Several nationwide studies in the United States have revealed serious flaws in the safety and quality of the American healthcare system. Patient safety is a new healthcare field that focuses on the prevention, mitigation, reporting, and analysis of medical errors that can have catastrophic consequences (Papa 1). Under the direction of its administration, the nursing department plays an active role in maintaining patient safety. The nursing manager is in charge of organizational leadership, governance, decision-making, and nurse recruitment. Nursing management is one of the most important factors in a patient's safety at a hospital. The nursing manager needs to be competent to design, coordinate and progress patient safety principles and practices in areas of governance, patient care, education, and in research. That requires the help of an interdisciplinary team of health care workers, solution providers, a policy-making team and the community. A culture of patient safety is trending at current times. Nursing managers, the world over, are seeking to improve patient safety in their health care centers. Nursing managers also strive to address recruitment of most competent nurses and evaluating and helping improve the quality of their work while aiming to enhance the safety of patients (Armstrong 124). Patient safety remains essential and an indispensable component of quality nursing care. A nation could have a system that is susceptible to errors, and this is harmful to appropriate patient care.
Nursing management can use seven factors in ensuring patient safety according to Sammer and James in 'Patient Safety Culture: The Nursing Unit Leader's Role' include leadership, evidence-based practice, communication, teamwork, learning, and just culture that is patient-centered. Leadership is particularly emphasized at the unit level in nursing management to achieve utmost safety for patients. Nursing management has the critical role of leadership. That means it is in charge of oversight of the function of all nurses. It is also answerable to the mistakes that nurses would make. Therefore leadership seeks to enhance the role of nurses in patient care. Nursing management achieves that through hiring qualified nurses, assessing their work in close cooperation, training and guidance of the nurses where they need help in the course of their work. Leadership aims at bringing out the best version of the nurse for maximum patient safety in the patient-centred approach. It is also in charge of enacting new models of work that are arising following the patient-centred approach: this includes the interprofessional collaboration, which aims at partnering the nurse with the physician and other involved professionals in a patient. This combined force aims at providing the best possible harmonized and informed patient care. Interprofessional collaboration is taking off well in several states in the US. (Papa 1).
Evidence-based practice refers to the meticulous use of the most updated health evidence to make decisions in patient care. It seeks to evaluate most relevant evidence to find answers. It also integrates that with healthcare provider expertise and patient preferences and values. Enables health staff to use research, clinical regulations, and additional credible material and apply findings in practice. In nursing, the same principles are applicable, and the goal is always to increase the safety and wellbeing of patients while giving care in an inexpensive manner to improve results for the patient and health system. For nursing based on evidence to work, a spirit of inquiry is needed: questions about existing practices need to be asked by nursing professionals to create change and improvement. Asking of clinical questions is also important to address the patient, issue of interest, comparison group, outcome and time frame. This generates the best information to a subject while reducing time require to come up with results. Looking diligently of relevant evidence is a must. Evidence should be critically appraised on its validity and correctness. Collected evidence is then integrated with clinical use. (Cronenwett)
Team interaction and integration of efforts are useful in fostering patient safety--there is improved communication and outcomes. According to Christina Hunt on 'Patient Safety is Enhanced by teamwork'(2010), some facilities in Pensylvania take part in teamwork training to improve it. Evidence to support teamwork in patient safety can be drawn from the US Army in the mid-1980s whereby aviation fatalities were attributed to errors in crew communication, management of workload and prioritizing tasks. The US army reacted by creating a coordination training and evaluation system. That shift ended up saving around 15 lives and $30million per year. Like the Army, healthcare relies on communication and teamwork. For the state of Pensylvania, medical facilities are required to inform incidents and dangerous events to the authorities since 2004. Reports have content on a situation, background, assessment and recommendation and handoff communication. One health care facility reports reduced healthcare error from 30.9% to 4.4% as a result of teamwork implementation. Skills such as leadership, mutual support, situation monitoring, and communication have been emphasized by Clancy and Tornberg and can be aimed at better teamwork in health care. Teamwork reduces clinical errors, increases good patient and process outcomes and raises patient and staff satisfaction. A team interacts interdependently and adaptively to a common good of a goal. A competent team has a common vision, clear duties and roles, common goals, strong leadership and ability to handle and optimize performance results.
Shared knowledge by the team is exchanged in group meetings, where they discuss roles of groups, clinical status of a patient, and challenges of team operations. They occur as often as necessary. Correct communication structure is vital for success. Inadequate communication is a primary cause of errors reported. Communication needs to be clear, brief and timely. It improves through SBAR, callout, check-back, and handoff, whose explanations are below. SBAR (Situation, Background, Assessment, Recommendation) is a standard method to communicate info about the state of the patient. An instance would be a nurse calling a physician to update them on current patient condition to receive new instructions to patient care. Callout communicates vital information during an emergency, like a cardiac arrest incidence: the nurse 'calls-out' what medication should be given to a patient. Check-back closes the loop of communication and verifies information upon exchange. One check-back instance is where a nurse checks critical information from the lab to the lab staff to authenticate that it is correct. Handoffs are for communication during transitions in care, of a report from the emergency room to the medical floor during patient admission. Nursing management is in charge of laying down best possible teamwork and communication strategies. Optimizing the strategies specifically to one's institution is important. (Hunt).
Nursing staff embracing learning as a tool to improve patient safety is compulsory. Nursing management facilitates learning in several ways. Where it can, nursing management influences curricula of trainee nurses to learn the most recent methods in nursing care. Current nurses are also facilitated to learn these new methods and information. A learning culture utilizes collection, analysis, and reporting of quality data to improve performance and share information with nursing management colleagues. Teamwork and proper communication go hand in hand with learning as it is a collective effort of nurses and nursing management. Mutual respect is shown to all team members despite their ranking. Errors are to be considered as opportunities for learning in the so-called 'just culture,' which addresses human fallibility and personal accountability. There, however, is a distinction between acceptable and unacceptable behaviors. Staff members should report all their work, including errors they make, to facilitate learning from them. Some employees might hesitate to say that which reflects poorly on their performance, but on encouraging a culture that promotes safety, one knows that transparency breeds awareness and outreach brings change. The patient is central in care for this model. (Sammer).
A just and patient-centered culture is a concept that patients participate actively in their health care management. That doable in conjunction with health professionals. Health care staff might be tempted to view the hospital as a place of work solely, ignoring that it is a place of patient attention and healing. Patient-centered care aims at improving outcomes in the form of curtailing hospital stays, readmissions, and visits to the emergency section. It also enhances patient compliance to care strategies. A patient-centered culture ensures personnel is satisfied with their jobs and patients attention and satisfaction are, in turn, improved. Developing such a culture normally requires time requires a shift in healthcare delivery. It acknowledges individual patient needs and also permits patients and their families to participate in patient care. The resultant system supports patient's physical, emotional and spiritual needs.
The starting point in shifting into this approach is an organizational assessment to determine readiness. It identifies gaps and areas that require upgrading. Staff and community education should then be done about the need for change. Society is not acquainted with this kind of care. Care for the patient should be based on their unique needs, and the health institution should focus on abilities of the individual and encourage activity. Healthcare needs to be coherent. Health care professionals need to treat patients with dignity, compassion and respect and should work in an ethical perspective. The approach addresses the patient holistically and not their health case. Nursing management expects nurses to remain advocates for their patients by identifying with them and their needs. An example of a plan for patient-centered care by nurses is one that patient care is reviewed daily with the patient, and also so as to encourage participation of family in patient care rightly. This has been documented to improve health outcomes in patients. (Jarousse)
Adapting new cultures in any organizations can be challenging but necessary in improving patient safety by nursing management. Patient safety would require drastic culture shifts. Adoption of a strong cultural foundation by the nursing administration and staff is critical to the attainment of the same goal.
Works Cited
Armstrong, Kevin J and Heather Laschinger. "Structural Empoowerment, Magnet Hospital Characteristics, and Patient Safety Culture." Journal of Nursing Care Quality 21.2 (2006): 124-132. Online.
Cronenwett, Linda, et al. "Quality and safety education for nurses." Nursing Outlook (2007): 122-131. Print. .
Hunt, Christina M. Patient Safety is Enhanced by Teamwork. 16 June 2010. Web. 16 January 2016. .
Jarousse, Lee Ann. Hospitals and Health Networks. 1 November 2011. Web. 16 January 2016. .
Papa, AnnMarie and Victoria L. Rich. EMPSF: The Role of Nurse Leaders in Quality and Patient Safety. 10 February 2013. Web. 16 January 2017.
Sammer C., James B. "Patient Safety Culture: The Nursing Unit Leader's Role." OJIN: The Online Journal of Issues in Nursing 16.3 (2011): 3. Print.
