Capstone Project: Significance of Patient Safety in Relation to Qsen Competencies

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SAMPLE EXCERPT:

[. . .] If the medical staff fails to inform patients about these details, the result will be a wrong decision made by the patient. (Rao, 2008)

The QSEN competencies have segment dedicated to patient safety as well. This shows the importance of this issue. It is mandatory for the nurses to have the necessary knowledge, skills and attitude about patient safety. If they fail to fulfil the requirements, they will not get the license or graduation. (Gorski, 2010)

Provision of information to the patient before making medical decision is an important part of patient safety. If the patient is not informed about the options and risks facing him, he will definitely be put in harm's way. So, it is a duty of the medical staff to supply reliable information to the patient. (Rao, 2008)

Patient safety directly affects the reputation of the medical practices worldwide. The topic must be studied and explored so that future errors can be avoided and the practices can be adjusted accordingly. In addition, medical practices are targeted to achieve the betterment of humanity and these errors and lapses in patient safety does not let the medical staff accomplish their main objective. Therefore, the issue of patient safety should be given the importance it deserves for the benefit of humanity and reputation of medical service providers. (Gorski, 2010)

Review of Literature

Patient safety, as the name suggests, is the safety of the patients that are admitted to medical institutions or getting nursing services at home. According to Cherill Scott, the attitude of patient safety is far more wide and positive and include practices and procedures covering more areas than just avoiding accidents. The patient safety is necessary for the patients who are under the care of nursing staff for 24 hours or more. (Scott, 2003)

The doctor-patient relationship is a complex one. The trend nowadays, is that the patients make the decisions about the type of medical assistance they are going to get. In addition to that, the patients also have a say in the strategy made to cure them. Therefore, the patients should be given complete information so that they make informed decisions. The permission given to the medical staff by the patient after knowing all the consequences is known as informed consent. According to Satyanarayana Rao, the information is a legal right of the patient and providing this information is the ethical responsibility of the medical staff. This information has a direct impact on the safety of the patient and therefore, on the repute of the medical staff as well. (Rao, 2008)

The medical staff should also be vigilant about the errors and lapses. In addition to that, Kenneth W. Kizer talks of patient safety as the basis of quality care. According to Kizer, there cannot be quality provision of care without patient safety. Moreover, Kizer also thinks that it is the moral responsibility of the medical staff to improve the state of patient safety. It is the duty of everyone who works in the field of medical science to reduce the errors and promote the safety of patients. (Kizer, 2001) (Scott, 2003)

The Quality and Safety Education for Nurses (QSEN) is and initiative targeted to improve the quality of nursing care provided to the patients. The faculty of QSEN has made a compendium of competencies. These competencies, according to the faculty of QSEN, help the nurses to develop certain knowledge, skills and attitude towards a certain aspect of care. According to the QSEN competencies, the nurses should keep in mind the KSA's and exercise different strategies in order to achieve a better standard of patient care and safety. These competencies are introduced to the nurses before graduation and licensure so that they are aware of these practices before starting practical work. The competencies are related to the following aspects of healthcare: (Batalden & Bednash et al., 2014)

Patient oriented care

Teamwork and helpfulness

Practice based on proof

Improvement of quality

Safety

Provision of information

The aspect related to safety is consistent with our current issue. (Batalden & Bednash et al., 2014)

According to the QSEN faculty, the definition of safety of patients, according to the competencies is to reduce the risk of adverse effects on the patients via correction of the system and individuals. The definition incorporates both the individuals and the system as a whole to make improvement in patient safety. There are certain skills, attitudes and pieces of knowledge (KSA's), which should be kept in mind in order to improve the performance of the nurse and the system. These KSA's are mentioned beforehand in the paper. (Batalden & Bednash et al., 2014)

Case Example

Sentara Norfolk General Hospital (SNGH) set a goal to improve the patient safety status of the hospital. The goal was to develop a culture of safety. SNGH needed a proper strategy to transform its culture into a safety oriented one. To accomplish the purpose, SNGH developed and implemented four strategies: (Mccarthy & Blumenthal, 2006)

To develop three sets of attitude expectations for the staff to learn and follow.

To steer the attention of the staff to the rules about operating in critical situations which may lead to adverse effects on the patient.

To provide information to the patients so that they are aware of the problems before making a decision.

To simplify the rules so that the staff can better understand and follow them. (Mccarthy & Blumenthal, 2006)

Changing the culture of an organization is never easy as bringing about behavioral changes is the most difficult. As a part of the strategy, all hospital staff was educated related to the expectations and rules. The staff was also trained to give the necessary information to the patients and help them in making correct decisions about their health. The results and changes in the behavior of staff was carefully monitored. (Mccarthy & Blumenthal, 2006)

Apart from that, the performance was checked using several indicators. The three indicators that were used are leading measures, real-time measures and lagging measures. Leading measures use data from a cultural survey in order to calculate a cultural index. Real-time measures are used to get observational data related to a specific topic of interest. Lagging measures include the calculation of errors and accidents that happen because of malpractice. The data obtained from these measures is then used to steer the overall project to success. (Mccarthy & Blumenthal, 2006)

As a result, the staff started to share information about the errors and accidents with their colleagues and patients. The employment of risk evaluation strategy and other sets of tools helped SNGH to get to the root of most of the accidents. Consequently, the cases of ventilator-associated pneumonia (VAP) was reduced by 84%. (Mccarthy & Blumenthal, 2006)

The aforementioned case shows that there were cases of VAP in the hospital. VAP is a special type of pneumonia that is found in patients who are getting mechanical ventilation in a hospital. The inflow of bacteria into a person's lungs causes VAP. Therefore, VAP is a disease which shows a lapse in patient safety. (Mccarthy & Blumenthal, 2006)

The strategies employed by the hospital are consistent with the strategies recommended by the QSEN competencies. The hospital started by making a culture of safety in the workplace which was the first piece of knowledge required by the competency. Therefore, application of the competency and its rules brought about favorable results. In addition to that, the employment of risk evaluation strategy and root cause finding tools is also consistent with the recommendations of QSEN. (Batalden & Bednash et al., 2014)

Implications

It is important to carry out safe practices on the patients so that the risk of any harm can be avoided. The practices of the nurses should be assessed and improved in order to ensure the safety of the patients who are under their care. First of all, a culture of safety should be developed in the workplace. For it to possible, the nurses should train themselves appropriately before handling a patient. In addition, there should be a feedback system for the patients and the staff so that the problems are traced and solved easily. Moreover, the medical institutions should make it their priority to identify the risks to patients and staff so that they can be avoided. (NATIONAL QUALITY FORUM, 2014)

Complete information should be given to the patient about the ailment and its treatment. This is to make sure that the patient makes the right choice and therefore, avoid any accidents. The nurses can also ask the patients to explain the treatment options and the ailment in order to make sure that he has understood what the nurse told him. Moreover, complete information about the progress of recovery from any error or professional malpractice should be given to the patient and his family. (NATIONAL QUALITY FORUM, 2014) (Wu & Nishimi et al., 2005)… [END OF PREVIEW]

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