Week 4 discussion.docx - Week 4 Nursing Roles in Quality...

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Week 4: Nursing Roles in Quality Improvement No unread replies.11 reply. How do nurses promote patient safety and improve quality at your workplace? How do you report errors and near misses? What changes would you suggest be made on your unit or facility to improve a nonpunitive culture of safety? Daily, at work, we do our best to provide high-quality care for our patients. Safety is one of the keystones to proficiency in the nursing career. In every aspect, such as: medication, falls, infection control and many more, we try to prevent mistakes and reduce adverse outcome, to protect patients from any harm and provide unconditional patient-centered care. According to The Institute of Medicine, quality, health care is safe, timely, efficient, equitable, effective, and patient-centered. Quality improvement and safety prevention are dual processes based on evidence-based practice and includes research, and analysis. I believe our hospital has non-punitive culture. Administration and management, most of the time, resolves issues and mistakes by the learning process, we involve to peer-review cases, or we take additional classes to improve our knowledge or we initiate a pilot project to reduce errors or mistakes. But, at the same time, I feel the major problems in our hospital are communication and teamwork, that effect quality patient care. As an example, last week, I had a patient with a brain aneurysm, who was scheduled for surgery within two days. Three different anticoagulant medication was prescribed at 9 am Aspirin 385mg tab., Plavix 150mg tab, and Heparin 5000 units SC at the same time. The risk of internal bleeding was very high, especially when the patient had a history of a ruptured aneurysm. Critical thinking approach was needed. I paged a resident and within 30 minutes received an angry answer that is safe to administrate all these medicines together. I was suspicious and was not satisfied by that answer.  I  called the pharmacy, which took me another 20 minutes to receive an answer, but they confirmed that it is not safe for a patient going to surgery in the next two days. To prevent medication error and harm to the patient, I went to my manager to explain this situation. The manager was able to contact to attending physician, who confirmed that dose of Plavix has to be decreased to 75mg. It took me a total of 1.5 hours to resolve that problem, and of course, medication administration has been late, but the safety of the patient is always our number one priority. This is an example of ineffective team coordination and communication, what reflect on patient care and safety. “Effective 
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  • Fall '14
  • Pettus
  • Nursing, Hood, quality patient care

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