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Nursing Home Surveys on Patient Safety Culture
Introduction
As we have studied through various discussion post and individual papers, evidence-based research is a fundamental part not only of nursing, but of the healthcare system as a whole. Evidence-based research is a combination of scientific evidence, clinical evidence, and patient preferences in nursing care (Houser, 2018). With continuous development, the countless numbers of articles and research resources we have access to, and advanced technological system; evidence-based practice is the new norm for effective nursing practice (Houser, 2018).
As we have discussed through various discussion post and individual papers, evidence-based research is a fundamental part of not only nursing but the healthcare system as a whole. Evidence-based research is a combination of scientific evidence, clinical evidence, and patient preferences in nursing care (Houser, 2018). With continuous development, the countless numbers of articles and research resources we have access to, and advanced technological system; evidence-based practice is the new norm for effective nursing practice (Houser, 2018).
Problem and Impact on Nursing Practice
The clinical problem assigned was Nursing Home Surveys on Patient Culture. Patient safety culture is vital because it advances the safety of patients and their quality of care which improves patients' ideal health and reduces errors (Temkin-Greener et al., 2020). The impact patient safety culture has on nursing practice is that it supports in preventing patient harm and empowers trust among staff to report safety or healthcare errors (American Nurses Association (ANA), 2016).
The clinical problem assigned was Nursing Home Surveys on Patient Culture. Patient safety culture is vital because it advances the safety of patients and their quality of care which improves patients' ideal health and reduces errors (Temkin-Greener et al., 2020). The impact patient safety culture has on nursing practice is that it supports in preventing patient harm and empowers trust among staff to report safety or healthcare errors (American Nurses Association (ANA), 2016).
Research Process
The research process followed a thorough systematic search strategy that incorporates online platforms, credible research database, key search terms, and a PICOT style questions.
What went well through the research process is how the information gained allowed us to get a better understanding of why nursing research is important to keep up with the evidence-based practices which are always evolving.
Barriers identified were time management and difficulty putting all thoughts together.
As we continued to grasp and developed a better understanding of our clinical problem we were able to implement what we have learned by conducting a proper research to gather all necessary information.
The research process followed a thorough systematic search strategy that incorporated the online platform, a credible research database, key search terms, and the PICOT process.What went well through the research process is how the information gained allowed us to get a better understand of why nursing research is important now, and for our future with evidence-based practice continually changing. Barriers identified was time management and difficulty putting all thoughts together. As we continued to grasp and developed a better understanding of our clinical problem we were able to implement what we have learned by conducting a proper research to gather all necessary information.
Correlate Research Findings to Identified Clinical Issues
Overall areas of strength:
Overall Perceptions of Resident Safety—85%
Feedback and Communication About Incidents—85%.
Supervisor Expectations and Actions Promoting Resident Safety—81%
Overall areas of Improvement:
Staffing—46%
Communication Openness—55%
Nonpunitive Response to Mistakes—56%.
Validity of Qualitative and Quantitative Evidence
In most of the studies used for the research, the method used to collect data was staff or patient surveys. This surveys are primarily of qualitative value. Such studies obtain the participants opinion or perspective as well as their personal interpretations (Houser, 2018).
Other studies used in our research obtained information from nursing homes records and documents. This type of research is also of qualitative quality. In order to maintain validity when using qualitative data is to collect it systematically. In the case of the where documents were used, the research process involved analyzing the information in order to determine its validity. These analysis methods are produce reliable and valid if results when paired with a systematic method of data collection as it was done in the case of the research we collected.
One of the main considerations when conducting this type of research that we had to keep in mind was biases. Since the data collected consisted mainly of personal opinions.
Findings
Safety of patients in nursing homes is a pressing concern in the healthcare field. All research pointed to major deficits when it came too patient safety (White et al., 2019).
Nursing staff morale is of great impact to patient safety
Almost a quarter of all nursing home patients experience complications that require hospitalizations (Vogelsmeier, 2019)
Another key finding in the research was a discrepancy of the results between staff, administration and patients opinions (Castle, Wagner, Perera, Ferguson, & Handler, 2016).
When implemented in a timely manner the nursing home surveys on safety culture can have a positive impact.
The major safety issues in nursing homes are all preventable when patient safety is made a priority Simmons, S. (2016)
Recommended Changes and Outcomes
In order to avoid injuries due to falls, nursing home facilities should install bed alarms to alert the nurses when patient is attempting get out of bed.
To prevent medication errors we must perform Nursing Rights of Medication: (Hanson, 2020)
Right Patient
Right Drug
Right Route
Right Time
Right Dose
To prevent infections we must educate about proper hand washing techniques, as well as proper disinfection of our medical equipment in between patients (Ex: stethoscope, BP cuff, thermometer, pulse oximeter)
To prevent pressure ulcers, we must implement interventions such as repositioning client every 2 hours & assist client with ambulation.
Patient safety should always be priority in all types of medical facilities.
Studies have shown injuries due to falls, medication errors, infections, pressure ulcers are some of the common problems regarding patient safety care. We believe that by implementing these changes within these facilities we could prevent majority of these issues. These recommended changes have been proved to be very effective strategies to improve patient safety in hospitals, we should implement these strategies in ALL medical facilities.
Suggestions for Implementations
Our team believes that the Nursing Home Patient Safety Culture Survey should be used to:
Bring awareness about patient safety issues in a nursing home facility.
To assess areas of strength within the home as well as areas that require improvement.
To implement the changes needed within the facility.
To evaluate if these changes are having positive outcomes.
Prevent unnecessary situations such as injuries due to a fall, medication errors, infections, and pressure ulcers (Simmons, 2016).
The Nursing Home Patient Safety Culture Survey was created with the intent to improve patient safety care in these facilities. Studies have demonstrated that patient safety in a nursing home is not held to same standards as one within a hospital. Reasons for this may be due to lack of evidence based practice implementation, education, under staff, resources, etc.
Conclusion
Patient safety is a major concern within nursing homes. Due to this, it is critical to evaluate the safety conditions implemented within these facilities. Through the use of evidence based research, specific instruments have been implemented to determine the extent of safety delivered. The Nursing Home Survey on Patient Safety Culture is one of these tools used to do so. It enables health care workers to assess conditions before determining what implementations could be used to increase safety. Overall, throughout our research process we have learned how to evaluate and dissect findings and determine how this information could be used to better nursing practice.
References
Agency for Healthcare Research and Quality. (2019). Nursing Home Survey on Patient Safety Culture: 2019 User Database Report. Retrieved from https://www.ahrq.gov/sites/default/files/wysiwyg/sops/surveys/2019-nhsops-dbreport-parti.pdf
American Nurses Association. (2016). Creating a culture of safety: ANA is offering activities to help RNs to make that goal a reality.
http://www.theamericannurse.org/2016/02/05/creating-a-culture-of-safety/
Castle, N. G., Wagner, L. M., Perera, S., Ferguson, J. C., & Handler, S. M. (2016). Assessing resident safety culture in nursing homes: using the nursing home survey on resident safety. Journal of patient safety. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890148/.
Hanson, A. (2020). Nursing Rights of Medication Administration. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK560654/.
Houser, J. (2018). Nursing research: reading, using, and creating evidence. Jones & Bartlett Learning.
Simmons, S. (2016). Resident Safety Practices in Nursing Home Settings. Resident Safety Practices in Nursing Home Settings [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK384628/.
Temkin-Greener, H., Cen, X., & Li, Y. (2020). Nursing Home Staff Turnover and Perceived Patient Safety Culture: Results from a National Survey. The Gerontologist, 60(7), 1303–1311. https://doi.org/10.1093/geront/gnaa015
Vogelsmeier, A. A. (2019). Long-term Care and Patient Safety. PSNet. https://psnet.ahrq.gov/primer/long-term-care-and-patient-safety.
White, Elizabeth, PhD, APRN, Aiken, Linda, PhD, RN, Sloane, Douglas, McHugh, Matthew, et al. (2020). Nursing home work environment, care quality, registered nurse burnout and job dissatisfaction. Geriatric Nursing, 41, 158-164. https://doi.org/10.1016/j.gerinurse.2019.08.007
