Contemporary Nursing Presentation
Contemporary Nursing Presentation
Contemporary Nursing Presentation
What if ?? You are working as a nurse in an acute medical unit. One day, you find that
a doctor has prescribed an incorrect dose of a calcium supplement, and that your
colleague has administered this without checking the patient’s drug chart against
the electronic patient medication record system.
What steps would you take to advocate for the patient, and reflect on how your
colleagues might react to your actions?
WHAT WOULD DO?
PATIENT SAFETY
- What is patient safety? Patient safety was defined by the IOM as “the prevention of harm to
patients.”
- Between 44,000-98,000 patients die in U.S. hospitals each year from preventable medical
errors (Kohn,2000).
- Organizations such as the National Database of Nursing Quality Indicators, Transforming
Care at the Bedside, and the Quality of Safety Education for Nurses project were created to
encourage quality and safety programs implemented by nurses.
- National Center for Nursing Quality (NCNQ) was created to address patient safety and quality
nursing care and nurses’ working lives ( ANA, 2011).
- What else do the NCNQ do? Uses qualitative measurements, research, and collaborative
learning ensure nurses are providing quality of care.
- National Database for Nursing Quality Indicators ( NDNQI)
PATIENT SAFETY….
Transforming Care at the Bedside (TCAB)
4 major areas for improvement (Institute of Healthcare Improvement, 2016)
A. Safe and reliable care
B. Vitality and teamwork TCAB has scored multiple hospitals
around the country to help improve
C. Patient-centered care
nursing quality care.
D. Value added care processes
INTERACTION AMONG HEALTH PROFESSIONALS
What happens when there is rude interaction by health care professionals that
threaten patient safety?
“ Intimidating and disruptive behaviors can foster medical errors, contribute to poor
patient satisfaction and to preventable adverse outcomes, increase the cost of
care, and cause qualified clinicians, administrators and managers to seek new
positions in more professional enviroments. Safety and quality of patient care is
depedent on teamwork, communication, and a collarboartive work enviroment. To
ensure quality and to promote a culture of safety, healthcare organizations must
address the problem of behaviors that threaten the performance of the health
care team.” ( TJC, 2008, paragraph 1)
WHISTLE-BLOWER PROTECTION
Nurses want to know that if they speak up and advocate for their patients that they
have retaliation. So what is whistleblower protection laws?
- It is protection that prohibits healthcare organizations from retaliating against nurses when
the professional nurse in good faith discloses information or participates in agency
investigations.
- Protects nurses who speak out about unsafe situations
- Ensures they can’t be fired for speaking up or be subjected to disciplinary actions by their
employers.
- Makes sure the law or upper hand people can’t abuse their power and silence nurses when
they speak up about wrong doings they see or experience.
- Nurses should always check with their hospitals laws when it comes to this. Every state is a
little different.
WORKPLACE SAFETY
Hospitals and healthcare places are not always the safest places to work. Its
becoming harder for nurses to provide the best quality of care.
Categories of healthcare hazards in the workplace
1.Biologic Hazards- bacteria, viruses, fungi, or parasites that may be transmitted by
contact with infected patients or contaminated fluids or body secretions
2. Ergonomic Hazards- musculoskeletal injury to the back due to lifting, standing for long periods,
and repeated hand motions.
3. Chemical Hazards- Medications, solutions, gases, cytotoxic agents, latex, PVC plastics, and
mercury exposures.
4. Psychological Hazards- Stress, shiftwork, mandatory overtime, verbal abuse by patients
5. Physical Hazards- Radiation, lasers, noise, electricity, and violence.
EXPOSURE TO BLOODBORNE PATHOGENS AND
ERGONOMIC INJURIES
- Exposure to pathogens is an extreme risk for medical professionals. They risk
exposure to : Hepatitis B, Hepatitis C, and HIV- AIDS
- Occupational Safety and Health Administration role
- Needlestick Safety and Prevention Act (2000)
- Nursing is ranked 2nd for physical workload intensity. Nurse aides, attendants,
and orderlies reported the highest MSD’s making them be away from work.
- RN’s rank 5th in reporting MSD’s. 12% of nurses leave the job annually due to
back injuries, 52% complain of chronic back pain
- ANA’s Handle with Care campaign
- Reluctance of reporting injuries ( fear of repercussions, ”complainer”,
harrassment, denial of promotion, termination)
WORKPLACE INJURIES…
- Each organization is different with their workplace injury policies.
- ANA provides resources concerning safety rights and nurses’ health
- OSHA requires to keep a log of workplace injuries, prevents discrimination against
employees who report a work related injury, illness, or fatality.
WORKPLACE VIOLENCE AND ADVOCATING FOR
SAFER WORKPLACES
- Healthcare workers have the highest rates of nonfatal assault injuries in the workplace
( U.S. Department of Labor, 2012)
- Most prevalent who experience workplace violence are ED nurses
- Ex: Nurses reported more than 20 times in the past 3 years they experienced
workplace violence and with thin that 3 year period they experienced more than 200
times verbal abuse by patients. ( Gacki-Smith et al, 2009)
- Lateral violence is acts between colleagues, usually perpetrated by those of an higher
authority. Can cause stress, or even cause nurses to leave their jobs.
- Its up to nurses to advocate for safer workplaces. Zero tolerance is a must and keeping
detailed records of these incidents if they do happen are key in prevention. Create
plans for how to handle violence within the workplace and train employees the proper
way on what to do in cases of violence.
WORKPLACE SAFETY
- Having a proper staff to patient ratio is important with workplace safety.
- Need efficient training on how to handle situations
- Safeguards in place if things happen
- ANA and other organizations advocate for administrative controls, adequate
staffing, health policies, protection equipment procedures.
- Understanding most workplace injuries are preventable is key.
REFERENCES
1. American Nurses Association: Whistle blower protection, 2011.
Http://www.nursingworld.org/MainMenuCategories/Policy-
Advocacy/State/2006/whistle12768.html.Accessed January 2012
2. Cherry, B., & Jacob, S. (Ed.) (2014). Contemporary Nursing: Issues, Trends, and Management. Elsevier
Mosby.
3. Choi, P. P. (2015, February 23). Patient advocacy: The role of the nurse. Continuing Professional
Development, 29, 41,52-58. Retrieved November 8, 2016, from
http://journals.rcni.com/doi/pdfplus/10.7748/ns.29.41.52.e9772
4. Gacki- Smith J, Juarez AM, Boyett L, et al: Violence against Nurses working in the US emergency
departments, J Nurs Adm 39(7-8):340-349, 2009.
5. Jones, C., Gates, M. (2007) "The Costs and Benefits of Nurse Turnover: A Business Case for Nurse
Retention" OJIN: The Online Journal of Issues in Nursing. Vol. 12 No. 3, Manuscript 4.
6. Occupational Safety and Health Administration: Bloodborne pathogens and needlestick prevention, 2011.
www.osha.gov/SLTC/bloodbornepathogens/index.html. Accessed January 2012.