22(4), 838-848.

Porterfield, A., Engelbert, K., & Coustasse, A. (2014). Electronic prescribing: Improving the efficiency and accuracy of prescribing in the ambulatory care setting. Perspectives in Health Information Management, 11. Web.

Rosenbaum, L. (2015). Transitional chaos or enduring harm? The EHR and the disruption of medicine. New England Journal of Medicine, 373(17), 1585-1588.