Patient Safety in Nursing

Patient Safety in Nursing

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Patient Safety in Nursing

Introduction

In the nursing and health care field, patient safety is considered a crucial component of quality service provision, and one that greatly improves the health outcomes of clients. As such, it has become part of an instrumental practice model, which allows nurses, physicians, and other health practitioners to adhere to strictly. However, patient safety has become a major challenge today. Nurses are placed at the center of this phenomenon because of their deeper involvement with not only the patients but also other health care providers tasked with taking care of them. Several dynamics exists within a health care and safety perspective for nurses, which can prove to become a challenge, especially for those who have not been adequately trained for this. The paper provides a conceptual analysis of the problem of patient safety using the PICOT question format to analyze some of the key elements of this phenomenon.

Literature Review

The population in question is the patients within the environment that provide health services. These may include hospitals, clinics, dispensaries, and other health care facilities that provide services on a long-term basis for patients. In such an environment, there exist a large proportion of patients as compared to health care providers. A large aspect of the challenges facing the nurses is the lack of sufficient staffing to provide care to each patient admitted to these facilities. According to Hughes (2008), patients’ levels of safety are dependent on the types of patients within these institutions. Some patients will be more vulnerable to safety hazards than others depending on their respective conditions will.

As such, the population in question is a crucial factor to consider when evaluating problems of safety for nurses. Hughes, therefore, states that the population in question is a fundamental aspect to take into consideration when nurses are evaluating how best to provide safety for a patient. These practices should be aimed at not only providing safety to patients but also increasing their chances of a positive health outcome. The population in question will, therefore, require different degrees of care depending on their overall health conditions. While some require complete attention, such as walking, eating, and going to the bathroom, others will require a simple observation while ensuring that the environment is safe and hygienic.

            Methods of intervention are crucial for allowing patients to remain safe and healthy within a health facility. Many of the issues arising from safety hazards within hospitals and dispensaries are the lack of knowledge as well as resources to implement safety procedures. The overall aim of the intervention is to ensure that safety of patients is enhanced to the best possible care available. Challenges of providing care arise from lack of sufficient training of nurses and other health practitioners (Armstrong et al., 2009). Nurses may not be qualified in certain fields, which facilitate their level of service provision to patients. Lack of sufficient experience will also curtail the ability of nurses to anticipate potential safety hazards within the health care environment.

Furthermore, the intervention methods can also be limited by lack of sufficient resources required to ensure that the environment within which patients reside is protected from safety hazards. For instance, the level of safety can be determined by factors such as good security systems, clean and dry areas where patients walk, keeping of accurate databases to reduce patient errors, and open communication with patients, among several others. Other interventions are based on promoting a culture of safety for patients within the health care staff, which can be achieved through building a strong professional foundation of workplace ethics, communication, and safety among nurses working within the institution.

            Control measures can be evaluated through making comparisons between two or more health care facilities. Health services are provided from different dynamics depending on the patient’s needs. As such, the health practitioners need to tailor their services to meet these needs (Bonner et al., 2009). Control factors will, therefore, be evaluated on an individual basis rather than from a perspective of the collective patient records. Another control factor will be dependent on the nurses working conditions as well as ability to deliver services in relation to better health outcomes and safety for patients.

Extensive studies have revealed a positive connection between better working conditions for nurses and improved patient safety. Nurses suffering from burnouts have proven to pose a greater risk to patient safety, which is because of their ability to make more human errors, as compared to if they were well rested before work. One of the factors influencing working conditions of nurses is ensuring that nurses receive an adequate amount of rest and working for shifts that are not too long, which can be achieved by reducing the nurses to patient ratio. A control factor could be an environment where there is sufficient nurse to patient ratios, which will be dependent on the level of care required for a single patient.

For those in the intensive care unit, the required nurse to patient ratio is 1:1 while for patients requiring minimum care, the ratio can be 1:3. Another measure of control will be the patient characteristics, which can vary from calm to uncontrollable, which will affect the overall results of the safety measures. While some patients can be cooperative with nurses and other practitioners, it is common to find others who are less concerned about facilitating their safety, whether knowingly or due to issues such as mental health illnesses.

            The overall outcome of the patient safety practice is improved safety for patients. The risk of patient safety hazards can lead to death, serious injuries, and lawsuits against the health facility, which will lead to not only loss of funds but also a tarnished image for the organization. Over the years, much has been done by the health care facilities as well as the nursing community to improve health care through improving the safety of the patient (Stone et al., 2007). However, challenges exist in all spheres of operation, including technological challenges, which increase errors. Some of the anticipated outcomes as a result of the interventions include reducing a number of falls, pressure ulcers, urinary tract infections, unjustified restraints, and errors in the administration of medication. Depending on the different levels of hospitalization, some of the patients will be more prone to these health hazards more than others are. Nursing outcomes will also be dependent on the overall operational models existing within the health institutions. Therefore, there is a need for facilities to establish the most realistic model with objectives that are achievable for nurses (Feng et al., 2008).

Within the research, there is need to evaluate the specific interventions based on the problems stated above. For instance, if the records of falls in the hospital indicate 14, health care decision makers need to make targets seeking to reduce these numbers, along with an evaluation of some of the factors causing falls in the hospitals. These could be shortcomings such as lack of clean and dry areas for patients to walk, or lack of adequate physical support provided to patients while walking. In the instance where errors are made, some of the factors leading to this could be inefficient systems and databases, overworked or undertrained nurses.

The time it takes for these interventions to take place will mainly depend on the availability of resources (Wachter, 2012). For instance, if interventions require more nurses to reduce the nurse to patient ratio, the facility will need to gain more financial support to pay these nurses. If the interventions require an overhaul of the systems to reduce technical errors, it is likely that more funds will be required for this. Such forms of interventions may take months or even years. However, simpler yet effective interventions involve adjustment of nursing practices, such as improvement of communication with patients to serve them better. For such interventions, the time taken to experience outcomes could be as short as two months.

Conclusion

Nursing practices are aimed at improving health outcomes and safety of patients within health care facilities. Patient safety is part of an important model, which ensures that patients receive the best possible care while admitted in hospitals. The research procedure is aimed at identifying patients requiring safety, determining intervention methods, evaluating possible outcomes, and determining the time in which these outcomes will be achieved.

References

Armstrong, K., Laschinger, H., & Wong, C. (2009). Workplace empowerment and magnet hospital characteristics as predictors of patient safety climate. Journal of nursing care quality, 24(1), 55-62.

Bonner, A. F., Castle, N. G., Men, A., & Handler, S. M. (2009). Certified nursing assistants’ perceptions of nursing home patient safety culture: is there a relationship to clinical outcomes. Journal of the American Medical Directors Association, 10(1), 11-20.

Feng, X., Bobay, K., & Weiss, M. (2008). Patient safety culture in nursing: a dimensional concept analysis. Journal of advanced nursing, 63(3), 310-319.

Hughes, R. (Ed.). (2008). Patient safety and quality: An evidence-based handbook for nurses (Vol. 3). Rockville MD: Agency for Healthcare Research and Quality.

Stone, P. W., Mooney-Kane, C., Larson, E. L., Horan, T., Glance, L. G., Zwanziger, J., & Dick, A. W. (2007). Nurse working conditions and patient safety outcomes. Medical care, 45(6), 571-578.

Wachter, R. M. (2012). Understanding patient safety. New York: McGraw-Hill Medical.

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