The Quality of Health Care in America - Thesis Example

Enhancing Quality And Safety Clinical Practice In Wards" Nursing is directly related to patient safety. Any mishap that takes place during the course of medical care displays the poor health care provided. In order to enhance the levels of medical facilities the role of nurses become imperative to check the expertise attained by the nurses in dealing with the situation and to provide excellent care, avoiding all the negative outcomes and to generate positive and congenial atmosphere for the reduction of level of anxiety and distress of the patient and construct an environment of trust and health progression to evade the pervasiveness of hospital-acquired ailments. The expertise as well as experience of the nurse is also essential in dealing with the difficult situation and cases demanding critical care and preclusion of accidents. The safety of the patient is of utmost significance and therefore it becomes essential for the hospital management not to suffer with the downturn of experience and efficient nursing staff. Introduction Health care is the key to high-quality life, beneath the health care facilities safety of the patient dwells. Health care results portray the kind of care that has been provided and the extent of professional understanding for the quality care. According to Institute of Medicine (IOM), "patient safety is indistinguishable from the delivery of quality health care" (Aspden, 2004). Further, the level of health services in a given condition is directly proportional to the health outcomes. Harteloh (2003), revealed that "Quality [is] an optimal balance between possibilities realized and a framework of norms and values." The positive outcomes of quality health care encompass attainment of apposite personal care, manifestation or expression of health-supporting approach, health-associated eminence of living, judgment of the individual being appropriately cared for along with managing symptoms properly (Mitchell, 2004). On the other hand any undesirable episode or morbidity and transience are considered to be the negative results (National Quality Forum). In the present scenario, conceptual components of quality are given privilege as compared to other deliberate markers indicating that a profound safety in quality care, success of the care, patient focused approach, well-timed, proficient, unbiased and reasonable predisposition. Safety in health care is the underpinning parameter that leads to the assembly of all other aspect of quality care (Committee on the Quality of Health Care in America). Quality care is the most essential component of the health care. Quality care encompass the patient safety which is the most imperative of all the components of the health care facility. Considering the importance of patient safety as the most essential aspect, IOM has defined health care as "the prevention of harm to patients" (Aspden, 2004). Prominence is positioned towards the entire system that is related to health care facilities to prevent the patients form any mishap, to avoid any inaccuracy, learn from the mistakes so as to avoid the repetition of the same in future, to provide the patient with the ethnicity of safety, a congenial atmosphere that is essentially built by the physician, nursing staff and the patient keeping the patient as the prime focus (Clancy, 2005). According to AHRQ Patient Safety Network patient safety is imperative to afford autonomy from unintentional or avoidable grievances or mishaps that are otherwise created by poor medical care ( AHRQ PSNet Patient Safety Network). Empirical awareness and practical familiarity is acquired by means of dexterous implementation of nursing measures along with the capability to execute composite, multidisciplinary evaluation, identification of symptoms as soon as they onset to avert worsening of the patients condition. Well-informed, educated and experienced nurses are potentially capable of providing premier quality of health care. According to Shojania (2001), patient protection exercises comprise the reduction in the jeopardy of undesirable happenings associated with disclosure to therapeutic concern transversely affected by a variety of analysis or diagnostic outcome of the patient. Experience is required to effectively upgrade and improve the protective measures to avoid harms. In order to have a profound understanding for safety measures required to be considered for appropriate patient care following measures are of utmost significance. Proper utilization of prophylaxis in order to avoid venous thromboembolism in cases at peril. Appropriate medication, pre- and post-operative cases to avoid transience. Appropriate use of sterilization methods in case of equipments such as catheters (should be antibiotic-impregnated) and also while handling patients under critical condition. Right utilization of antibiotic prophylaxis especially surgery cases to thwart postoperative contagion. Counselling patient to substantiate their involvement. Constant aspiration of subglottic secretions to avoid ventilator-associated pneumonia. Use of all the measures that are prescribed to prevent hospital acquired ailments, viz. utilization of pressure-relieving bedding, sterilization measures, use of equipments only after thorough sterilization to prevent complications. Nutrition should be provided as per the recommendation especially to critical cases (Shojania, 2001). Patient cantered care needs are the most vital components to enhance the safety of the patients in wards. More care could be attained by encouraging the patients to participate in their care as it builds confidence in the patient and the psychological mind set of getting recovered and hence they are given the chance to contribute in their personal-care. Better health facilities and care provided to the patient builds a chain reaction for the reputation of the hospital as the patient who received good care speaks about the hospital services and health and speedy recovery of the patient without complications converse in public about the efficient medical standards of the hospital, adding a feather to the hospitals cap. The co-ordination between the doctors and nursing staff, their knowledge, understanding towards patients needs and requirements, attentiveness and their ability to work as a team paves the way for maintaining a consistently high standard of health care facilities and aids in identifying methods to provide safer and even better care for their patients especially through the nursing staff as these actions diminish the risks and health hazards which are otherwise caused to the patients due to poor health care, culminating into health hazards in wards. The motive of the nursing staff is desired to be oriented towards generating a congenial and co-operative safety culture which is cultivated by means of good nursing practice and adoption of systematic research outcomes for better efficacy and patient safety. Considering these of paramount significance, the National Quality Forum tried to fetch precision and concentration to the numerous descriptions with their information, Standardizing a Patient Safety Taxonomy (National Quality Forum, 2006). Accordingly the severity of harm due to negligence in health care or due to failure to take appropriate care could be defined as "temporary or permanent impairment of physical or psychological body functions or structure." Other methods responsible for the failure process encompass- Communication error, which is responsible for the mishap. Lack of communication could be either from the patients side or from the physicians or non-medical staff. Poor patient management due to inappropriate allocation, breakdown in pathway location erroneous medical recommendation, or incorrect utilization of reserves. Poor clinical presentation during the entire course of hospitalization. Failures are also classified according to their occurrence comprising: Latent failure occurs when the hospital staff or physicians are not directly involved but certain decision made by the patients and their associates that influence distribution of resources. Active failure that is directly associated with the patient. Organizational system failure which occurs due to poor management displayed by the organization, culture, lack of knowledge, conflict, inappropriate procedure or protocols responsible for substandard patient care. Technical failure or lack of apparatus or due to non-functioning equipments which directly affect the patients health care. Mitigation actions are also responsible for the patients health care which if worked out in a well-co-ordinated manner could bring better health benefits to the patient and prevent mishaps and failures. Nursing as a key in enhancing quality and safety clinical practice in wards Nursing profession is a highly responsible job as patients medication and prevention of falls are taken care by the nursing staff. One of the chief parameter for the nursing profession, along with the patients safety is the quality, as it matters not only for the patient but also for the reputation of the hospital (Tourangeau, 2006). The aptitude of nurses to harmonize and incorporate in manifold characteristics of excellence in care honestly offered by the nurses, moreover they deliver care in different environment with diligence, resulting in reduction in complications and mortality as nurses could potentially seize mistakes, examination and recognize the vulnerability well ahead of time. An experienced and knowledgeable nurse with good communication skill could prevent errors related to failure in implementing standard operating procedures, underprivileged management, split in conveying appropriately, poor team teamwork, neglecting or disregarding individual fallibility and setting indistinct objectives (AHRQ PSNet Patient Safety Network). Conclusion Safety of the patient is of paramount significance. It directly implies the quality of healthcare being provided during the course of ailment. Eliminating the negative outcomes discussed in the present article could enhance safety and practices that are responsible in promoting harmonization and diminishing the adverse consequences. Elements that potentially improve the quality and safety of care encompass the reporting and procedures of incidents was the element of clinical governance, excellent communication, for example sharing information or staff meeting, teamwork and feedback, guidelines, polices and protocols associated with clinical governance are prompted; multidisciplinary, clinical or significant event meetings; audits of different types are promoted; disease or medicine management training courses that could eliminate the failure ratio. Appropriate understanding and knowledge could result in high-quality training and hence better patient management and retention of experienced and intellect staff is also imperative for the hospital management. References AHRQ PSNet Patient Safety Network. Patient safety. Available at http://psnet.ahrq.gov/glossary.aspx. [Accessed on 15th October 2011]. Aspden, P., Corrigan, J., Wolcott, J., et al., eds. (2004). Patient safety: achieving a new standard for care. Washington, DC: National Academies Press. Clancy, C.M., Farquhar, M.B., Sharp, B.A. (2005). Patient safety in nursing practice. J Nurs Care Qual. 20(3), 193-7. Committee on the Quality of Health Care in America. (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press. Harteloh, P.P.M. (2003). The meaning of quality in health care: a conceptual analysis. Health Care Analysis. 11(3), 259-67. Mitchell, P. H., Lang, N. M. (2004). Framing the problem of measuring and improving healthcare quality: has the Quality Health Outcomes Model been useful? Med Care. 42, II4-11. National Quality Forum. (2004). National consensus standards for nursing-sensitive care: an initial performance measure set. Washington, DC: National Quality Forum. 40 p. National Quality Forum. (2006). Standardizing a patient safety taxonomy: a consensus report. Washington, DC: National Quality Forum. Shojania, K. G., Duncan, B. W., McDonald, K. M, et al., eds. Making health care safer: a critical analysis of patient safety practices. Evidence Report/Technology Assessment No. 43 (Prepared by the University of California at San Francisco-Stanford Evidence-based Practice Center under Contract No. 290-97-0013). Rockville, M. D (2001). Agency for Healthcare Research and Quality; July 2001. AHRQ Publication No. 01-E058, Summary. Tourangeau, A. E, Cranley, L.A., Jeffs, L. (2006). Impact of nursing on hospital patient mortality: a focused review and related policy implications. Qual Saf Health Care. 15(1), 4-8. Read More