NURSING ROLES IN QUALITY IMPROVEMENT DISCUSSION

Post #1

One way nurses promote patient safety and improve quality in my facility is by participating in bedside shift report. “Effective handoff communication is essential to optimizing the delivery of safe patient care.” (Bigani and Correia, 2018). Shift report is done at the patient’s bedside. It promotes effective communication, accuracy of the information in report, and helps reduce errors and uncertainty. The oncoming nurse has the opportunity to assess the patient’s mental status and perform safety checks. Assessment of IV lines, high alert IV medication, wounds and incisions are done while the off going nurse is present. Patients are involved in their care and can participate in report as well. According to Bigani and Correia, “Both the Joint Commission and The Institute for Patient-and Family-Centered Care consider the presence of patients and families during change-of-shift hand off report an essential safety measure as it promotes collaboration and further enhances effective communication.” When safe care is delivered, quality of that care improves.

Nurses report errors to the Charge RN, Manager (and Supervisor on evenings/overnights). We also have an electronic Safety Event Reporting system to document errors and near misses. The information entered into the report is reviewed by a Quality Assurance and Performance Improvement Team. Data is collected and a report is generated, and the RN reviews the results with their manager. At that time, the RN is reeducated/counseled on the event that occurred. I feel that the nonpunitive approach in my facility makes staff more willing to report errors without fear of retribution. Employees don’t hesitate to submit safety event reports because of the system in place.

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Post # 2

Nurses must follow policies and always do double checks in order to follow safety guidelines for their workplace and per Joint Commission’s standards. Every time that we see a patient we are making sure to promote safety for our patients. Always verifying the correct patient, completing the five checks of medication administration, using proper body mechanics when moving our patients to prevent falls and injuries, and also providing good, quality care for our patients. A safe workplace makes for happier patients.However, we do not live in a perfect world, so we can not expect everything to always work out 100% of the time. The hospital where I work has a electronic Event Reporting System (ERS) in which you report incidents that have occurred in the workplace. These incidents can range from a patient fall to an unexpected death that occurred due to unsafe working conditions (lets hope that this does not happen). The number one safety issue that is heard all across the United States is safe safe staffing ratios. I have not met a nurse that does not believe in safe staffing ratios. Shekelle states, “A small percentage of hospitalized patients die during or shortly after hospitalization. Evidence suggests that some proportion of these deaths could probably be prevented with more nursing care.” Studies have been done on high and low staffed hospitals and it has been proven that post hospitalization deaths can be prevented by this. My one simple, short and sweet answer about safe staffing ratios? You, as a nurse will have much more time to spend with each patient. They will receive better care physically and emotionally due to being able to have more time with their nurse.

MY QUESTION is for both of these post 1 & 2. I need one reply for each post ( at least 2 paragraphs for each post ) Thanks!