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 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...
When a new system is implemented, an initial setback is always a major hurdle to overcome. In case of E-health the hurdle is the initial training provided to the staff as this can significantly decrease the productivity of the staff. A study conducted by the University of California-Davis found a 25-33 percent drop in physician productivity in the initial implementation phases of the EMR. While ultimately the goal is to increase productivity in the office or hospital, expect to see a significant drop in productivity, and ultimately revenue, in the first several weeks, and perhaps longer. (Palma,
Firstly, Nurses must develop the right communication tools when dealing with their patients. For example most nurses do bedside reporting, before they change their shift in the morning, therefore they would be relaying information to the other nurse about the patient they dealt with during the night. The nurse that is going off shift would give a report to the incoming nurse in the presence of the patient. He or she has to discuss the condition of the patient, medications and the procedures so the next nurse would be on the same level. Most nurses in the General Hospital do their reporting by the bedside of their patients.
It allows students to think differently and creatively while allowing them to see how they can change the world. Horace Mann’s knowledge theory promotes this idea. For example, Mann argued that practical knowledge is a tool that everyone was entitled to and that it was incredibly powerful. Mann explained that practical knowledge is what helps people compete in society (fairly). Knowledge helps people excel and change classes in society. It gives people a chance to contribute to society in a positive way. In many ways, Mann argued that it was a form of justice. For instance, Mann thought that once you learn to read and write, the world becomes filled with endless opportunities. I fervently agree that we still see Mann’s knowledge theory at work in today’s society. Many people have fought for the right for education and one way it has been enforced is through the no child left behind act. In order to change the world, we have to educate the students because they are our
“An electronic health record (EHR) is a digital version of a patient’s paper chart. EHRs are real-time, patient-centered records that make information available instantly and securely to authorized users.” (healthit.gov) The EHR mandate was created “to share information with other health care providers and organizations – such as laboratories, specialists, medical imaging facilities, pharmacies, emergency facilities, and school and workplace clinics – so they contain information from all clinicians involved in a patient’s care.” ("Providers & Professionals | HealthIT.gov", n.d., p. 1) The process has proved to be quite challenging for providers. As an incentive, the government began issuing payments to those providers who “meaningfully use certified electronic health record (EHR) technology.” (hhs.gov) There are three stages that providers must progress through in order to receive theses financial incentives. Stage one is the initial stage and is met with the creation and implementation of the HER in the business. Stage two “increases health information exchange between providers.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) Stage three will be the continuation and expansion of the “meaningful use objectives.” ("United States Department of Health and Human Services | HHS.gov", n.d., p. 1) The hospital, where I work, initiated the HER mandate many years ago. In this paper, I will discuss the progression and the challenges that my hospital encountered while implementing the EHR mandate.
pg. 19, 2014). The first rule of nursing is to do no harm, but since we are human, errors will happen. Inaccuracies in delivering treatment are due to mistaken identity, falls, burns, nosocomial infections, suicides, death or injuries due to restraints, wrong site surgery, surgical injuries, transfusion errors, adverse drug events and pressure ulcers (Kohn and Donaldson, pg. 35, 2000). Nurses use autonomy to contemplate on where corrections can be made through their daily routine. By knowing where the shortcomings are in delivering treatment, allows for errors to be corrected and to decrease adverse patient outcomes.
The medical secretary, registered nurses, licensed practical nurses, and physicians communicated consistently and appropriately so that all staff could effectively complete the actions required of their respective roles. I noted the strong relationship between the nurses and the physicians. The nurses held a heavy influence on the physician’s decisions regarding a situation, because the nurses were the ones conveying pertinent information related to the patient’s status. Based on the information provided, the physician would make recommendations and provide guidance to the nurses. The physician’s directions were then carried out by the nurse, influencing the nurse’s plan of care for his/her
They must be able to appreciate the value of standardization in nursing practice as well as the limitations of the human mind in memorizing and coming up with effective solutions all the time. The practitioner must also play their role in the prevention of errors within the facility while valuing the role of the patient, families and colleagues in as far as monitoring and cross checking is concerned. In addition, they must be able to appreciate the significance of the national safety campaigns and their positive impacts upon implementation in practice.
We are not only responsible for patient care, but we are also included in many other roles. Before nursing school, I thought that the main responsibility of the nurse is to take care of patient. During nursing school, I learned that patient care was not the nurses known just for. We took many general courses and nursing course work to prepare ourselves to be an educated member. For example, it was required to us to take microbiology, anatomy, leadership, professionalisms, etc to help us to become a better nurse and have a foundation base of education. We give patient care in the hospital, but we are also provider of care. We use the nursing process to help and make decision for our patient. Our decisions are based on critical thinking, clinical reasoning, and accountability. We are hold accountable for everything we do and based on our judgment to provide care to the best of patient’s benefit. We are also known for our role as a manager, designer, and coordinator of patient care. I plan and coordinate patient’s care based on their health care needs. In clinical, my patient has a Foley catheter, I will know to plan and implement Foley care to help with personal hygiene and preventing infections. It is important to make decisions based on priorities, time, and resources. As nurses, we need to know how to delegate and ask for assistance when needed. For example, I needed help to ambulate my patient who has a total knee replacement, I then ask
...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.
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.,
improving the quality of care, it is important to begin by defining quality. Quality is purposed by
As health care providers, nurses strive to instill confidence in their patients and their loved ones. A nurse is respectful to their colleagues as well as their patients. Nurses promote patients’ independence, patients can be confident in the knowledge that a nurse will do what is best for them, respecting their privacy and dignity. This means that a nurse does not share the patient information for personal reasons nor does the nurse get involved in a patients personal relationship if it is not medically relevant (NCSBN, 2011).
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
In order to understand and gain knowledge, learning theories stress the importance of creating a relationship between all pieces of information, the learner, and the environment. It is the responsibility of both the teacher and the learner to link the appropriate information together. If students can develop a relationship for the "underlying reasons for ‘how’ and ‘why’ to use specific procedures, they will be able to store this information as part of their knowledge network," and develop links with other pieces of information (Gersten and Baker, 1998, p.24). On the contrary, if learners learn facts of information that are isolated from a meaningful context, their understanding is often incomplete and meaningless. As a result of these linked relationships between individuals and environments, knowledge is the prevailing outcome. In summary, "knowledge is situated, being in part a product of the activity, context, and culture in which it is developed and used (Brown, Collins, and Duguid, 1989, p.32).