Didactic Strategies Used By Department Heads with the Nursing Staff That Have Worked Best for Patient Safety.

2016 ◽  
Vol 06 (06) ◽  
pp. 12-15
Author(s):  
Ferreira Umpiérrez Augusto
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Department Heads ◽  
Didactic Strategies

scholarly journals The quality of handover on an inpatient psychiatric unit - information is key!

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S183-S183
Author(s):  
Emma Davies ◽  
Ijeoma Enemo-Okonkwo
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Current Issue ◽  
Improve Patient Safety ◽  
Quality Care ◽  
Limited Information ◽  
Psychiatric Unit ◽  
Trainee Doctor ◽  
Inpatient Psychiatric Unit

AimsTo study the quality of handover, between nursing staff and doctors, on an inpatient psychiatric unit.Effective handover between professionals is vital to ensure the accurate transfer of useful information to enable quality care and patient safety.Implementation of a handover tool has been shown to improve patient safety, especially when used to structure communication over the phone.Feedback at trainee doctor forums highlighted insufficient handover from nursing staff whilst on-call, a problem which prompted further exploration.MethodStandards were developed for the expected quality of handover, consisting of a set of criteria for the minimum information required to ensure a safe and effective handover, stemming from the SBAR (Situation, Background, Assessment, Recommendation) approach, with adequate identification of patients, clear communication of the current situation and relevant details.In an inpatient psychiatric setting, telephone calls to the on-call doctor were recorded for a two-week period, documenting whether key information was communicated.ResultTotal number of calls to on-call doctor recorded: 68. The patients name was given in 49% and the ID number in just 10%. Both relevant diagnosis/history and NEWS score was provided in 18%. However, the current issue and recommendation was given in 90% and 95% respectively.ConclusionThe results thus far demonstrate a lack of structure and often limited information delivered in handover from nursing staff to the on-call doctor. This leads to difficulties in prioritisation, identifying the urgency of the situation and inefficiencies, as time is spent requesting further information which is not readily available.After nursing colleagues were made aware, results from a further two-week period, from 65 total calls, demonstrated some improvement. Patient name given in 51%, ID number in 18%, relevant diagnosis/history in 12%, NEWS score in 17%, current issue in 92% and recommendation in 51%. It is clear that with marginal improvement, there remains a problem which we aim to address by collaborating further with senior nursing leads whilst implementing a succinct handover proforma. It is likely that with COVID-19 as the priority on the agenda this past year, quality improvement projects such as this has not been the main focus. We hope that we will be able to implement these changes in the coming months.

scholarly journals O10 A quantitative and qualitative evaluation of the introduction of ‘smart’ syringe pumps into a paediatric intensive care unit

2019 ◽  
Vol 104 (7) ◽  
pp. e2.2-e2
Author(s):  
Nurain Binti Abu Hasan ◽  
Andrew Wignell
Keyword(s):  
Patient Safety ◽  
Data Collection ◽  
Nursing Staff ◽  
New Technology ◽  
Objective Assessment ◽  
Qualitative Evaluation ◽  
Infusion Pumps ◽  
Library Use ◽  
Smart Pumps ◽  
Set Up

AimInfusion pumps are commonly used to administer medicines by intravenous infusion. Traditionally, pumps are programmed by simply entering the required number of millilitres (mL) per hour, and there has been no mechanism whereby the pump can alert the operator to a programming error e.g. the wrong mL/hour rate being entered.More recently, ‘smart’ infusion pumps have become available which have in-built drug libraries. For each drug, defined dosing limits are set. Users are required to reconfirm the selected infusion rate when ‘soft’ limits are overridden and the infusion cannot be commenced if ‘hard’ limits are exceeded. Soft and hard limits can also be set for the administration of boluses from continuous infusions. This study aimed to evaluate the introduction of smart syringe pumps into a UK PICU by objective assessment of compliance with drug library use, and by obtaining direct feedback from nursing staff.MethodsData was collected over a 4 week period, immediately following the introduction of new Alaris CC smart syringe pumps. Objective assessment of drug library use utilised a piloted data collection form. One form was completed for each infusion running at the time of daily data collection. The prescription, syringe label, and programmed pump parameters were checked for each infusion and any discrepancies noted. Where the drug library was not being used, reasons for non-use were recorded. Nursing views on the benefits and potential risks of the new smart syringe pumps were determined through individual and group interviews, each following the same pre-prepared format.Results79 individual drug infusions were observed. 4 (5%) were being given without using the drug library, i.e. just in terms of mL/hour; in all cases, the explanation was the fact that the drug was not included in the library. 73 (92%) of the infusions observed were continuous, the remainder intermittent. 13 nurses were interviewed: the unanimous view was that the new smart pumps improved patient safety. One nurse described a situation where the smart pump had prevented a 10-fold paracetamol overdose. Many nurses commented that pre-defined sedation boluses were a definite patient-safety benefit, both in terms of preventing incorrect dosing or the bolusing of the wrong drug. Nurses, in general, felt that the safety benefits of smart pumps applied equally to intermittent and continuous infusions. Nurses found the drug libraries easy to use, and whilst infusion set-up may take marginally longer with the drug libraries than without, this was offset by patient safety benefits. It was noted that the longer time taken to programme the pumps may diminish as familiarity increases. A small number of minor issues with the drug library were identified through nursing feedback, though none of them were patient-safety critical. This has allowed the drug library to be modified before the same pumps are also introduced to general wards across the Children’s Hospital.ConclusionThe drug libraries in the new smart syringe pumps were being routinely and correctly used throughout the study period. Nursing staff had embraced the new technology, seeing clear patient safety benefits.

scholarly journals P13 Optimising paediatric intravenous fluid management plans: a quality improvement project

2020 ◽  
Vol 105 (9) ◽  
pp. e12.2-e13
Author(s):  
Jenny Gray ◽  
Susie Gage
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Fluid Balance ◽  
Medical Staff ◽  
Fluid Management ◽  
Management Plan ◽  
Intravenous Fluid ◽  
Safety Alert ◽  
Management Plans ◽  
National Patient

IntroductionIntravenous (IV) maintenance fluids are often prescribed post-surgery when enteral routes are contraindicated. Serious consequences have been documented when poor fluid management has occurred, as highlighted in the National Patient Safety Alert (NPSA) 22; reducing the risk of hyponatraemia; when administering IV fluids to children.1 In response to this, the National Institute for Health and Care Excellence (NICE) published their guidance in December 2015 regarding IV fluids in children.2 Based on NICE recommendations, a pan hospital fluid guidance was produced. Within the NICE and hospital’s own guideline it states that there should be a daily fluid management plan documented. It has been well recognised that this daily fluid management plan was not routinely been completed; hence showing non-adherence to our hospital policy and NICE recommendations.AimsPrimary aim was to improve the documentation of the daily fluid management plan; aimed at the medical staff and the secondary aim was to improve the monitoring requirements of IV fluids and documentation of these; largely aimed at the nursing staff.MethodsA simple sticker was designed and attached to continuous sheets for medical notes which had a checklist of monitoring requirements and a section for fluid balance. Additionally, 2 posters were produced; one aimed at medical staff for documenting a fluid management plan and one aimed at the nursing staff with the monitoring requirements. These posters were displayed on the paediatric surgical ward.ResultsA total of 22 patients who were prescribed IV fluids were identified for a baseline measurement, an equal number of patients were compared after the intervention. Neonates and children receiving total parenteral nutrition were excluded from the data collection. There were 41% of daily fluid management plans completed pre intervention and post intervention there were 56% completed; showing a 15% increase in completion. As regards the monitoring indications; there were increases for nursing fluid balance completed from 19% to 46%, blood glucose taken and recorded from 64% to 83% and the daily weight documented from 10% to 49%.ConclusionsThis short QI project shows that implementation of an intervention did improve outcomes across all indications investigated. The results are not as dramatic as first hoped, but this is largely due to the short time scale of 4 weeks to introduce our change and it coincided with the change-over month of junior medical staff. With further education and champions within the medical and nursing teams; further improvement is very much possible, with the main aim in reducing risk and improving patient safety.ReferencesNational Patient Safety Alert: Reducing the risk of hyponatraemia when administering intravenous infusions to neonates 2007. Available at https://www.sps.nhs.uk/articles/npsa-alert-reducing-the-risk-of-hyponatraemia-when-administering-intraveneous-infusions-to-neonates/ [Accessed 12th June 2019]NICE guidance: Intravenous fluid therapy in children and young people in hospital. Available at https://www.nice.org.uk/guidance/ng29 [Accessed 12th June 2019]

scholarly journals A Perception of health care providers toward quality work environment and patients’ safety culture at hemodialysis units.

2016 ◽  
Vol 4 (12) ◽  
pp. 110-128
Author(s):  
Maha Adel Salem ◽  
Hala Ahmed Abdou ◽  
Hoda Ibrahim El-Trawy
Keyword(s):  
Patient Safety ◽  
Work Environment ◽  
Health Care Providers ◽  
Nursing Staff ◽  
Safety Culture ◽  
Patient Safety Culture ◽  
Practice Environment ◽  
Care Providers ◽  
Ministry Of Health ◽  
Safety Work

Many changes have been made in the healthcare practice environment. Understanding of quality practice environment in hemodialysis units has certain implications for maximizing outcomes for clients, nurses, and systems. Developing quality practice environments takes time and commitment to promote and support patients’ safety. Hence improving safety patient culture is vital in dialysis units because it requires for reducing risks for harm, errors of patients and delivering high quality of patients care. The Study aimed to determine the perception of nursing staff’ toward quality practice environment and patients’ safety at Hemodialysis units. Methodology, data collection was utilized a descriptive correlational design for this study, all nursing staff amounted to (n= 90) They are classified into: all head nurses n = 7,, and all nurses who have either diploma (n = 40) or baccalaureate degree (n = 43) who are affiliated to all hemodialysis units (n =7) at Ministry of Health ,Egypt. A package composed of two instruments was used, namely: Environment Scale-Nursing Work Index (PES-NWI) and Hospital Survey on Patient Safety Culture (HSPSC). Results, the major findings indicated that there is a positive correlation significant among practice work environment and patient safety culture except for staffing and resource adequacy in all hemodialysis units of Ministry of Health Hospitals. Also, results point out that the organizational structure of the Ministry of Health Hospitals is characterized by unhealthy environment and unsafe climate that force the nursing staff to have low perception toward most of quality practice environment and patient safety culture factors. The study recommended that initiating a blame-free reporting system to prevent re-occurrence of problems and actions to eliminate them from the workplace by detecting, evaluating, preventing and treating safety work environment

scholarly journals Evaluating the intervening factors in patient safety: focusing on hospital nursing staff

2015 ◽  
Vol 49 (1) ◽  
pp. 104-113 ◽  
Author(s):  
Roberta Meneses Oliveira ◽  
Ilse Maria Tigre de Arruda Leitao ◽  
Leticia Lima Aguiar ◽  
Adriana Catarina de Souza Oliveira ◽  
Dionisia Mateus Gazos ◽  
...  
Keyword(s):  
Patient Safety ◽  
Nursing Staff ◽  
Quality Care ◽  
Team Work ◽  
Structured Interviews ◽  
Professional Qualification ◽  
Hospital Nursing ◽  
Training Team ◽  
Intervening Factors ◽  
And Training

OBJECTIVE To evaluate intervening factors in patient safety, focusing on hospital nursing staff. METHOD The study is descriptive, with qualitative approach, excerpt from a larger study with analytical nature. It was undertaken in a public hospital in Fortaleza, CE, Brazil, between January and June 2013, with semi-structured interviews to 70 nurses, using Thematic Content Analysis. RESULTS The principal intervening factors in patient safety related to hospital nursing staff were staff dimensioning and workload, professional qualification and training, team work, being contracted to the institution, turnover and lack of job security, and bad practice/disruptive behaviors. These aspects severely interfere with the establishment of a safety culture in the hospital analyzed. CONCLUSION It is necessary for managers to invest in nursing staff, so that these workers may be valued as fundamental in the promotion of patient safety, making it possible to develop competences for taking decisions with focus on the improvement of quality care.

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