NR 351 Week 4 Discussion 1 – Nursing Roles in Quality Improvement

NR 351 Week 4 Discussion 1 – Nursing Roles in Quality Improvement

Patient safety and quality improvement can mean different things to different people in the healthcare system. As a nurse, patient safety means to me that the physician is doing everything they can to assist a patient, preventing medical errors and protecting the patient from any harm or negligence (Horn, 2018). For this to be successful in the healthcare setting, the hospital needs to create a culture that supports patient safety and implement practices to promote it (Horn, 2018). Nurses promote safety in the health care setting by the double-step verification method before administering medication, re-reading orders back to a physician for verbals or by phone, reporting adverse events, utilizing resources, being an advocate for the patient, being an educator, effective communication, collaboration, and helping your physician with patients to catch any errors. Study experts from Johns Hopkins University estimated that 250,000 Americans died in 2013 from medical errors (Hood, 2018). As a bedside nurse working in an ER where the physician sees many patients per day and are in critical situations, it is our job to help them prevent errors. An example from my workplace is that we get many doctors from different parts of the country that come and work at my employers, and I guide them to where everything is, our protocols, our computer system, and many other things. Another example that I have had is we had a critical patient where the doctor was trying to perform a subclavian central line and caused a pneumothorax. I noticed the patient became apneic underneath the sterile drapes while he was focused on getting the central line, and he was unable to see the patient from being underneath the drapes. This allowed him to quickly respond, ordering the nurse to bag via BVM, intubate, and get the x-ray for placement and then identify the pneumothorax then place a chest tube. This is why we are called a team because not one individual can perform these tasks and be successful or prevent harm to the patient without each other.

NR 351 Week 4 Discussion 1 – Nursing Roles in Quality Improvement

The nurses that work in administration at my facility help with quality improvement and patient safety by performing studies each month based on patient surveys, quality assurance programs, AMA, LWOTS, site of reporting complaints, incident report sheets, reviewing or updating policies, and I’m sure many other things that I’m unaware of that promote those things. As a bedside nurse, to improve patient safety and quality improvement, I do crash carts are checked and working at the beginning of each shift, my rooms are supplied with everything, trauma carts are stocked, checking for expired objects, educate my patients, talk with my physician about orders or something that is concerning, providing roles during trauma or code to each person, and being a patient advocate. One thing that I would suggest at my facility to improve patient safety and care is having devices that prevent elderly or confused patients from getting up or falling. The beds in our ER do not have bed alarms, and there have been instances, especially when we are very busy, where patients have gotten up and fallen. Having a device where it just monitors if they get out of bed by placing it underneath them can improve patient safety and quality improvement at my employer.

References:

Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Wolters Kluwer.

Horn, J. (2018, September 12). How Nurses Can Support a Culture of Patient Safety. Retrieved May 25, 2020, from https://www.cerner.com/perspectives/how-nurses-can-support-a-culture-of- patient-safety

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NR 351 Week 4 Discussion 1 – Nursing Roles in Quality Improvement

How do nurses promote patient safety and improve quality at your workplace (or previous clinical setting)? What changes would you suggest being made on your unit or facility to improve a nonpunitive culture of safety?