Quality and Safety in Healthcare and Nursing Practice-Fall Prevention

Nurses play a significant role in improving health care quality through patient safety. In fact, nursing is concerned with defining and measuring quality, a role that has always been part of nurses. From as early as Florence Nightingale first analyzed mortality data in 1855 among British troops to the use of the data in significantly reducing mortality through hygiene and organization practices, nurses have been an integral part of quality measures and patient safety. These early nursing forays introduced performance measures in health care facilities, allowing nurses to define quality and patient safety as degrees and characteristics of excellence with standards presented as the general agreement on what quality and safety levels are acceptable (DeNisco & Beauvais, 2020) Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

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As a novice nurse, I viewed nursing responsibility in care quality and patient safety in the narrow aspects of patient care, such as preventing falls among patients and avoiding medication errors. However, through continually engaging in nursing practice, I have come to understand that while the dimensions in my previous narrow understanding remain important within the nursing purview, the depth and breadth of what nurses can achieve in quality improvement and patient safety is far greater. I have developed a new understanding that nurses and nursing care makes critical contributions to care quality and patient safety, in any setting, by integrating and coordinating the multiple aspects of care quality and patient safety within nursing care and even in care delivered by other providers within the same setting. This coordinating and integrative nursing function is a component associated with lower mortality and fewer complications (Joel, 2018) Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

While the mechanism of this integrating and coordinating function is not evident at the level of novice nurses, it is related to the role of the more experienced and higher level nurses in care integration (which includes intercepting errors and near misses). In addition, it is related to roles in surveillance and monitoring to identify patient deterioration and hazards before they turn into errors and adverse events. Nurses have a constant presence at the bedside where they regularly interact with patients, families, and medical personnel. This makes them crucial to timely communication and coordination. From a perspective of care quality and patient safety, nurses have a role in identifying changes in the condition of a patient and communicating the changes, understanding care processes and weaknesses inherent within a system, detecting errors and near misses, monitoring clinical deterioration in patients, and performing countless other tasks to ensure that high quality care is delivered to patients (Nash et al., 2019)Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

Besides that, nurses play a key role in communication. Communication lapses contribute to the commission of errors with nurses playing a role as a prime communication link in all health care settings. A look at ‘error chain’ (all nodes involved in the commission of errors), clearly indicates that nurses have a communication and leadership role in the serious of events that lead to a patient being harmed. Through root cause analysis, these linked causes can be identified as categories in which nurses can intervene to include losing track of the objectives, ignoring or overlooking individual fallibility, breakdown in teamwork or communication, poor leadership, and failure to follow the standard operating procedures (Koutoukidis & Stainton, 2020)Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

It is evident that patient safety is the cornerstone of health care quality. Nurses play a role in supporting care quality and patient safety by defining the two concepts with a focus on the negative outcomes and prevention of harm as it relates to morbidity and mortality. In addition, nurses are critical to coordination and surveillance that reduce care outcomes. Besides that, nurses can take on a proactive role in positively affecting quality, safety indicators and other measures of improved health status (DeNisco & Beauvais, 2020). In this respect, nurses play an important role in supporting quality and safety measures Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

References

DeNisco, S. M. & Beauvais, A. M. (2020). Advanced Practice Nursing: Essential Knowledge for the Profession (4th ed.). Jones & Bartlett Learning, LLC.

Joel, L. A. (2018). Advanced Practice Nursing: Essentials for Role Development (4th ed.). F.A. Davis Company.

Koutoukidis, G., & Stainton, K. (2020). Tabbner’s Nursing Care: Theory and Practice. Elsevier.

Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The Healthcare Quality Book: Vision, Strategy, and Tools (4th ed.). Health Administration Press Quality and Safety in Healthcare and Nursing Practice-Fall Prevention.

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How will you, as a future DNP-prepared nurse, keep patients safe? This is a multi-layered question with many different answers. Yet, it is important to note that as the nurse leader, quality and safety measures are at the forefront of how you deliver nursing practice. Quality and safety measures are integral components in healthcare. According to Nash et al. (2019), “Around the end of the twentieth century and the start of the twenty-first, a number of reports presented strong evidence of widespread quality deficiencies and highlighted a need for substantial change to ensure high-quality care for all patients” (p. 5). Understanding the prominence of error, it is important to consider your role as a DNP-prepared nurse. For this Discussion, take a moment to consider your experience with quality and safety in your nursing practice. Reflect on your experience and consider how your role may support quality and safety measures. Reference Nash, D. B., Joshi, M. S., Ransom, E. R., & Ransom, S. B. (Eds.). (2019). The healthcare quality book: Vision, strategy, and tools (4th ed.). Health Administration Press Quality and Safety in Healthcare and Nursing Practice-Fall Prevention