HowAre The National Patient Standards Being Enforced In Health CareEnvironment? Discuss The Impact On The Nursing Profession.
Patientsin a hospital setting are exposed to a number of risks which canresult to danger in their health or even lead to fatalities. Toensure the safety and quality of care offered to patients orresidents, the Joint Commission came up with National Patient SafetyGoals in 2002. This was to assist accredited organization deal withspecific fields of concern related to patient safety. The NationalPatient Safety Goals were effective on January 1 2013. When NationalPatient Safety Goals are made a standard, the goal code is droppedand is no longer applied. Thus, it is normal for one to find mostnumbers missing. There are various goals that ensure that nationalpatient standards are implemented and that they achieve the intendedresults. As a member of the health care team, there is need tounderstand these goals in order to enhance patient/resident safety inaddition to understanding your role as a health care giver. The goalsinclude identify patient correctly, enhance support communication,improve the safety of medicines given, reducing harm caused byclinical alarm system, minimizing the risk of health care associatedinfections, protecting residents from fall, prevent health careassociated pressures, and identifying patient safety risk. Thesenational safety standards have influenced the nursing profession in agreat way through their enforcement. One of the areas that have beenimpacted include communication development among support, policymaking in the profession, gaining experience in surgical procedures,implementation of electronic health records to enhance patientidentification, response to alarm in hospital setting, sanitationespecially hand washing and gloves wearing has also changes andultimately policy in the nursing profession has changed due to theneed to achieve patient safety as recommended by the JointCommission.
Thesafety of patients is very critical in health care environment. Everyyear, thousands of patients die due to direct result of avoidablemedical events like hospital related infections, surgical errors andsentinel events that happen when patient alarms are stopped. Mortality for example is four times higher in facilities wherepatients have infections acquired in the hospital settings. Studieshave also demonstrated that, more almost a quarter of patients in theintensive care unit, ICU develops hospital acquired infections. Thisis not only affect the patient’s health, but also implicates thehealth care cost as the patient has to extend his or her stay inhospital by almost half i.e. from 8.1 days to 15.8 days according to(Davis,Lockhart, Landon & Henry, 2014).This therefore brings a lot of concern for patient safety. The JointCommission has been responsible for enhancing patient safety.
Toensure the safety and quality of care offered to patients orresidents, the Joint Commission came up with National Patient SafetyGoals in 2002. This was to assist accredited organization deal withspecific fields of concern related to patient safety. The NationalPatient Safety Goals were effective on January 1 2013. When NationalPatient Safety Goals are made a standard, the goal code is droppedand is no longer applied. Thus, it is normal for one to find mostnumbers missing. There are various goals that ensure that nationalpatient standards are implemented and that they achieve the intendedresults. As a member of the health care team, there is need tounderstand these goals in order to enhance patient/resident safety inaddition to understanding your role as a health care giver. Thestandards provided are always a revised version of the previousyear’s standards. They are made specifically in a manner thatresponds to concerns in the health care environment on the resourcesrequired to address National Patient Safety Goals as stipulated byThe Joint Commission (2012). For a successful accreditation survey asprovided by the Commission. A fresh National Patient Hospital Goalwas added in the year 2014 regarding the safe clinical alarmmanagement for facilities and critical access hospitals (The JointCommission, 2014). These goals will be discussed in order of how theyare enforced in the hospital environment.
Overviewof Goals Development
TheJoint Commission is usually advised by a panel of highly recognizedpatient safety professionals and also helps in updating NationalPatient Safety Goals. The panel is called the Patient Safety AdvisoryGroup and comprises of nurses, pharmacists, risk managers, clinicalengineers, and other professionals who posses hands-on experience onpatient safety. The Safety Advisory together with the JointCommission helps identify emerging patient safety concerns andadvices the commission accordingly in NPSGs, standards and surveyprocesses, Sentinel Event Alerts, performance measures, Center forTransforming Healthcare projects and educational materials. Inconsideration to collaboration made with practitioners, purchasers,provider organizations, consumer groups and other stakeholders, thecommission determines the most priority patient safety concerns andhow they can best address them (The Joint Commission, 2012). Thecommission is usually the overall determinant of the patient safetypriorities and provides different agencies with guidelines forimplementation. The goals are implemented in different ways.
Thereare different identifiers which are accepted which entail the name ofthe patient, a telephone number, an identification number assigned tothe patient, as well as other personal identifiers like hospital I.D,physical location, date of birth (Davis,Lockhart, Landon & Henry, 2014).The residents or patients room number or physical placements arenever used as identifiers. This applies to behavioral health care,ambulatory, critical access hospital, office based surgery, andnursing care center.
Healthcare givers must ensure that the correct resident/patient gets theright blood when they are getting a blood transfusion. To achievethis, match the blood component or blood to the order match theresident to the blood group or component using a two-personidentification process or a one person confirmation process followedby automated identification procedure like bar coding (The JointCommission, 2012).
Toensure that no mistakes are done, this goal emphasizes on health caregivers to give the correct results to the right staff member on atimely. This applies to hospital, office based surgery, criticalaccess hospital and ambulatory.
Improvethe safety of medication use
Allmedications, containers and other solutions on and off the sterilearea need to be labeled well. Medication containers entail thingslike syringes, basins and medicine cups. This should apply toambulatory, hospital, critical access hospital, and office basedsurgery. In addition, the chances of harm to a patient connected toanticoagulant therapy should be minimized. This also applies tocritical access hospital, nursing care center, and ambulatory.
Thecorrect information should be recorded and passed along regarding apatient or resident’s medications. The nurse and other health careparticipants handling the patient have to find out which medicinesthe patient is currently taking, and compare these medicines to thefresh medicines prescribed to the patient (Aikenet al., 2012).In addition, one must make sure the patient understands what medicinethey will be taking at home. Patients should be advised by healthcare givers to bring their up to date medication list each time theyvisit a physician. This is applicable to behavioral health care,ambulatory, office based surgery, home care, critical accesshospital, a hospital and nursing care center.
Reducingthe harm related to clinical alarm system
Improvementsshould be made to make sure that alarms on medical facilities andequipment are heard and replied to in good time. This applies tohospital and critical access hospital.
Reducingthe risk of health care related infections
Thisis enforced through the use of the hand hygiene directions providedby the Center for Disease Control and Prevention (CDC) or that of theWorld Health Organization (WHO). Also a team or a facility may setgoals for enhancing hand cleaning. Evidence based practices meant toprevent central line associated bloodstream infections should beimplemented. Also evidence based practices for preventing health careassociated infections as a result of multi-drug resistant organismsin acute care hospitals must be put in place (Davis,Lockhart, Landon & Henry, 2014).Other evidence based practices to prevent surgical areas infectionsneed to be observed as well as evidence based practices to protectindwelling catheter-related urinary tract infections are implemented.
Residentsprotected from falling
Fallsshould be reduced to prevent injuries among residents. This appliesto nursing care center and home care.
Preventhealth care related pressure ulcers
Alsoknown as decubitus ulcers should be prevented by accessing thepatient’s risk of developing these ulcers. Action need to be takenif any risk is noticed. This is common in nursing care center.
Identifypatient safety risk
Thosepatients or residents at risk of committing suicide should bechecked. This is done in behavioral health care and hospital. Therisks related to home oxygen therapy also need to be identifiedincluding home fires and is common to home care.
TheImpact of National Standards Implementation to Nursing Profession
Nationalpatient safety standards are meant to protect patient and improve thequality of care delivery. At the heart of their enforcement arenurses who are mainly responsible for caring for patients andresidents in a hospital environment. As such, nurses are alwayscareful and up to date with the guidelines to ensure that mistakes donot happen. When mistakes happen however, nurses are always at thecenter of the blame, even if when the mistake could have originatedfrom another field in the health care facility, such as the pharmacy(Aikenet al., 2012).Nurses feel the pressure of ensuring that nothing goes wrong. Thenursing profession has thus been impacted in various areas.
Toachieve high level of patient identification, the nursing professionhas been forced to adopt and use the latest technologies in healthrecords and to capture the identity of a patient. HER or electronichealth records has been highly embraced in order to ensure that awide range of information on a particular patient is capture, storedand easily retrieved from any point of the hospital environment(Sittigand Singh, 2012).Palm scanners in particular have been widely employed in ensuringthat the patient is correctly identified for quality and effectivecare.
Anotherarea that has been impacted in the nursing profession is developmentof communication skills. Communication is necessary in providing thecorrect results and information regarding a patient’s treatment.Nurses have learnt that maintaining a health communication system iscritical in ensuring patient safety in a hospital environment (Aikenet al., 2012).Patients also need to be explained how to take their medication,about any necessary therapy or other treatments. Giving a patient hisor her medication which is well labeled is not enough, withoutexplaining how to take them and ensuring that they understand. Thishas improved the relationship between nurses and patients thusenhancing care delivery outcomes.
Alarmshave been identified as one of the critical components in health caresettings. Switching them off or ignoring them endangers the safety ofpatients. Nurses have been encouraged to respond immediately to anysentinel events. This has placed nurses to be alert and responsive tosounds in the hospital and care for patients at the right time.
Surgicalmistakes are another area, where safety of the patient isjeopardized. As such, nurses have been keen surgical procedures andhave been fully engaged in the process as much as surgeons (Aikenet al., 2012).This have made nurses gain even a better experience in surgery andrelated procedures which have influenced the quality of health careservices rendered to patients, besides enhancing patient safety.
Ultimately,the reduction of HAIs (Hospital Associated Infections) has been thecore of patient safety in a hospital environment. The work ofmaintaining high levels of sanitation in clinical setting is amongthe key responsibility of nurses. The nursing profession haveemphasized on nurses washing their hands with disinfectant andwearing new gloves every time they are handling a different patient(Aikenet al., 2012).This way they reduce the rate or chances of infection from thehospital environment and ensure patient safety throughout theirinteraction in hospitals. In addition, nurses are able to stay safefrom infections that occur in the hospital setting.
Inaddition, nursing profession has been influenced through policymaking by the implementation of the national safety standards. Policymakers have focused on these national standards established by theJoint Commission to achieve the set goals and ensure patient safetyand quality of care delivery.
Ahospital environment is expected to offer clinical and medical careto restore health. However, there are various accidents that occurthat may undermine patient safety. Cases of patients dying fromdirect mistakes of health care givers are not new. As such, the JointCommission has taken the necessary steps to set the National PatientSafety Goals meant to enhance the safety of the patient in a hospitalenvironment. Among the goals include having proper patientidentification, enhanced communication to prevent result errors,communication and minimizing surgical errors among others. Theenforcement of these national patient standards has greatly impactedthe nursing professional in various areas. Some of the most notableimpact include the communication among nurses, adaptation of EHR andthe finger print technology in patient identification, understandingof surgical procedures, sanitation standards in the hospital and whenhandling patients and finally have affected policy in the nursingprofession.
Aiken,L. H., Sermeus, W., Van den Heede, K., Sloane, D. M., Busse, R.,McKee, M., … &
Kutney-Lee,A. (2012). Patient safety, satisfaction, and quality of hospitalcare: cross sectional surveys of nurses and patients in 12 countriesin Europe and the United States. Bmj,344,e1717.
Davis,C., Lockhart, L., Landon, D., & Henry, D. (2014). Let`s talkabout safety! The 2014 hospital National Patient Safety Goals.Nursingmade Incredibly Easy,12(2),36-43.
Sittig,D. F., & Singh, H. (2012). Electronic health records and nationalpatient-safety goals. NewEngland Journal of Medicine,367(19),1854-1860.
TheJoint Commission on Accreditation of Healthcare Organizations (2011).Facts About the National Patient Safety Goals. Retrieved fromwww.jointcommission.org/assets/1/18/National_Patient_Safety_Goals_6_3_111.PDF(Accessed May 5).
TheJoint Commission on Accreditation of Healthcare Organizations.(2014). 2014 National Patient Safety Goals. Retrieved fromhttp://www.jointcommission.org/standards_information/npsgs.aspx(Accessed May 3, 2015)