Culture of Safety

Culture of Safety

This is a 250 - 350 Words essay in APA format

One of the issues facing nursing practice is that of accountability. Nurses are increasingly held accountable for errors in an effort to improve patient safety and quality-care delivery. Throughout this degree program, this issue has been presented. Reflect on what you have read about quality and safety and the many presentations on this important issue. Consider the ANA’s Code of Ethics and its application to patient safety and quality-care delivery. You may also want to review some of the earlier media presentations including that of Dr. Don Berwick in NURS 3005, Dr. Lucille Joel in NURS 3000, and the media presentations for this week. With these thoughts in mind, read the following scenario and respond to the questions below.

Tower 4 West is a 36-bed medical unit. The nurse leader, Renee, is a new leader, and her performance is evaluated based on the number of medication errors reported on her unit. As a result, she has told everyone very clearly that she will tolerate no errors and that she wants the unit to have zero medication errors each month. When an error does occur, she meets individually with the nurse, writes up the nurse’s error, and puts a report in the nurse’s performance review files. She has put two nurses on performance probation. As a result, the nurses on the unit are afraid to report when an error occurs, and they have begun to cover for each other and not report errors. You are a staff nurse on the unit, and you want to serve as a leader in creating a blame-free environment.

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• What’s wrong with Renee’s approach to medication errors?
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• What first steps would you take to change the culture?
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• How do you think the ANA Code of Ethics applies, or does not apply, to this situation?

Support your response with references from the professional nursing literature.
Learning Resources

Prior Knowledge

Today's patients are more aware of their health care than ever before. Internet resources such as WebMD allow people to get instant diagnoses and treatment options without consulting with a medical professional. Even though the accuracy and quality of this is questionable, patients are coming to hospitals with preconceived ideas that can present challenges for nurses. Reflect on your work experiences. How do you deal with a patient who has been misinformed? When a medical error does occur, how does your organization respond?

Required Resources

This page contains the Learning Resources for this week. Be sure to scroll down the page to see all of the assigned resources for this week. To view this week's media resources, please use the streaming media player below.

Media

• Video: Laureate Education, Inc. (Executive Producer). (2010). Leadership competencies in nursing and healthcare: Impacting quality and safety through leadership. Baltimore: Author.
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  • Note: The approximate length of this media piece is 16 minutes.
    
    This week, the experts discuss the critical role of nurse leaders in improving patient safety and care through emotional intelligence and excellence in nursing practice.

Readings

• Course Text: Effective Leadership and Management in Nursing (8th ed.)
• • Chapter 6, "Managing and Improving Quality"
    
    This chapter explores ways in which nurses can increase the quality of care their organizations provide. Quality improvement is a continuous process guided by staff insights and a commitment to reducing accidents, accepting responsibility, and increasing productivity. The chapter makes note of Six Sigma, a quality management program used to measure an organization's effectiveness. Here, the authors also argue for creating a blame-free environment where incidents can be reported and repaired without fear of disciplinary action.
• Course Text: Guide to the Code of Ethics for Nurses: Interpretation and Application Retrieved from the Walden Library databases.
• • "Provision 3"
    
    Provision 3 argues that the needs of the patient transcend organizational rules. This is a moral edict, the provision states, and cannot be removed from the patient-centered prerogative of the code.
  • "Provision 7"
    
    Provision 7 states the nurse's commitment to advancing the knowledge in his or her field through study, experience, and civil engagement. This provision has evolved from a research-oriented dictum to one that incorporates all areas of nursing and values the insights from each education level.

Articles

• Fagan, M. (2012).  Techniques to improve patient safety in hospitals: What nurse administrators need to know.  The Journal of Nursing Administration, 42(9),426-430.
  Retrieved from the Walden Library databases
   
• Goh, S., Chan, C., &  Kuziemsky, C. (2013). Teamwork, organizational learning, patient safety and job outcomes. International Journal of Health Care Quality Assurance, 26(5), 420-432.
  Retrieved from the Walden Library databases
   
• Johnson, J., Veneziano, T., Green, J., Howarth, E., Malast, T., Mastro, K., Moran, A., Mulligan, L., & Smith, A.  (2011). Breaking the fall.  The Journal of Nursing Administration, 41(5), 538-545.
  Retrieved from the Walden Library databases
   
• Seidl, K. & Newhouse, R. (2012). The intersection of evidence-based practice with 5 quality improvement methodologies. The Journal of Nursing Administration, 42(6),  299-304.
  Retrieved from the Walden Library databases

Document

• Patient Falls Data (Excel)

Website

• American Society for Quality (n.d.) Cause analysis tools: Fishbone diagram. Retrieved from
  http://www.asq.org/learn-about-quality/cause-analysis-tools/overview/fishbone.html