Quality and Safety of Nursing Care Systems in Mental Health - Essay Example

Quality and Safety of Nursing Care Systems in Mental Health Name Institution Date Introduction Quality and safety in the healthcare involves both patients and staff in the healthcare environment. For instance, there is adverse exposure to microorganisms in the health care environment. Moist organic environments are likely to be more exposed than dry environments. According to Curtis (2008), it is the duty of workers in the social and healthcare facilities to practice infection control management to ensure the safety of patients. However, performance of healthcare staff is also likely to be affected by human factors and such as design of equipment, human behavior and interaction with the environment. Sensitization of medical professions and parties within the medical environment will help minimize negative effects of such factors and improve quality and safety in the healthcare environment. The legislation of Victorian mental Health Victoria is a legislative framework of Victoria’s mental health and a system of the Victorian health sector under improvement through reforms. The legislation reform has been developed and implemented within the last twelve months, since October 2012 although there some elements that is still in the process of implementation. The new legislation has so far proved its effectiveness in improving the quality and safety of healthcare in Victoria and generally, Australia. This paper illustrates the legislative mental health system of Victoria in relation to improving quality and safety in the mental healthcare sector by giving an overview and evidence of the system and the developments made over the last twelve months. The paper examines application of professional communication, leadership and interpersonal skills on stakeholders’ relationships such as patients, carers and patients so as to improve safety and quality among patients. Legislative compliance and appropriate description of major terms will also be identified. Systems, quality processes, infrastructure improvement and effectiveness Systems refer to frameworks or linking of a number of activities or procedures to form a strong, viable and reliable structure that will attain effectiveness and quality in the mental health sector. The public mental health sector in Vitoria Australia, qualifies the definition on a mental health system linking the needs of patients, families, careers and institutional management. The system has linked consumer involvement to quality and safety frameworks, strategies and mental health legislation. Quality processes in a mental health setting refers to worthiness or value of the mental systems, infrastructure and procedures. Professionals in the mental health sector consider programs for educating and training people on healthcare are vital although they have long not been considered as such. Public mental health services in Victoria have gradually been improved to ensure that quality is attained. For example the deinstitutionalization of the system to a mental health system that is community based in 1992 to 1998 aimed to improve and extent mental health services to community levels so that those who could not gain access from the grass roots would also be reached (Department of human services, 2006). Infrastructure improvements include enhancements of structures in the mental healthcare so as to attain effectiveness in service delivery. Quality in healthcare and patients safety cannot be distinguished. According to Pamela (2007), quality involves a prime balance between a context of norms and values in a healthcare setting and realized potentials. However, quality in such settings cannot be attained without being measured through interactions among parties responsible for formation and implementation of the standards comprising of values and norms and the possibilities. The American academy of nursing expert panel on quality health consider a high quality care to be characterized by demonstration of behaviors that promote health which is vital for nursing input. Attaining an appropriate level of self-care, patient satisfaction of nursing care and appropriate criteria for symptom management are also other indicators of quality as stated by AHRQ. Effectiveness aims at adequate operation of the mental health centers to put errors and risks at a minimum level possible. Nursing as a profession defines quality and is considered among the main concerns of medical professions. The nursing responsibility to minimize mortality by employing hygiene and organizational practices is provided by both nursing standards and other settings of care. Nursing professions must therefore coordinate and balance both the safety standards. Communication of previous errors and successful care is important for improving efficiency in healthcare by reducing errors (Duthie, 2010). Safety for patients involves protection of patients from any kind of harm by entities in the nursing environment. Nursing professions must ensure that they install appropriate systems that prevent medical errors, learn from mistakes or errors and construct a safety culture in the medical world that incorporates firms, patients and the professionals. AHRQ considers patient safety to involve liberation of patients from preventable or accidental medical care incidences. For instance, preoperative hair removal in reducing surgical infection and use of coated catheters to impede micro-organic infection in urinary tract are safety procedures in the healthcare environment (Savage & Ford, 2008). Overview and evidence of the system The new reform for mental health implemented in October 2012 is categorized in the legislation for compulsory treatment, after assessment and detaining patients who are severely ill mentally. Key aspects in the reform address a structure that will facilitate recovery that involves making of decisions, orders for compulsory treatment including minimization of the previously proposed duration, protection of mentally ill patients and support for improvement of services. Based on the reform, the laid down framework can be illustrated as shown below: Reform objective Reform actions Outcome Recovery structure: Implement a framework that supports decision making and is based on recovery -Recognize the role of carers -Presume adequate capacity -Established advocates -Informed patients and reverence of treatment preferences -Patients understanding of their rights -Better appreciation for compulsory treatment by patient, family and staff -Patient involvement in decision making Compulsory treatment: Minimize required duration -New treatment orders by mental health tribunal -Revised criteria for assessment and compulsory treatment -Advocacy or shorter duration to protect young people -Minimized duration -Less restriction and intrusive treatment Improved safety measures for patients with mental illness -Alternative to psychiatric opinion -ECT action by mental health tribunal -Independency in hearing by mental health tribunal -Improved autonomy for patients -Exercise of patients’ rights -Less restraints and seclusion durations Support of Service improvement and oversight -Revised codes in mental health practice -Introduce mental health complaints commissioner position -More roles for head psychiatrist -Improve communication and information sharing -Enhanced service delivery and quality -Improve responsiveness to complaints and resolutions -Enhanced communication among stakeholders such as patients, families, clinical staff and careers. Australia as a nation has long been known for implementing reforms to improve mental health services. Other than reforms, policies and strategies have been set by the government targeting these systems and health structures. The 2003 to 2008 plan targeted improved responsiveness of services, innovation, refining the quality of service and sustainability. This in turn prevents problems encountered in mental health and offer support to mental health. Application of Leadership, professional communication and interpersonal skills Leadership in the public health service in Victoria, Australia is evidenced in the successful management of all the systems stakeholders. The hierarchical arrangement and coordination with the organization is well developed. The framework states new roles for the chief Psychiatrist so as to improve the organization (State of Victoria, Department of Health, 2012, pg. 9). Attending to patients especially in cases of mental treatment procedures require teamwork and maximum coordination and cooperation. Lack of a team leader to issue instructions might result to confusion through random leadership and unspecific instructions that compromises efficiency and quality in ensuring patient safety. The management is responsible for creating a culture in the medical organization operations, setting organizational goals and quality levels. Less organized management affect quality of the organization systems and therefore healthcare safety will be affected. Misleading instructions from senior management will affect safety and cause disorganization (AHRQ, 2004). Management issues in medical centers influence the safety in healthcare. Organizational behavior management in medical fields improves safety in both the medical and behavioral perspective by correcting errors through an analytic and critical examination of errors, establishment of reasons for errors and giving evidences to improve such situations. Management issues like risk management procedures determine levels of safety in a medical center. Well instituted risk procedures for operations and normal patient treatment improve patients’ safety if well implemented. Most organizations dealing in healthcare consider merging risk management and quality initiatives to one common department to improve such practices (Acton, 2013). The open culture and communication allows staff to raise issues concerning the safety of their patients to workmates and their seniors since they will be free to discuss incidences of patient safety. The just culture allows fair treatment of patients, staff and care givers and therefore issues raised by them are considered. This gives staff and care givers confidence and boosts their performance. Embracing a reporting culture by the organization improves staff confidence in the local reporting framework and reports all incidences including errors they detect in the process of attending to patients. Staff should not be punished as a result of reporting patient incidences so as to improve their performance in adhering to organization systems or frameworks (National Patient Safety Agency and NHS Confederation, 2008). Legal and regulatory compliance The nursing body in Australia is governed by a number of standards defined by the Australian Nursing and midwifery Council. The nursing and midwifery regulatory authorities (NMRAs) also provides national standards that guide nursing practitioners, enrolled nurses and midwives in observing ethics and their professional conduct codes (ANMC, 2007, p.1). Since this applies to mental healthcare, the system also practices professionalism and nursing standards of ethics such as patient or family consent in treatment by instituting the patient autonomy reform on treatment (State of Victoria, Department of Health, 2012,pg 7 and 8).According to Emslie (2008), nurses and doctors are expected to employ these standards in carrying out their duties such as patient presentation, nurse assessment, doctor diagnosis and nursing care. Other than nurses, these standards are used to inform customers under medical care of their expectations from the medics and in schools; it is applicable in assessment of nursing student performances The system has complied with legislative requirements as provided by the Health and safety executive. A successful management of safety and patients’ health in clinical settings require implementation of a well-organized framework. According to a publication by the Health and safety executive (2008), one of the approaches for managing quality and safety involves institution of viable plans for health quality and safety. Another approach is the investigation of any incidents accidents or errors that occur in the health centers. After investigation, auditing of the entire health system and the incidents for quality and safety is important so as to detect areas that need to be improved and corrected. Key elements for successful management of health quality and safety can be represented in a diagram as shown below: The arrows represent information and control links. Feedback loop to improve performance Conclusion The quality of healthcare settings and safety of patients in such environments is inseparable. The concept of safety of patients involves ensuring that they are out of danger with respect to their health. Organizations therefore embrace systems that improve quality and ensure safety of their patients. Human factors also influence performance of staff and as a result their attention to patients. Human factors involve distractions to medical attendants, teamwork failures, mental workload and physical demands. These affect the ability of the staff to function properly and therefore quality of performance. The Victorian public mental health system has proven quality and efficiency other than safety for its stakeholders through the new reform implemented since October 2012. Legislative compliance to mental health regulations is also appropriate in the system. References Curtis, L. T. (2008). Prevention of hospital-acquired infections: review of non-pharmacological interventions.Elsevier Ltd. Journal of Hospital Infection. Agency for healcareresearcg and quality (AHRQ) PSNet. (2007). Patient Safety Network: Patient safety.  State of Victoria, Department of Health. (2012). A new mental health Act for Victoria: summary of proposed reforms.Victorian Government, 50 Lonsdale St, Melbourne. Department of human services, (2006).An introduction to Victoria’s public clinical mental health services.Victorian Government Department of Human Services, Mental Health Branch, Melbourne, Victoria, Australia. Duthie, E. A. (2010). Application to human error theory in case analysis of wrong procedures. Pubmed Savage, G. T., & Ford, E. W. (2008). Patient safety and health care management. Bingley: JAI Press. Acton, Q. A. (2013). Issues in Healthcare Management, Economics, and Education: 2012 Edition.ScholarlyEditions. Australian Nursing Midwifery Council (ANMC). (2007). Nursing competency standards for the registered nurse. ANMC Emslie, S., Knox, K and Pickstone, M. (2001). Improving patient safety: Insights from America, Australia and British healthcare. ECRI Health and safety executive (HSE). (2008). Managing health and safety: Five steps to success. HSE State of Victoria. (2009). Strengthening consumer participation in Victoria’s public mental health services. Portfolio Services and Strategic Projects, Victorian Government Department of Human Services, Melbourne, Victoria. AHRQ.(2004). Programs and Tools to Improve the Quality of Mental Health Services. Agency for Healthcare Research and Quality. Read More