A Framework for Patient Safety, Part 2

The Joint Commission, Oakbrook Terrace, IL 60181, USA.
The Journal of nursing administration (Impact Factor: 1.27). 11/2011; 41(11):450-2. DOI: 10.1097/NNA.0b013e3182346eae
Source: PubMed


Last month in Part 1, the authors discussed the critical aspects associated with building a safety culture and holding staff and leadership accountable through measurement and expected performance. Sustaining a safety culture begins with the human aspects but must reach beyond the underlying systems and processes, which enable resilience and error prevention in today's complex healthcare environment.

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    ABSTRACT: : The purpose of this study was to determine if teamwork training improved employees' perception of the culture of safety in the emergency department. : Communication failure is frequently the root cause of medication errors, delays in treatment, and wrong-site surgery, leading to an estimated 200 000 deaths annually in the United States. : Independent sample comparison study with a quantitative design was conducted with staff who received teamwork training. Posttraining perceptions were measured using the Agency for Healthcare Research and Quality's patient safety culture survey. : The average score for the 12 domains increased by 9% in positive responses after training. One domain (nonpunitive response to error) had a decrease in the percentage positive score. : Training on teamwork skills can lead to a positive improvement of staff perception related to a culture of safety among emergency department staff.
    No preview · Article · Apr 2013 · The Journal of nursing administration
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    ABSTRACT: Little is known about how exclusionary practices (i.e., ignored, ostracized) by managers differ across demographics and influence nursing outcomes. This study examines whether managerial exclusion varies by generation, race, and gender, and the extent to which these variables, in turn, relate to turnover intention and perceived patient care among a sample of 747 nurses working in hospitals in a midwestern health system. Exclusion did not differ across most demographic groups, though men reported less exclusion than women. Younger nurses of the Millennial generation, those feeling excluded, and those with fewer years of experience reported lower quality patient care. Managerial exclusion, being a nurse of color, and less experience were associated with stronger intentions to leave. Nursing leaders should attend to factors that may contribute to racial minorities seeking other jobs, diminish younger nurses' ability to provide high-quality care, and minimize practices that might lead nurses to feel excluded.
    Full-text · Article · Apr 2013 · Western Journal of Nursing Research
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    ABSTRACT: This article reports on a qualitative study of nurse perceptions of caring nurse practice in the complex adaptive system of health care. Caring nurse practice encompasses technical skills and caring behaviours. Maternity care in the USA has seen worsening maternal and neonatal outcomes and safety has become a priority. As a result, hospital systems have begun efforts to improve outcomes, initiating safety and quality programmes that standardize care and implementing nursing frameworks that enhance relationships. Qualitative hermeneutic phenomenology. A qualitative design analysed 13 nurses' perspectives on caring practice during the second stage of labour. In June and July of 2012, interviews were conducted with 13 labour and delivery nurses located in a hospital that had adopted a perinatal safety initiative and relationship-focused nursing model. The nurses described caring nurse practice and the factors that affected its provision. Transcripts of audio recordings and notes taken during interviews were analysed for themes and fundamental meanings. Nurses' perspectives about the provision of caring nurse practice was affected by the complexity of the healthcare system, interactions with team members, challenges related to documentation; and respect for natural birth. Nurses at all levels of practice can use these perspectives to identify patterns in the complex adaptive healthcare system to improve quality and safety. Best practices include enhancing teamwork, implementing safety initiatives and promoting a Relationship-Based framework. Continued study of caring nurse practice could lead to establishment of additional safety and quality protocols vital to improving patient outcomes.
    No preview · Article · Feb 2014 · Journal of Advanced Nursing