Assuring safe patient care in a level III NICU in anticipation of hospital closure

Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed. After thorough planning, the date and location of the training session were identified. Contingency plans were put in place to ensure that patient care was not compromised at any point. To ensure success, checklists for faculty were devised and adhered to. A medium fidelity manikin with live monitoring was used. The first part of the scenario involved management of a surgical emergency by theatre staff. The second part involved management of a fire in the operating theatre while an emergency procedure was being undertaken. To achieve maximum learning potential, debriefing was provided immediately after each part of the scenario. A fire safety officer was present as a content expert. Latent errors (hidden errors in the workplace, staff knowledge etc) were identified. Malfunctioning of theatre floor windows and staff unawareness about the location of an evacuation site were some of the identified latent errors. Thorough feedback to address these issues was provided to the participants on the day. A detailed report of the training session was given to the relevant departments. This resulted in the equipment faults being rectified. The training session was a very positive experience and helped not only in improving participants’ knowledge, behaviour and confidence but also it made system and environment better equipped.

Download Full-text

A qualitative positive deviance study to explore exceptionally safe care on medical wards for older people

BMJ Quality & Safety ◽

10.1136/bmjqs-2018-008023 ◽

2019 ◽

Vol 28 (8) ◽

pp. 618-626 ◽

Cited By ~ 5

Author(s):

Ruth Baxter ◽

Natalie Taylor ◽

Ian Kellar ◽

Rebecca Lawton

Keyword(s):

Older People ◽

Patient Care ◽

Social Contexts ◽

Positive Deviance ◽

Multidisciplinary Teams ◽

Safe Patient Care ◽

Working Together ◽

Multidisciplinary Staff ◽

Medical Wards ◽

Safe Care

BackgroundThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people.MethodsA qualitative positive deviance study was conducted on four positively deviant and four slightly-above-average matched comparator wards, which had been identified using routinely collected NHS Safety Thermometer data. In total, 70 multidisciplinary staff participated in eight focus groups to explore staff perceptions about how their teams deliver safe patient care. A thematic analysis was conducted in two stages: first to identify the tools, processes, strategies, and cultural and social contexts that facilitated safety across all wards; and second to generate hypotheses about the characteristics that facilitated ‘positively deviant’ patient care.ResultsBased on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented.ConclusionThis study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.

Download Full-text

Operating room nurse residency and specialty educators: Paramount in the success of novice nurse retention

Journal of Nursing Education and Practice ◽

10.5430/jnep.v8n5p20 ◽

2017 ◽

Vol 8 (5) ◽

pp. 20 ◽

Cited By ~ 1

Author(s):

LaSandra Brown ◽

Debbie Belgard ◽

Nakeisha Washington ◽

Sparkle Grueso

Keyword(s):

Patient Care ◽

Operating Room ◽

Residency Program ◽

Surgical Patients ◽

Team Approach ◽

Residency Programs ◽

Nurse Residency ◽

Safe Patient Care ◽

Nursing Curricula ◽

Nurse Residency Program

Perioperative service is one of the specialties of nursing in which a team approach is vital for optimal patient care. The registered nurse is responsible for coordinating and delivering safe patient care. Operating room (OR) nurses are responsible for applying fundamental applications of the nursing process while formulating plans of care unique to surgical patients. The growing shortage of nurses worldwide especially impacts highly complex areas such as the OR, where skills specialized are needed to care for patients. One of the largest challenges of a graduate nurse (GN) is becoming enculturated to new environments. Traditionally, OR nursing is a paradigm foreign in nursing curricula; this creates challenges in the GN population in applying their practical nursing skills to surgical patients. In an effort to combat ongoing knowledge deficits unique to OR nursing, Houston Methodist Hospital (HMH) created an OR nurse residency program. The literature suggests that specialty-specific nursing residency programs offer GNs essential tools for becoming successful in their transition. Additionally, research suggests reductions in nurse burnout and turnover rate among GNs with adequate training and preparation. The purpose of this article was to provide insight on the importance of introduction to the OR prior to graduating from nursing school and the importance of OR nursing specialty residency programs and specialty educators as they pertain to the ideal nursing transition, sustainability, retention, and favorable patient outcomes. A questionnaire was created to capture successful applicable practices; the questionnaire also provided an opportunity for GNs to suggest opportunities for program improvements. The questionnaire was used to explore feedback from the summer 2014 Operating Room (OR) residency program graduate nurses in an effort to capture improvements needed for future program success.

Download Full-text

Competence, Nursing Practice, and Safe Patient Care

Perioperative Nursing Clinics ◽

10.1016/j.cpen.2008.08.003 ◽

2008 ◽

Vol 3 (4) ◽

pp. 297-303 ◽

Cited By ~ 4

Author(s):

Linda Brazen

Keyword(s):

Patient Care ◽

Nursing Practice ◽

Safe Patient Care

Download Full-text

Safe Sterile Processing Supports Safe Patient Care

Biomedical Instrumentation & Technology ◽

10.2345/0899-8205-12.1.20 ◽

2012 ◽

Vol 46 (sp12) ◽

pp. 20-23 ◽

Cited By ~ 1

Author(s):

Linda Condon

Keyword(s):

Patient Care ◽

Safe Patient Care ◽

Sterile Processing

Download Full-text

Can the NHS return to safe patient care post-lockdown?

Practice Management ◽

10.12968/prma.2020.30.5.12 ◽

2020 ◽

Vol 30 (5) ◽

pp. 12-13

Keyword(s):

Patient Care ◽

Nursing Staff ◽

Safe Patient Care ◽

Safe Environment

‘Confused’ guidance has left nursing staff in the independent care sector exposed to COVID-19, a union has warned, with doctors expressing concern about their ability to ensure a safe environment for patients returning for scheduled procedures

Download Full-text