Patient Safety and Quality: An Evidence-Based Handbook for Nurses - Essay Example

Patient safety remains a fundamental component for any healthcare service offered within a given establishment. The role played by patient safety regulation becomes a fundamental determinant of the quality of healthcare received from different organisations. The level of application of patient safety differentiates similar services offered within different healthcare establishments. The policy development and implementation within different organisations depends heavily on the organisational systems, enhancing the utilisation of patient safety. Sufficient application of patient safety within various organisations contributes to overall quality of services offered within a specified establishment. Patient safety and healthcare quality, therefore, remain two components which affect each other directly. This paper seeks to analyse the element of patient safety within various healthcare organisations. The paper presents a discussion of the various factors influencing the occurrence of patient safety incidents within a hospital setting. Patient safety incidents become significantly affected by three major factors; human factors, medical complexity and system failures within healthcare organisations. Majority of issue leading to the occurrence of these instances could be regulated through adoption of efficient patient safety framework and policies, enhancing patient safety. The current framework includes guidelines provided by government organisations regarding processes of implementing sufficient patient safety policies. Numerous organisations continue to follow the government provisions; however, modifications enhancing safety become necessary in increasing the efficiency of the safety systems. These modifications, however, must conform to the provisions of regulating government authorities, charged with overseeing implementation of patient safety. The report provides various recommendations regarding improvement of the framework through the introduction of amendments into the current policies. Table of contents Abstract 1 Table of contents 2 Introduction 3 Current situation 4 Factors affecting patient safety 4 Human factors 4 Medical complexity 5 System failure 5 Quality framework 6 Cost benefit analysis 11 Conclusion 12 Recommendations 13 References 14 Introduction Patient safety refers to the prevention of erroneous occurrences, related to healthcare provision, which could present adverse effects on patients. Comprehensive safety includes the capacity for employees to operate within stipulated regulations, seeking to minimise occurrence of medical mistakes (Hughes, 2008). Such medical errors could potentially harm patients through presenting a hazard to patients. The inclusion of these regulations within different healthcare establishments ensures that patients remain unexposed to dangers, while residing within these establishments. Patients commonly attribute patient safety to quality healthcare; hence seek healthcare from organisations where they feel safe. Safety of patients remains fundamental to establishing a good reputation for various healthcare organisations. Enhanced safety operation ensures minimal cases of injuries and deaths of patients while residing within hospitals. The inclusion of safety procedures within the healthcare sector remains fundamental in improving the quality of services offered within healthcare organisations. Patient safety has been identified as an indistinguishable component of overall patient safety (CokerGroup, 2008). Through patient safety, the balance realised between the realised operational procedures and provided guidelines comprise patient safety. The quality of healthcare resides within the perception of individuals receiving the care. This perceived quality could become enhanced through ensuring patient safety while receiving medical services, within a medical organisation. Enhanced patient safety, therefore, signifies quality healthcare to the recipients of the services. While safety procedures can become clearly defined, quality cannot be defined, and normally results from adherence to stipulated regulations regarding safety and other controllable components of healthcare service delivery. Current situation Patient safety incidents normally occur during the process of medical practice. While enough care might be taken to avoid such instances, the occurrence of patient safety incidents cannot become totally eliminated. The occurrence of these events becomes affected by different causative agents and factors. The factors remains associated with the occurrence of different patient safety incidents. Different medical practices report varying levels of incidents based on the prevalent of contributing factors (Neale et al., 2001). General medical practice reports the least number of incidents because of the nature and environment under which the practice is undertaken. The adversity of the effects presented by different incidents remains determined by the contributing factors. Factors affecting patient safety Patient safety is affected by various factors as might be present within the environment where healthcare in administered. These factors could be attributed to the various individuals involved ranging from the medical professionals to patients (Neale et al., 2001). The available systems present within the establishments could also contribute to the occurrence of patient safety incidents. These factors could be identified as discussed below Human factors These include elements concerning the capacity for individuals involved in healthcare service delivery to undertake various functions. Differences in training of medical professionals could result in doctors undertaking different diagnosis for the same individual. The knowledge of these professionals could result in prescription of different medication which might cause safety concerns for patients, when they visit different doctors. Experience of nurses could enable them become updated with current medical practices and enhance their operation; hence limiting instances of patient safety incidents when serving patients. The workload performed by an individual could affect his/her capacity to perform duties efficiently. Overworked medical professionals would become prone to making errors during service delivery (Nocera & Khursandi, 1998). Human factors remain the most common causes of patient safety concerns, and these factors cannot be efficiently controlled through policy formulation. Many of these factors are contributed by the working conditions and the individual’s perception of patient safety. Medical complexity Some medical operation could become complicated for individuals faced with the situation and might require services of specialists. People normally visit healthcare facilities when faced with common problems, and the professional visited should provide proper advice regarding conditions. Undertaking complex medical operations could result in medical professionals making errors (Wilson et al., 2001). Medical practitioners, for example, might fail to realise the presence of comorbidity within certain patients. This could result in treatment of a less life threatening condition while leaving the life-threatening condition in the individual. This could be the result in adverse effects being observed following a patient’s treatment. System failure This commonly occurs within operation theatres where different systems are utilised in performing of various analytical functions. Some systems could be faulted for occurrence of miscommunication, which could result in patient safety incident. Some organisations have communication channels requiring all medical operations to be authorised by certain individuals. These bureaucratic organisational structures could affect the time taken while seeking authorisation to administer medication upon patients. During the process of following the bureaucratic communication channels, adverse effects could occur upon patients, such could be associated with system failure or weakness. Quality framework The quality framework remains controlled by the government and various hospitals also have their own frameworks. Within each healthcare organisation, quality frameworks have been adopted to enhance patient safety while residing within a hospital environment. This framework includes policies and guidelines regarding patient safety. In Britain the guidelines are provided by the National Health Service, and its authorities. The NHS provides guidelines for implementing policies seeking to enhance patient safety within the healthcare sector. This framework remains essential in providing information regarding issues arising within the patient safety element. Patient safety remains a major concern within the healthcare sector, for all stakeholders within the industry. In the United States of America, for example, the Patient Safety and Improvement Act of 2005, was developed for purposes of monitoring patient safety incidents. The National Patient Safety Agency operated with a similar mandate in England. This special authority performed the functions of monitoring safety issues within the country through reporting of safety incidents among other related medical errors, which might occur. The authority’s main aim was to enhance openness within public and private medical institutions within the country (NHS, 2009). The authority encouraged workers within the healthcare service delivery to share personal experiences which could be utilised in improving patient safety. Following collection of sufficient information, the authority then proposed implementation of various components aimed at improving safety, within healthcare facilities. Since June 2012, many key functions of NPSA became transferred to NHS commissioning board. In the management of patient safety, the organisation charged with responsibility of performing these functions receives patient safety incident reports across the country. Healthcare workers are encouraged to provide this information, anonymously, to the relevant authority. The organisation then utilises the knowledge of clinicians and safety experts in providing analysis of the received reports. Through the information received, common patient safety risks become identified. The panel of experts then develop sufficient improvement methods aimed at enhancing the safety of patients, while residing within hospitals. Through these analysis and reports, the organisation becomes able to implement procedures which enhance patient safety, within different hospitals. The organisation provides alerts to relevant institutions seeking to enhance patient safety countrywide. The commissioning board has an automated safety alert system which automatically redirects alerts to relevant societies and establishments. The body charged with overseeing the development of patient safety, has developed various guidelines for patient safety regarding various services offered within public hospitals. These guidelines are utilised by medical practitioners in enhancing patient safety and reducing patient safety incidents, countrywide. These guidelines vary between the type of care being administered to a patient including, mental care, primary care and general care. The guide acts to regulate the procedures applied by medical professional in administering healthcare services, which meet the basic requirements, and adhere to safety provisions of the government. The guideline begins with requiring the establishments to undertake internal assessment of safety operation, aimed at ensuring safety at the establishment level. Establishments normally undertake self-assessment to establish their weaknesses in offering patient safety (NHS, 2009). The establishments are required to develop internal systems for enhancing patient safety. This includes conducting regular patient safety training events within the organisation to enhance employee knowledge of safety requirements. The organisations are expected to facilitate internal processes seeking to enhance patient safety (Major, 2002). Employees on their part are expected to become motivated towards encompassing safety practices while undertaking their functions. Through observation of safety processes, improved patient safety can be achieved internally, without including government authorities like NHS. Within the various healthcare organisations, employees are expected to jointly undertake patient safety meeting to provide and share information regarding patient safety within their working environment. Individual employees are supposed to offer suggestions to organisation management, seeking to improve the various elements of patient safety encountered during work. This approach ensures basic patient safety becomes initiated from the organisational level, significantly plummeting the work performed by the enforcing authorities. Following the development of sufficient patient safety procedures and practices within the establishments, the organisations are then expected to adopt suitable risk management activities. These activities become integrated within the routine practices of medical professionals working within the establishment. These activities include reporting of errors, handling complaint, controlling infection among other risk management activities (Martin & Henderson, 2001). The major element contained within risk management practices remains the prevention of risks. This element remains fundamental in ensuring the patient safety incidents do not occur. Through adopting preventive, operative measures, safety becomes sufficiently enhanced and the quality of healthcare offered could improve drastically. Through the integration of risk management processes, general practice becomes safe with minimal patient safety incidents being reported. Proper recording remains an integral component of risk management as risks could become traced to their sources. This enables sufficient remedial action to be performed upon recorded incidents. Integrating risk management processes into the overall medical procedure remains fundamental towards enhancing patient safety. The next guideline in general practice requires the organisations to provide an environment and procedure for reporting patient safety incidents. The essence of reporting remains to be able to utilise this information in enhancing patient safety from recorded incidents. When incidents are reported appropriate remedy could be included within the standard operations to ensure such incidents do not become repeated. This reporting element would enhance patient safety through availing information regarding incidents. Through reporting, healthcare workers can be able to learn something regarding patient safety from the incidents. The reporting should always be documented for future reference within the organisations and among interested stakeholders. This information remains fundamental in implementing safety measures aimed at eliminating incidents within hospital environments. Elimination of these incidents would significantly enhance the quality within the healthcare sector. Following the reporting of patient safety incidents, the guideline requires communication to be initiated between the hospital, patients and the entire community seeking healthcare from the hospital. Efficient communication would normally involve informing the general public about the incidents. These incidents can inform the public about prevalent outbreaks of common communicable diseases like cholera. When the public becomes aware of such outbreaks, the public could adopt necessary protective procedure to prevent infection by communicable diseases during outbreaks. Through communication, healthcare organisations become obliged to seek patient views regarding the incidents (Wilson et al., 2001). Communication also includes responding to complaints presented by various stakeholders. Feedbacks communicated through websites following patient surveys also provide sufficient information to patients regarding safety. This remains relevant because some patient safety incidents, like misdiagnosis, commonly occur from poor communication between medical staff and patients. Knowledgeable patients could provide essential information, which could be utilised in improving patient safety. Proper safety practice could be defined through providing capacity to prevent the occurrence of patient safety incidents. When incident occur, however, organisations seek to analyse the cause in order to prevent repetition of such incidents. Healthcare organisations hold regular meetings seeking to provide a sharing platform for patient safety concerns among healthcare professionals. Healthcare organisations provide numerous forums through which sharing of patient safety information occurs among different professionals. Discussions enable different stakeholders to adopt different methods aimed at enhancing patient safety within the profession. Through sharing, professionals become aware of incidents which they might not have experienced personally. This ensures that nurses become sufficiently informed about patient safety issues arising within working environments. Following all the previous processes, the final stage presented by the guideline becomes implementation of essential solutions aimed at preventing future occurrence of similar incidents. The urgency of the corrective measure implementation becomes determined by the risk presented by the safety issue raised. Analysis of the impact remains fundamental in ensuring proper policy formulation and comprehensive implementation of necessary preventive measures. During the implementation process, the various stakeholders involved, become important in ensuring comprehensiveness of the adopted plan. The input of patients becomes important in enhancing the knowledge regarding an occurrence of the incident. Patients can provide sufficient information, which can be utilised by decision-makers in implementing proper corrective measures. The information presented by patients helps in increasing the understanding of other stakeholders, regarding the incident. The adopted systems are then tested to ensure their conformity to available standards provided by regulating authorities involved in the healthcare sector. Cost benefit analysis The implementation of risk management plans for handling patient safety incidents remains fundamental in enhancing patient safety within a healthcare setting. These plans are essential requirements according to the National Patient Safety Agency guidelines, which detail the various safety requirements within the healthcare setting. Though an essential requirement, integration of patient safety measures within professional operations remains fundamental in assuring patients of quality healthcare services. The element of quality within a healthcare setting remains a perception existing within the patients’ minds. The implementation of patient safety policies, therefore, could immensely enhance the quality of services offered. Occurrence of patient safety incidents hampers the reputation of medical organisations within the perception of public. While the implementation seeks to conform to provisions of governing authorities, the organisations also stand to benefit immensely from this implementation. Policies regarding patient safety remain fundamental in improving the quality healthcare offered through reduced incidents of patient safety being recorded. A comprehensive policy would also ensure that the medial professional working within a healthcare organisation observe professional ethical values (Martin & Henderson, 2001). Operating within the provisions of professional ethnics remains fundamental in ensuring reduced incidents of patient complaints. The process of handling complaints would become sufficiently reduced increasing the efficiency of the department. Many healthcare organisations continue to face numerous lawsuits resulting from patients who suffer injuries while receiving medical care. Following implementation of patient safety policy, many financial constrains resulting from lawsuits initiated upon organisation from injuries incurred by patients, could become eliminated. Healthcare organisations continue to become legally responsible for injuries patients get during treatment within these organisations (Nocera & Khursandi, 1998). Successful litigation could result in hospitals being required pay hefty compensations to patients initiating the lawsuits. The impact of these lawsuits is not only financial, but also destroys organisation reputation. The financial implications could result in hospitals being incapable of delivering other essential services, because of financial constrains. These incidents could be eliminated through comprehensive adoption of proper patient safety procedures within the organisations. Conclusion Patient safety remains a fundamental element of quality healthcare service delivery. Ensuring patient safety within medical operations enhances the quality of healthcare services; ultimately improving the organisation reputation. The quality of healthcare services offered within different organisations remains highly dependent on the capacity to provide sufficient patient safety. This component of healthcare remains a fundamental element of the overall healthcare quality as it assures patients of safety while receiving healthcare services. Governments continue to impose regulations upon all healthcare providing organisations regarding adoption of comprehensive and efficient patient safety policies. The healthcare organisations, however, have the liberty to implement independent patient safety policies. These policies, however, should conform to the provisions of various government regulations regarding patient safety. While implementation of the patient safety framework could be an extremely expensive project, the potential benefits surpass the incurred costs; hence the policies remain almost inevitable within healthcare organisation. Recommendations This report recommends adoption of various changes within the framework of patient safety. These recommendations aim at improving the delivery of services through improving patient safety, consequently improving healthcare services quality. The following recommendations can be integrated within the current framework to improve patient safety. Allow employed workers to report patient safety incidents anonymously to the relevant authorities. Anonymous reporting would significantly increase the reported cases as some individuals might fail to report for fear of being held responsible for such occurrences. Increase the amount of research undertaken regarding patient safety to enhance information availability. Information availability would enhance the policy formulation capacity, towards ensuring efficiency of adopted policies, within the healthcare sector. Increase public participation in providing information regarding the components of patient safety requiring comprehensive amendments. The public could raise concerns based on experiences they might have encountered which were never reported. References CokerGroup, 2008. A Guide to Patient Safety in the Medical Practice. Chicago: American Medical Association . Hughes, R. G., 2008. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: Agency for Healthcare Research and Quality (US). Major, S., 2002. Dysfunctional Teams: a health resource warning. Nursing Management , 9(2), pp. 25-28. Martin, V. & Henderson, E., 2001. Managing in Health & Social Care. London: Routledge. Neale, G., Woloshynowych, M. & Vincent, C., 2001. Exploring The Causes of Adverse Events in NHS Hospital Practice. Journal of the Royal Society of Medicine, 94(7), p. 322–30. NHS, 2009. SEVEN STEPS TO PATIENT SAFETY IN GENERAL PRACTICE, s.l.: National Reporting and Learning Service. Nocera, A. & Khursandi, D., 1998. Doctors' Working Hours: Can the Medical Profession Afford to Let the Courts Decide What is Reasonable?. Medical Journal of Australia, 168(12), pp. 616-18. Wilson, T., Pringle, M. & Sheikh, A., 2001. Promoting Patient safety in Primary care: Research, Action and Leadership are Required. British Medical Journal, Volume 323, pp. 583-584. Read More