NR 351 Week 4 Graded Discussion: Nursing Roles in Quality Improvement.
How do nurses promote patient safety and improve quality at your workplace? How do
... [Show More] you report errors and near misses? What changes would you suggest be made on your unit or facility to improve a non-punitive culture of safety?
ANSWER
According to Massachusetts Nurse of the Future Department of Education Nursing Initiative (2016), the Nurse of the Future will use data to monitor outcomes and will use improvement methods to continuously improve the quality and safety of health care systems. One way I promote patient safety is that I provide quite a bit on ongoing education regarding safety and prevention planning to the staff that directly serve our patients. I also spend a lot of time working with incident reporting to promote the health and welfare of the population we serve.
According to Barnsteiner (2011), a balance between not placing blame when an error occurs and not tolerating unsafe behavior that can lead to serious errors is very important. I agree. I believe that we currently do have a non-punitive culture of safety within my team, to us, education is a very important piece to maintaining this balance. When an “error/near miss” occurs within my team, our process is that these “reportable events” are reported to myself, an incident report is submitted. The “incident” is investigated, education is provided where needed, and a prevention plan is put in place. This prevention plan is closely monitored ongoing. If there is no progress being made toward the goals outlined in the prevention plan, we will then discuss the implementation of a “PIP” (Performance Improvement Plan) for the employee.
According to Hood (2018), Six Sigma uses the PDCA (Plan, Do, Check, Act) cyclical process to improve quality in professional nursing care. My team utilizes a similar process. Our process is PDSA (Plan, Do, Study, Act) where we review and identify which area(s) we may need to work on to increase quality (usually based on audits). We then put a plan in place that we think may help us reach the goal and follow through with the rest of the PDSA cycle. This has helped my team to significantly increase quality in areas we were struggling.
References:
Barnsteiner, J. (2011). Teaching the culture of safety. Online Journal of Issues in Nursing, 16(3). doi:10.3912/OJIN.Vol16No03Man05
Hood, L. J. (2018). Leddy & Pepper’s professional nursing (9th ed.). Philadelphia, PA: Wolters Kluwer Health | Lippincott Williams & Wilkins.
Massachusetts Department of Higher Education Nursing initiative. (2016). Massachusetts Nurse of the Future Nursing Core Competencies Registered Nurse. Retrieved from http://www.mass.edu/nahi/documents/NOFRNCompetencies_updated_March2016.pdf [Show Less]