scholarly journals What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety?

2021 ◽  
Author(s):  
◽  
Philip Charles Hawes
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Learning Styles ◽  
Patient Care ◽  
Role Models ◽  
Clinical Environment ◽  
Contributing Factors ◽  
Clinical Role ◽  
Safe Patient Care ◽  
Clinical Risk

<p>This research was undertaken to investigate how newly graduated nurses recognise and develop skills relating to clinical risk and patient safety. I set out to understand how and where new graduates learn those skills and what would help future undergraduate nurses better prepare for the complexities of the clinical setting.  A qualitative research study using Appreciative Inquiry (AI) was the chosen methodology. This was selected for its aspirational outlook, which allows positive conclusions to be drawn from the study’s findings. Nine nurses in their first year of clinical practice participated in the study and they were interviewed on a one-to-one basis.  The key findings demonstrated that the approaches to teaching clinical risk and safe patient care and experiences of these in the undergraduate setting were variable, with many participants describing that they were ill prepared for the rigours of the clinical environment. They identified workplace culture, clinical role models, exposure to the clinical environment; experiential learning, narrative story sharing, debriefing and simulation as contributing factors to their ability to learn and understand clinical risk and safe patient care.  Despite their initial uncertainty, the participants were able to describe safe patient care and clinical risk. They identified cultures of safe patient care, safe teaching and safe learning. The participants further identified their preferred learning styles and recommended strategies that educationalists and clinical stakeholders employ to facilitate their professional development and understanding of clinical risk and patient safety.  The participants identified a more thoughtful, structured and overt approach to teaching the subject of clinical risk and patient safety to prepare for the clinical environment. They desired more experiential exposure, either clinical or simulated. They highlighted the need for effective preceptors and role models, alongside opportunities for sharing their clinical experiences and debriefing critical incidents. Furthermore, they recognised aspects of workplace cultures that facilitated or hindered effective clinical practice and safe patient care.</p>

What educational and other experiences assist recently qualified nurses to understand and deal with clinical risk and patient safety?

2021 ◽  
Author(s):  
◽  
Philip Charles Hawes
Keyword(s):  
Patient Safety ◽  
Clinical Practice ◽  
Learning Styles ◽  
Patient Care ◽  
Role Models ◽  
Clinical Environment ◽  
Contributing Factors ◽  
Clinical Role ◽  
Safe Patient Care ◽  
Clinical Risk

<p>This research was undertaken to investigate how newly graduated nurses recognise and develop skills relating to clinical risk and patient safety. I set out to understand how and where new graduates learn those skills and what would help future undergraduate nurses better prepare for the complexities of the clinical setting.  A qualitative research study using Appreciative Inquiry (AI) was the chosen methodology. This was selected for its aspirational outlook, which allows positive conclusions to be drawn from the study’s findings. Nine nurses in their first year of clinical practice participated in the study and they were interviewed on a one-to-one basis.  The key findings demonstrated that the approaches to teaching clinical risk and safe patient care and experiences of these in the undergraduate setting were variable, with many participants describing that they were ill prepared for the rigours of the clinical environment. They identified workplace culture, clinical role models, exposure to the clinical environment; experiential learning, narrative story sharing, debriefing and simulation as contributing factors to their ability to learn and understand clinical risk and safe patient care.  Despite their initial uncertainty, the participants were able to describe safe patient care and clinical risk. They identified cultures of safe patient care, safe teaching and safe learning. The participants further identified their preferred learning styles and recommended strategies that educationalists and clinical stakeholders employ to facilitate their professional development and understanding of clinical risk and patient safety.  The participants identified a more thoughtful, structured and overt approach to teaching the subject of clinical risk and patient safety to prepare for the clinical environment. They desired more experiential exposure, either clinical or simulated. They highlighted the need for effective preceptors and role models, alongside opportunities for sharing their clinical experiences and debriefing critical incidents. Furthermore, they recognised aspects of workplace cultures that facilitated or hindered effective clinical practice and safe patient care.</p>

Simulation training for critical care

2016 ◽  
Author(s):  
Ben Shippey ◽  
Graham Nimmo
Keyword(s):  
Critical Care ◽  
Patient Safety ◽  
Patient Care ◽  
Simulation Training ◽  
Assessment Tool ◽  
Common Elements ◽  
Clinical Environment ◽  
Summative Assessments ◽  
Educational Efficiency ◽  
Educational Methodology

Simulation in various guises can be an extremely useful educational methodology. Its use should be planned carefully to maximize educational efficiency and minimize disruption to patient care. It requires the facilitator to enable the participants to behave as they would in the real clinical environment. Fidelity is one aspect of the simulated clinical environment that helps participants engage with the clinical material. The participants should be debriefed after the simulated experience. Video-assisted debriefing facilitates reflection on elements of behaviour that affect patient safety. Many styles of debriefing exist, but there are common elements. Debriefing should be carefully facilitated by faculty with the necessary skills. Simulation is increasingly being used as an assessment tool, but the validity of summative assessments using simulation is unclear.

scholarly journals Competence in Patient Safety: A Multifaceted Experiential Educational Intervention for Resident Physicians

2011 ◽  
Vol 3 (3) ◽  
pp. 360-366 ◽  
Author(s):  
Michael P Lukela ◽  
Vikas I Parekh ◽  
John W Gosbee ◽  
Joel A Purkiss ◽  
John Del Valle ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Faculty Attitudes ◽  
Learning Program ◽  
Improvement Project ◽  
Faculty Evaluations ◽  
Safe Patient Care ◽  
Safety Improvement ◽  
Care Processes ◽  
Comprehensive Survey

Abstract Background The need to provide efficient, effective, and safe patient care is of paramount importance. However, most physicians receive little or no formal training to prepare them to address patient safety challenges within their clinical practice. Methods We describe a comprehensive Patient Safety Learning Program (PSLP) for internal medicine and medicine-pediatrics residents. The curriculum is designed to teach residents key concepts of patient safety and provided opportunities to apply these concepts in the “real” world in an effort to positively transform patient care. Residents were assigned to faculty expert-led teams and worked longitudinally to identify and address patient safety conditions and problems. The PSLP was assessed by using multiple methods. Results Resident team-based projects resulted in changes in several patient care processes, with the potential to improve clinical outcomes. However, faculty evaluations of residents were lower for the Patient Safety Improvement Project rotation than for other rotations. Comments on “unsatisfactory” evaluations noted lack of teamwork, project participation, and/or responsiveness to faculty communication. Participation in the PSLP did not change resident or faculty attitudes toward patient safety, as measured by a comprehensive survey, although there was a slight increase in comfort with discussing medical errors. Conclusions Development of the PSLP was intended to create a supportive environment to enhance resident education and involve residents in patient safety initiatives, but it produced lower faculty evaluations of resident for communication and professionalism and did not have the intended positive effect on resident or faculty attitudes about patient safety. Further research is needed to design or refine interventions that will develop more proactive resident learners and shift the culture to a focus on patient safety.

Self-care as an ethical obligation for nurses

2020 ◽  
Vol 27 (8) ◽  
pp. 1694-1702
Author(s):  
Mary Linton ◽  
Jamie Koonmen
Keyword(s):  
Patient Care ◽  
Role Models ◽  
Code Of Ethics ◽  
Self Care ◽  
Holistic Approach ◽  
Codes Of Ethics ◽  
Safe Patient Care ◽  
Health Risk Appraisal ◽  
Loving Kindness ◽  
American Nurses Association

As members of the largest and most trusted healthcare profession, nurses are role models and critical partners in the ongoing quest for the health of their patients. Findings from the American Nurses Association Health Risk Appraisal suggested that nurses give the best patient care when they are operating at the peak of their own wellness. They also revealed that 68% of the surveyed nurses place their patients’ health, safety, and wellness before their own. Globally, several nursing codes of ethics include the requirement of self-care. Often, these codes embed the responsibility to protect and promote one’s own health within the clearly described obligation to provide safe patient care. The American Nurses Association Code of Ethics for Nurses is unique in that it states explicitly that nurses must adopt self-care as a duty to self in addition to their duty to provide care to patients. One of the basic assumptions of Watson’s Philosophy and Science of Caring is that caring science is the essence of nursing and the foundational disciplinary core of the profession. Watson’s theory of human caring provides support for the engagement in self-care. Two important value assumptions of Watson’s Caritas are that “we have to learn how to offer caring, love, forgiveness, compassion, and mercy to ourselves before we can offer authentic caring and love to others” and we also must “treat ourselves with loving-kindness and equanimity, gentleness, and dignity before we can accept, respect, and care for others within a professional caring-healing model.” Embedded within several caritas processes is an outline for a holistic approach to caring for self and others that can guide nurses to improve their mental, physical, emotional, and spiritual health.

scholarly journals Examining the average scores of nursing teamwork subscales in an acute private medical ward

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Martina Costello ◽  
Kylie Rusell ◽  
Tracey Coventry
Keyword(s):  
Patient Care ◽  
Pilot Project ◽  
Medical Ward ◽  
Clinical Environment ◽  
Team Members ◽  
Healthcare Facilities ◽  
Safe Patient Care ◽  
Acute Healthcare ◽  
Descriptive Survey ◽  
Future Work

Abstract Background Healthcare is delivered by multidisciplinary healthcare teams who rely on communication and effective teamwork to ensure safe patient care. Teamwork builds on employee cohesion and reduces medical and nursing errors, resulting in greater patient satisfaction and improved healthcare. Effective teamwork not only improves efficiency and patient safety but leads to a healthier and happier workplace, reducing burnout among healthcare professionals. The purpose of this paper is to describe the findings of a pilot project on an acute medical ward in Western Australia. The aim was to understand the participants perceived level of teamwork to support future work practices and ultimately patient care. Methods This study used a descriptive survey research method to measure nursing teamwork in a clinical environment. The Nursing Teamwork Survey (NTS) measures the levels of nursing teamwork in acute healthcare facilities. Items for the NTS were generated on theoretical grounds, based on teamwork behaviours, offering a practical explanation of teamwork dynamics. Results The survey incorporated five subscales. The response rate to the survey was 90 % (n = 45) with an overall average result on the survey being (m = 2.97) on a 0–4 Likert scale. The validated NTS has provided participants the opportunity to consider nursing teamwork with regards to their position and perceived responsibilities towards patients and team members. Conclusion The findings highlight areas for consolidation and improvement in teamwork. Introducing teambuilding strategies and acting on results of this survey may support enhanced communication and teamwork influencing nursing care and patient outcomes. Findings recommend that activities to improve teamwork and ensuring teambuilding strategies are implemented to improve effective communication in an acute medical care setting would have significant impacts on staff satisfaction.

NURSE STAFFING UNDER DEMAND UNCERTAINTY TO REDUCE COSTS AND ENHANCE PATIENT SAFETY

2014 ◽  
Vol 31 (01) ◽  
pp. 1450005 ◽  
Author(s):  
ASHLEY DAVIS ◽  
SANJAY MEHROTRA ◽  
JANE HOLL ◽  
MARK S. DASKIN
Keyword(s):  
Patient Safety ◽  
Intensive Care ◽  
Patient Care ◽  
Demand Uncertainty ◽  
Nurse Staffing ◽  
Cost Savings ◽  
Staffing Level ◽  
Safe Patient Care ◽  
Demand Distribution ◽  
Using Data

Hospitals must maintain safe nurse-to-patient ratios in patient care units to offer adequate and safe patient care. Since the patient demand is highly variable, during high patient demand periods temporary or overtime nurses are hired to ensure safe nurse-to-patient ratios. These overtime nurses incur higher expense, and are often less effective. We study the problem of permanent nurse staffing level estimation under demand uncertainty as a newsvendor model. Our models are based on limited moment information of the demand distribution. Additionally, we introduce the use of asymmetric cost functions representing overstaffing and understaffing nursing costs. Findings using data from the general surgery and intensive care units at hospitals in Chicago, IL and Augusta, GA are presented. Computational results based on publically available cost data show that 3.1% and 7.3% annual cost savings result by introducing salvage value and newsvendor optimization in intensive care and general care units respectively. This new staffing scheme also improves patient safety as shifts are staffed with more permanent nurses.

scholarly journals Incorporating 3D and 4D Ultrasound into Clinical Practice

Ultrasound ◽  
2005 ◽  
Vol 13 (1) ◽  
pp. 4-11 ◽  
Author(s):  
Alison Smith ◽  
Trish Chudleigh ◽  
Darryl Maxwell
Keyword(s):  
Clinical Practice ◽  
New Technology ◽  
3D Ultrasound ◽  
Clinical Environment ◽  
Clinical Role ◽  
4D Ultrasound ◽  
Diverse Application ◽  
2D Ultrasound ◽  
Wide Scale ◽  
Release Of Information

3D ultrasound has been slow to make significant impact in clinical practice. In a large part, this is because 2D ultrasound is of such superior quality that sonographers have not seen any gain in adopting the new technology. More recently, however, diverse application of 3D technology has taken place in many branches of medicine, with obstetrics and gynaecology at the forefront. Several manufacturers now produce machines of remarkable sophistication and utility. Hardware and software have been integrated to allow the release of information from the ultrasound examination that has hitherto not been possible. In addition, virtual real time 3D images (4D ultrasound) have captured the imagination of both public and media. We report our preliminary clinical experience with 3 and 4D ultrasound in a limited clinical environment. While not suitable for wide scale application at present, we believe this technology has inherent advantages that will secure its clinical role and that this role will widen rapidly in the near future.

Clinical Cybersecurity Training Through Novel High Fidelity Simulations (Preprint)

2018 ◽  
Author(s):  
Christian Dameff ◽  
Jordan Selzer ◽  
Jonathan Fisher ◽  
James Killeen ◽  
Jeffrey Tully
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Medical Devices ◽  
Healthcare Systems ◽  
High Fidelity ◽  
Protected Health Information ◽  
Patient Harm ◽  
Security Vulnerabilities ◽  
Clinical Simulations ◽  
Medical Infrastructure

BACKGROUND Cybersecurity risks in healthcare systems have traditionally been measured in data breaches of protected health information but compromised medical devices and critical medical infrastructure raises questions about the risks of disrupted patient care. The increasing prevalence of these connected medical devices and systems implies that these risks are growing. OBJECTIVE This paper details the development and execution of three novel high fidelity clinical simulations designed to teach clinicians to recognize, treat, and prevent patient harm from vulnerable medical devices. METHODS Clinical simulations were developed which incorporated patient care scenarios with hacked medical devices based on previously researched security vulnerabilities. RESULTS Clinician participants universally failed to recognize the etiology of their patient’s pathology as being the result of a compromised device. CONCLUSIONS Simulation can be a useful tool in educating clinicians in this new, critically important patient safety space.

scholarly journals 179 Evaluating a Clinical Pharmacist Service in a Residential Care Unit

2019 ◽  
Vol 48 (Supplement_3) ◽  
pp. iii1-iii16
Author(s):  
Claire Kavanagh ◽  
Eimear O'Dwyer ◽  
Róisín Purcell ◽  
Niamh McMahon ◽  
Morgan Crowe ◽  
...  
Keyword(s):  
Patient Safety ◽  
Patient Care ◽  
Patient Outcomes ◽  
Residential Care ◽  
Clinical Pharmacist ◽  
Comparative Evaluation ◽  
Positive Impact ◽  
Standard Of Care ◽  
Pharmacist Interventions ◽  
Medication Reviews

Abstract Background This study assessed the pharmacist role in an 80 bed residential care unit by: Quantifying the number and type of pharmacist interventions made and their acceptance rate.Assessing impact of pharmacist interventions on patient care.Assessing staff attitudes towards the clinical pharmacist service. Methods This was a non-blinded, non-comparative evaluation of the existing clinical pharmacist service in the unit. All residents were included. All pharmacist interventions over a 10-week period were recorded, then graded according to the Eadon scale1 by a consultant gerontologist and an experienced pharmacist to assess their impact on patient care. Results There were 615 pharmacist interventions. The most common interventions were: Drug Therapy Review, 34% (n=209) Technical Prescription, 26.5% (n=163) Administration, 15.3% (n=94) Drug Interaction, 10.4% (n=64) Medication Reconciliation, 8.5% (n=52) 98% (n=596) of interventions were rated as having significance to patient care, of which: 48.4% (n=298) and 41.8% (n=257) of the interventions rated as ‘significant and resulting in an improvement in the standard of care’1% (n=6) and 0.5% (n=3) rated as ‘very significant and preventing harm’. There was a statistically significant agreement between the evaluators, κw = 0.231 (95% CI, 0.156 to 0.307), p < .0005. The strength of agreement was fair. Of interventions requiring acceptance by medical team (n=335), 89.9% (n=301) were accepted. 95% (n=36) of staff who responded agreed or strongly agreed that improved patient safety resulted from the pharmacist’s involvement in multidisciplinary medication reviews. Over 92% (n=35) agreed or strongly agreed that their experience of the pharmacist was positive. Conclusion The pharmacist has an important role in our residential care unit. Their involvement in the medicines optimisation process positively impacts patient outcomes and prevents harm. Staff perceived a positive impact of the clinical pharmacist service provided on patient care and patient safety.

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