Monitoring and Ensuring the Quality of Health Care Practices 1) Nurses are ever present and coordinate the multiple interactions the patient has with the health care team. Nurses are in a position to prevent and detect errors quickly. Many nurses are uncomfortable with this domain because as a general rule this domain goes unnoticed when things go well and mistakes are avoided; but when things go wrong there are incident reports to be filed, accepting ownership of the error and then correcting the error (Benner, 2001, p.143).
2) The Monitoring and Ensuring the Quality of Health Care Practices is broken down into three competencies:
1. Providing a backup system to ensure safe medical and nursing care
2. Assessing what can be safely omitted from or added to medical orders
3. Getting appropriate and timely responses from physicians (Benner, 2001, p. 137) A couple of years ago our hospital switched from paper to an electronic medical record (EMR). This mandated for staff hospital-wide to attend training on the new software. Each department chose a handful of employees to obtain advanced training in order to be known as ‘super-users’ and be a resource for the remaining staff once we went ‘live’ with the programs.
I was fortunate enough to be asked to be a ‘super-user’ and was a part of the team that helped to incorporate many evidence based practices into the programs with the help of our information technology department.
While we set the system to remind you for things like obtaining blood cultures for a pneumonia diagnosis or giving aspirin for the chest pain patient, the one area we still do on paper is that of conscious sedation.
Just this week, I had a 92 year old female with a dislocated prosthetic hip that required cons...
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... 2-4). Practical knowledge helps you acquire the specific skills needed for day-to-day work. This is your learning through hands on experiences through the reality in life. It is being successful at knowing how to start an intravenous line or insert a foley catheter which is different from the theoretical knowledge of being able to identify them. Practical knowledge often leads to a deeper understanding of the concept as you practice more and gain experience.
Theoretical knowledge
Theoretical knowledge is the “knowing that” (Benner, 2001, p. 2-3). Theoretical knowledge teaches the why by helping you understand why one method works and another fails. It helps you be able to build on the information, helps you to set a strategy and see the whole picture. It helps teach you through the experience of others; leading to a deeper understanding of the source of reason.
Nurses help patients with their physical needs with details, explain the complex steps of medical treatment, communicate with doctors to share patients’ health conditions and proper treatments, and give emotional support to patients in stressful situations. There are certain limitations that nurses have in decision makings because doctors obtain the most power in patients’ medical clinics. However, nurses are more friendly, helpful, and suffering for patients. Lastly, experienced nurses can make a better choice for the patients over young and un-experience
...estions if not 100% sure of something or use a double checking system. When a nurse is administrating medication, they should use the ten rights of medication administration (right patient, right drug, right route, right time, right dose, right documentation, right action, right form, right response, and right to refuse). Nurses should always keep good hand hygiene and always wear appropriate clothing to prevent from the spread of disease. Good communication with patients and healthcare team members is also key to success. Keeping on the eye on the patient within an appropriate time is important. If the patient ever seems to be looking different than their usual self vitals should be taken immediately. Encouraging patients to ask questions if they are unaware of something can prevent errors as well. Nurses should make sure the patient is on the same page as they are.
The Meaningful use program was set up for implementation in three stages over a five-year period. The first stage ended in 2012 and involved evaluating health trends, and ...
This systems limits patient involvement creates a delay in patient and nurse visualization. Prior to implementation of bedside shift reporting an evidenced based practice educational sessions will be provided and mandatory for nursing staff to attend (Trossman, 2009, p. 7). Utilizing unit managers and facility educators education stations will be set up in each participating unit. A standardized script for each nurse to utilize during the bedside shift report will be implemented to aid in prioritization, organization and timeliness of report decreasing the amount of information the nurse needs to scribe and allowing the nurse more time to visualize the patient, environment and equipment (Evans 2012, p. 283-284). Verbal and written bedside shift reporting is crucial for patient safety. “Ineffective communication is the most frequently cited cause for sentinel events in the United States and in Australian hospitals 50% of adverse events occur as a result of communication failures between health care professionals.” Utilizing written report information creates accountability and minimizes the loss in important information during the bedside shift report process (Street, 2011 p. 133). To minimize the barriers associated with the change of shift reporting process unit managers need to create a positive environment and reinforce the benefits for the procedural change (Tobiano, et al.,
Furthermore, there should be enough trust between the nurses and physicians where they can easily put aside their egos and ask for a second opinion when they have any doubts concerning a patient's safety. This was clearly exemplified when the nursing staff attending to Lewis Blackman failed to contact the physician when various side effects arose; instead they tailored the signs to fit the expected side effects. Even after Blackman’s health was deteriorating, the nurses remained in their “tribes” and never once broke out of it to ask for help. The entire hospital was built on strong culture of remaining in their tribes instead of having goals oriented towards patients care and safety.
Unfortunately, the quality of health care in America is flawed. Information technology (IT) offers the potential to address the industry’s most pressing dilemmas: care fragmentation, medical errors, and rising costs. The leading example of this is the electronic health record (EHR). An EHR, as explained by HealthIT.gov (n.d.), is a digital version of a patient’s paper chart. It includes, but is not limited to, medical history, diagnoses, medications, and treatment plans. The EHR, then, serves as a resource that aids clinicians in decision-making by providing comprehensive patient information.
Nurses should foster collaborative planning to provide safe, high-quality, patient-centered health care. As nurses, we probably know the patients the best since we spend much more time with them than any other members of the care team. We are the liaison between the patient and the rest of the care team. We need to identify a potential problem or issue, and bring it to the attention of the whole care team. We should facilitate mutual trust, respect, shared decision-making, and open communication among all relevant persons in the care of the patients. With the collaborative support of the whole care team, the patients are in a much better position and are more likely to make an informed and deliberate decision. Besides, the collaboration among the care team can facilitate communication among the care providers, and provide a channel for the care providers to vent their stress caused by the ethical dilemmas that they encounter in work. The support from peers is very important for care providers to maintain their emotional and psychological
Nurses have a considerable amount of responsibility in any facility. They are responsible for administering medicines and treatments to there patient’s. While caring for there patients, nurses will make observations on patient’s health and then record there findings. As well as consulting with doctors and other healthcare professionals to plan proper individual patient care. They teach their patients how to manage their illnesses and explain to both the patient and the patients family how to continue treatment when returning home (Bureau of Labor Statistics, 2014-15). They also record p...
Quality and quality improvement are important to any healthcare organization because these principles allows organizations to fulfill their missions more effectively. Defining what quality is may differ depending on whom is asking the question, as differing participates may have differing ideas about what quality means and why it is important. Being that quality is what unites patients and healthcare organizations, we can see the importance of quality and the need for strong policies and practices that improve patient care and their experience while receiving that care. Giannini (2015) states that this dualistic approach to quality utilizes separate measurements, conformance quality that measures patient outcomes against a set standard and
The purpose of quality initiatives is to promote safe, timely, effective, efficient, equitable patient centered care( DeNisco & Barker, 2013). The quality improvement evaluation is important in the health care industry to find out the best practice care and to provide high quality cost effective care to patients. The public and private agencies are the regulatory entities in the health care Industry which promote quality and safety in the delivery of health care. The major regulatory agencies are CMS, the Joint commission, and AHRQ (deNisco & Barker, 2013).
According to Boykin “Caring is the foundation of nursing” (Boykin et al, 2011), and it is the nurses’ responsibility to understand what it means to be caring toward patients, which can be achieved through having professional communication skills. Not only does not being able to communicate affect the patient, but also it affects how the nurse is able to do his or her job to the best they can. Smith and Pressman say that the Institute of Medicine has released reports, which stress, “good communication is critical to ensuring safe and reliable nursing” (Smith & Pressman, 2010). Bad communication skills have the potential to be more dangerous to the patient and can in tern make a life-threateni...
Quality care, safe practices and principles, and accountability constitute the foundation of any health care organization (Huber, 2014). Addressing patient safety issues and improving health care quality may include reorganizing operations to improve efficiency, coordinating care with interdisciplinary team members, and using information technologies (Wang, Cha, Sebek, McCullough, Parsons, Singer, & Shih, 2014). In this paper, I will review my organization’s quality program goals, objectives, and management structure, how quality improvement (QI) projects are selected, managed, and monitored, and how nursing staff are trained and supported in
The World Health Organization outlines 6 areas of quality that help shape our definition of what makes quality care. Those areas are; (1) Effective: using evidence bases practice to improve health outcomes based on needs of individuals and communities. (2) Efficient: healthcare that maximizes resources and minimizes waste. (3) Accessible: timely care that is provided in a setting where the skills and resources are appropriate for the medical need and is geographically reasonable. (4) Acceptable/Patient-Centered: healthcare that considers individual needs, preferences, and culture. (5) Equitable: healthcare quality that does not vary because of race, gender, ethnicity, geographical location, or socioeconomically status. (6) Safe: healthcare that minimizes harm and risks to patients. (Bengoa, 2006)
When working and during my clinical rotation in long term care I had patients with functional limitations due to chronic illness or patients that were there to stay and live there. It was limiting to certain clinical experiences. During this rotation I got hands on experience with patients with acute conditions, infections and accidents.
Understanding quality measurement is essential in improving quality. Teams need to be able to understand whether the changes being made are actually leading to improved care and improved outcomes. For data to have an impact on an improvement initiative, providers and staff must understand it, trust it, and use it. Health care organization must understand the measurement of quality provided by the Institute of Medicine (patient outcomes, patient satisfaction, compliance, efficiency, safe, timely, patient centered, and equitable. An organization cannot improve its performance if it does not know how it is performing. Measuring quality improvements is essential as it reflects the quality of care given by the providers and that by comparing performance