Effective Care For Our Client

Effective Care For Our Client
ethics to be truthful, courageous, showing compassion and commitment at all times to provide safe
and effective care for our client. Failure to know the physical state of the clients and to communicate
with the team could result in bad practice. For example a health service that does not listen to
complaints is unlikely to reflect its patients' needs. One that does will be more likely to detect the
early warning signs that something requires correction, to address such issues and to protect others
from harmful. A classic example is The Francis Report (2013) "They were failed by a system which
ignored the warning signs and put corporate self–interest and cost control ahead of patients and their
safety" therefore as nurses, emphasizing the physical state of clients is essential because it enables to
rule out any changes in behaviour before administering the medication (NICE, 2015). The NHS
constitution cited from British Journal of Nursing, 2015 has launched that clients and their safety
should come first in providing care and is also and ethical principle as nurses, we are obliged to do
no harm or to minimise the risk of harm. As a learning disability nurse we have the professional and
legal duties to always check clients' medication against their treatment plan, prescription and clients'
information in accordance to name of drug, administration routes and duration, time of
administering, the required dose, and expiry date on the medication before administering, we also
need
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Raising Public Awareness Of The Rapid Response Team
Raising Public Awareness of the Rapid Response Team "Failure to rescue" is becoming increasingly
important in the hospital. Rapid response/STAT teams are being put into place to intervene where
there is evidence of "failure to rescue" leading to serious adverse events. There are clinical trials
showing that patients display a need for a rapid response team sometimes up to four to six hours
before an unexpected clinical deterioration requires a traditional code team. Reading many news
articles about "failure to rescue" and from my own personal experience in clinical during nursing
school, many patients and visitors are unaware that these rapid response teams are part of the
hospital and that they have access to them. The intent of my ... Show more content on
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A traditional code teams differs from a rapid response team in a number of ways. A rapid response
team assesses a greater quantity of hospitalized patients at an earlier stage of clinical deterioration.
This is because their goal is to prevent critical adverse events such as cardiac arrests and unexpected
deaths. Consequently, rapid response teams assess patients in whom cardiac, respiratory, or
neurologic deterioration develops as opposed to patients who have already experienced a respiratory
or cardiac arrest (Jones, DeVita, & Bellomo, 2011). A failure to react promptly or appropriately
escalate care in patients with sudden, critical abnormalities in vital signs constitutes a "failure to
rescue" and may end in a serious adverse event. There are many causes for an abrupt critical event
and for failure to rescue, and they help hospitals understand why these events are astoundingly
frequent (Jones, DeVita, & Bellomo, 2011).
Review of Literature
Many of us know the story of 18–month old Josie King as it has been discussed in hospitals, nursing
schools, and more. The story has led to important changes in numerous clinical settings regarding
receptivity to feedback by family members and others related to potential care issues for patients.
Several errors were made in caring for her and her condition began to rapidly deteriorate. Sorrell
King's story has illustrated her sense of frustration and powerlessness as she attempted to alert
nurses and doctors

The Importance Of A Primary Key Component Of An...
A primary key component of an improvement plan is the sustainability plan. This is developed to
assist with obtaining goals and objectives of the organization and maintaining. It is broken into four
distinct sections: Bundle of Actions, Data Analysis and Results, Communication, and Training. The
sustainability plan will address the procedural Sedation procedure, documentation audit, data
gathering, data analysis, result reporting, the project team, department leaders, certification renewal
and department huddles and miscellaneous activities. Each of these elements within the
sustainability plan, will have an assigned action, responsible person, and frequency. Following this
lay–out makes it clear and in written documented form what the ... Show more content on
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Leadership, will provide sponsorship for process changes, the Nursing Director will be accountable
to communicating the identified needs of the initiatives to ongoing to the Executive leadership team.
Training, staff certification renewals and competency will be monitored by the Staff Education
department on an annual basis, the department RN manager is to oversee that all staff are re–
certified and competent before work shifts are assigned. Team or department huddles, are quick and
efficient ways to share information, changes and reinforcement for the procedural sedation navigator
tool utilization and documentation practices. The Department RN managers are responsible for
leading the huddles twice daily (Morning and evening shifts). The last area is listed as miscellaneous
and generally for Question and Answer refresher that can be conducted during the procedural
sedation quality meetings, department meeting, team huddles and 1:1 coaching session. This activity
will take place ongoing and is the responsibility of all level of staff. It is vital to obtain approval and
acceptance of the recommended improvement plan to all departments and leaders involve. The
understanding the importance of both the monitor and control plan and the sustainability plan, will
lead to an increase in success rates of the overall plan. It is vital that efforts to support and address
all areas of the project so that there are no gaps that can

The Bedside Shift Of Patient Participation
Abstract
Recognizing that patient participation is vital to their personal medical care, healthcare organizations
are conducting nursing staff shift reports at the bedside in the patient's presence. Bedside reports aim
to avoid communication failures by exchanging real–time information at shift change. Bedside
reporting is a new alternative to the customary change of shift report that traditionally takes place in
a unit hallway or at the nurse's station. This provides an opportunity for questions before valuable
information is lost or overlooked. In this literature review of bedside shift reporting, three studies
were compared in order to show that a patient's perspective is valued as they can see and hear from
the team of professionals who are providing their care. Bedside shift report also improves the nurses'
understanding of the patient's condition as the nurse is able to visualize the patient and share
relevant information.
Bedside Shift Report Literature Review
The bedside shift report occurs between the outgoing and oncoming nurse next to the patient's
bedside at shift change. It is intended to engage patients in the conversation and exchange of
information. This gives both nurses and the patient the opportunity to ask questions and verify
important information about the patient's history and care plan.
In a research article by Lamond (2000), the assistive role of the nursing shift report in information
processing and plan of care discussion was examined. This study

Wgu Accreditation Audit Aft2 Task 4 Essay
Continuous Accreditation Compliance – Task 4
AFT2 Accreditation Audit
October 31st, 2014
Continuous Accreditation Compliance – Task 4
Nightingale Community Hospital (NCH), like many other health care facilities, uses a Periodic
Performance Review (PPR) as an assessment tool that assists in examining performance on a
consistent basis to ensure compliance with Joint Commission standards. A PPR concentrates
attention on procedures, methods, and processes that contribute an environment that provides for
proper care and emphasizes patient safety. NCH has shown to be 100% compliant with the majority
of standards including: Infection Prevention and Control, Right and Responsibilities to Patients,
Human Resources, Transplant ... Show more content on Helpwriting.net ...
The Joint Commission (n.d.) states that, "Verbal orders are authenticated within the time frame
specified by law and regulation"( Joint Commission, n.d., RC.02.03.07 – 4). With so many
departments found to be in non–compliance during the process of just one audit this trend proves
this issue is likely widespread throughout the entire hospital and that NCH is regularly non–
compliant with this issue. The departments that did not show to have this non–complaint issue were:
Cardiac Cath Lab, Endoscopy, ICU, OR, and Surgery Pre–op. To fix this issue, it is advisable to
ascertain why and how some departments are meeting the standard while others are not. This issue
may stem from improper procedures, training, a deficiency in staffing, or a lack of leadership in the
non–compliant departments. Comparing and contrasting the departments should assist in resolving
this non–compliant issue.
Prohibited Abbreviations There are two prohibited abbreviations that are tracked, "cc" and "qd", as
they are the most common. Throughout the year there has not been consistent improvement in the
area. The trending data shows some improvement in parts of the year and then some months, April
and September, to have increased spikes of use of prohibited abbreviations. During the PPR it was
noted that the following departments were non–compliant concerning using prohibited
abbreviations: 3E, 4E, ICU, and Telemetry. The

A Brief Note On Bar Code Technology On A New Electronic...
Initializing Bar Code Technology in a New Electronic Health Record System
Alizabeth Madison
Liberty University
Implementing Bar Code Technology in a New Electronic Health Record System
"The United States based Institute of Medicine (IOM) reported in 1999 that at least 44,000 people,
and perhaps as many as 98,000 people, die in hospitals each year as a result of medical errors that
could have been prevented..." (Anonymous, 2015). When faced with more than a singular sentinel
event related to medication administration errors, the organization must begin to look into why this
happened and what can be done to prevent any more errors from occurring. Implementing new bar
code technology into a new electronic health record (EHR) system can dramatically reduce the
number of errors made by healthcare providers. In order to implement a new system; several steps
must occur. An informatics nurse plays a vital role in not only the design of new program interfaces,
but in developing educational programs for the new systems. Not all studies have shown that
implementing a new bar coding system can be beneficial to healthcare providers, though.
Assessment and Framework Assessing the situation is the first step in implementing a new system.
Knowing where the errors have occurred is a must in knowing what needs improved. In this
instance, there have been two sentinel events surrounding the usage of the current electronic health
record (EHR) and medication administration.

Reflection Upon A Critical Incident Essay
This paper will reflect upon and explore a critical incident which occurred whilst attending a clinical
placement. Reflective practice has become very popular over the last few decades throughout a
variety of professions. In some professions it has become one of the defining features of
competence. The wide spread utilization of reflective practice is due to the fact that it 'rings true'
(Loughran, 2000). Within different disciplines, what is understood by reflective practice varies
considerably (Fook et al, 2006). Despite this, some agreement has been achieved. In general,
reflective practice is understood as the process of learning through and from experience towards
gaining new insights of self and/or practice (Boud et al 1985; ... Show more content on
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The model encourages the person to think systematically about and experience or activity and
allows the opportunity to recognise areas that can be improved upon or developed. The model takes
the form of a cycle, which uses a six step approach covering a description, feelings, analysis,
evaluation, conclusion and finally action plan. My choice of model, over Johns (2000) model for
example, was due to its clear structured cycle which allows the opportunity to renter a stage in order
to try and improve upon a situation. Where as Johns (2000) model, does not allow this opportunity
although it is a useful model as a guide for analysis of a critical incident. Although, I will have to
develop the model to ensure that I critically analyse in order for it be of a higher standard at this
stage of the training. The topic of reflection is a potential drug error made whilst on my clinical
practise placement. The area of drug administration is an important role for nurses and therefore I
will incorporate research evidence, policies and guidelines surrounding drug administration, discuss
how the area can be developed and applied in professional practise. The National Patient Safety
Agency (NPSA 2010), defines a drug error as 'any preventable event that may cause or lead to
inappropriate use of patient harm. Although not all drug errors have lead to patient harm it is
important to recognise that if a mistakes has been

My Leadership Initiative : Develop A New, Simpler And...
Part A The focus of my leadership initiative is to develop a new, simpler and leaner approach
(Fillingham, 2008) to the assessment process, ensuring safe and reliable delivery of right care, in the
right place and at the right time, to the patients. Recently we implemented monthly practice
governance meetings in our team to regularly reflect on areas of improvement and discuss changes
that would improve patient care. I have been using the practice governance meetings to present
results from our recent audit demonstrating increased treatment–waiting times, share real stories
highlighting the gap between the current and desired state of the service and encourage engagement
of frontline staff in delivering this initiative. Staff was given opportunity to perform a Cause and
Effect Analysis (figure1) and map patient journey (figure2) to identify activities that add value
(Bennington, 2011) and reduce waste. I was hoping to use these meetings to frame and embed a
strategy of implementing the improvement initiative and whilst I have been successful in developing
a framework of the new leaner assessment process, the process has suffered from poor staff
engagement and conflicts with trusts' agenda of standardising the delivery of care. During these
practice governance meetings, the team was unable to come up with any suggestions to improve the
assessment process and other agendas related to the new community service review policies were
given greater priority. Some clinicians

Hand Hygiene Compliance Report
Hand washing has been proven to be one of the most effective means of preventing the spread of
infection in healthcare facilities (Centers for Disease, 2015). An outpatient dialysis facility noted
that staff was very complacent about hand hygiene. The Joint Commission National Patient Safety
Goal 7 (JCPSG) states" that healthcare organizations must perform an accurate "baseline assessment
of hand hygiene in order to identify opportunities for improvement" (The Joint Commission, 2016).
90,000 people die each year from hospital acquire infections at about a cost of 4.5 billion dollars
(Fairchild, 2009). By increasing hand hygiene compliance could save this facility many dollars and
not only that many precious lives.
The purpose of this paper is to take a look at an investigational look at change in hand washing
compliance through education and covert observation to see if the change was effective.
B Summary This brief summary addresses the hand hygiene proposal for the advanced nursing
practice field experience. The organizational change I am investigating is an increase in staff
compliance with hand hygiene in an outpatient dialysis facility. The population affected by this
change is all outpatient dialysis patients. My change leader is the Director of Education for the
facility. My plan for conducting this investigation was to find a current and ongoing quality
improvement that was being conducted and look at what was being done to make the change and the
outcomes

Risk Management : An Organization Of Patient Safety
According to ECRI Institute (2014), risk management did not emerge as a distinct profession in
healthcare, primarily in the hospital environment, until the mid–1970s, when the number of
malpractice claims against physicians and hospitals increased dramatically, and settlements and
judgments skyrocketed. In 1977, the American Hospital Association encouraged hospitals to
implement risk management programs as a solution to malpractice problems, calling risk
management the "science for the identification, evaluation, and treatment of the risk of financial
loss" (Dankmyer and Groves; Holloway and Sax). Risk management's focus was to protect the
financial assets and reputation of organization (Kuhn and Youngberg). During the patient safety ...
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According to Mrs. Parker, Memorial Hospital of York "Is dedicated to excellence in healthcare for
our community. We believe that a comprehensive quality improvement program is a primary means
of organizational goals and promoting our mission of providing the community with an array of
high –quality health care services." Memorial hospitals promote and adopt the six aims for
improvement as identified by the Institute of Medicine; 1. Safe, 2. Effective, 3. Patient–centered, 4.
Timely, 5. Efficient, and 6. Equitable. The six aims for improvement set forth by the Institute of
Medicine are the basic foundation for Memorial Hospital structure of the Quality program.
Memorial Hospital of York, defines quality as a never–ending cycle of continuous improvement
(parker, 2015). They accomplish this goal by proactively identifying and improving systems causes
of medical errors. Some goals of the hospital quality program include; improving the quality and
safety of patient–care processes and outcomes and to organize data into useful information,
including comparison to an internal and external data source, among other few, (parker, 2015). All
employees and departments are expected to be actively involved in the program, the Board of
Trustees, Administration, Department Leaders and leaders of the organized

Ineffective Handoff Report For Nurses
According to the first step of Lewin's theory Unfreeze phase is about helping nurses to recognize the
need for change and encourage them to think about what the current process of end of shift
reporting, what the disadvantages are, and how it can be improved. According to Sand–Jecklin and
Sherman (2014), significant percentage of a nurse's communications occurs during end of shift
handoffs, and the safety of the patient can be compromised at this time. Nurses recognized that
patient handoffs as a factor regarding near miss incidents. According to the Joint Commission
(2011), miscommunication is one of the factors that leading to sentinel patient events, therefore, it is
a requirement of Joint Commission National Patient Safety Goals. Nursing handoff report is the
time, when responsibility and accountability for the care of a patient would be transferred from one
nurse to another. Ineffective handovers, such as when not all required information is provided, can
be risky for patients and staffs. According to Novak and Fairchild (2012), the method for delivery of
shift report varies among hospitals, units, and nurses. These handoffs occur at busy times with
multiple distractions and time constraints. This makes shift–to–shift report a time with high potential
for the occurrence of errors related to communication. Reports done away from bedside hinder the
patient's participation in their care, which results in a decrease in patient satisfaction scores.
According to Maxson,

Roles And Responsibilities Of An Effective Nurse
As a nurse there are multiple roles and responsibilities one must uphold to, to be successful and
professional. A nurse is expected to grow professionally and personally throughout their career by
identifying values, by reflecting on actions and ideas and gaining more knowledge with each new
experience. To be successful one must commit to the growth and development of their knowledge
and experience and strive to be an effective nurse. A nurse is responsible for being the patient's
caregiver, decision maker, communicator, advocate and teacher. Not only are these roles an
important part of being successful as a nurse, they are also an important part of ensuring the safety
of the patient. A nurse is responsible and accountable for the care ... Show more content on
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A nurse must commit to being informed and knowledge on these processes in ensuring patient
safety.
In providing a safe and effective environment for a patient, it is important the nurse follow the
National Patient Safety goals and implement them in their daily routine. These goals were developed
by the Joint Commission's Patient Safety Advisory group which consists of physicians, nurses, risk
managers, pharmacists and other professionals involved in care giving. These goals are put into
effect "to assist accredited organizations to address specific areas of concern in regards to patient
safety" (TJC, 2015). One of the first goals is to correctly identify patients, which should be done for
each patient before any procedure that involves the patient or anytime they are receiving medication
or blood products. Identifying the patient should be done by using 2 identifiers which would be
name and date of birth. This is used to help prevent a medication or procedure being given or done
on the wrong patient. As a nurse it is critical to report severe or life altering lab tests or situations
right away to the right person, which is another patient safety goal. Medications are given frequently
in the hospital so a goal is for each medication to be given safely and correctly. This can be done
according to the National Patient Safety Goals by monitoring patients closely who are taking blood
thinners, making sure that

The Role Of The Nurse Leader
The Role of the Nurse Leader in Quality
Preventable hospital readmissions remain among one of the many serious quality issues plaguing the
healthcare industry today. Readmissions can carry fiscal implications, impact patient safety, and
outcomes of care (Helm, Alaeddini, Bretthauer, & Skolarus, 2016). The cost of unplanned hospital
readmissions is estimated to be upwards of $15 billion dollars annually of which $12 billion has
been associated with preventable admissions (Helm et al., 2016). It is highly recognized that as
many as 20% of Medicare beneficiaries are presently being readmitted within 30 days of discharge
(Hunter, Nelson, & Birmingham, 2013; Verhaegh, Mac–Neil–Vroomen, Eslami, Geerlings, de Rooij,
et al., 2014). The presence of ... Show more content on Helpwriting.net ...
Posing the question: what else can be done to keep patients from returning to the ED for care and
consequently being readmitted? (K. Larry, personal communication, March 15, 2017).
How Were Readmissions Measured
Ms. Larry stated that reviewers measured the total number of patients presenting to the ED within
30 days of a hospitalization (personal communication, March 15, 2017). Additionally, she said they
compared the patient's ED diagnosis to the previous admission and discharge diagnosis (K. Larry,
personal communication, March 15, 2017). Finally, reviewers correlated readmissions with the
following information: site of hospitalization, type of admission (i.e. surgical, medical, or behavioral
health), the complexity of the hospitalization, and the age of the patient (K. Larry, personal
communication, March 15, 2017). After obtaining the necessary data, Ms. Larry stated that
reviewers worked on determining the frequency of post–discharge ED visits resulting in
readmissions and the factors associated with each ED visit (personal communication, March 15,
2017).
MTF Action Plan
With a goal to obtain a 33% reduction in ED utilization by recently discharged patients, the MTF
devised the following strategies to facilitate care transitions and improve communication from
inpatient units to clinics and between clinics and patients (K. Larry, personal communication, March
15, 2017). Collectively the interventions were recognized locally as Project Red Light

Health Care Organization : Safety, Quality And Patient...
Post # 2 TCAB Many researchers have been focusing on safety, quality of care, to explain change in
the health care organization. For example, the institute of medicine, the institute of healthcare and
the Picker institute outline elements such as environment, patient centered and the needs the need
health care to promote safe nursing practice across the nation to improve quality and patient
satisfaction outcomes. TCAB is not a traditional quality improvement program; one primary
characteristic that sets it apart is its focus on engaging frontline staff and unit managers. Ideas for
transforming the way care is delivered on medical/surgical units come not from the executive suite
or a quality improvement department, but from the nurses and other care team members who spend
the most time with patients and their families (RWJF). The purpose of this work is to assess
initiative that has been putting in place to improve TCAB because it helps improve patient and
families outcome. Our goal is also to answer the questions related to the case study as specified in
the book, page 239. The TCAB project started with the American Heath Institute (AHI) and the
Robert Wood Johnson Foundation (RWJF). The program was as expressed by Needleman in the
AJN was designed to "improve inpatient care and the hospital work environment by empowering
front–line nursing staff". The idea was front–line staff and unit nurse managers can see the needs to
change and initiate changes that will

Policies And Procedures For Student And Faculty Performance
Policies and procedures for student and faculty performance will be defined and consistently
applied. Using a process described by Bourke and Ihrke (as cited in Billings & Halstead, 2012),
faculty will be evaluated at end of course and annually (including teaching assignments/approaches,
advising). Students will be evaluated with formative and summative evaluations including
coursework (exam grades), clinical (performance, concept map, and reflective clinical evaluation
tool or CET), and simulation. Curriculum will be evaluated at end of course (including clinical
requirement/location, clinical site surveys, course sequencing, remediation, admission
requirements). Program will be evaluated by retention, progression, and National ... Show more
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Class preparation will be ensured by requiring an assigned PrepU mastery level prior to class. Exam
preparation will be ensured by requiring an assigned PassPoint mastery prior to exam. Faculty will
provide timely, constructive, and thoughtful feedback, including exam reviews. Faculty will provide
counsel at risk students at midterm and create a peer mentoring program for at risk students.
Individual exam reviews will be provided to students scoring below an 80 on any exam. Students
who score below an 80 on any exam or below the designated score on benchmark exams will
develop a remediation plan.
Following Dewey's (1938) experiential learning, hands–on activities and practical exercises will
help faculty evaluate student understanding of important course related concepts. Strategies to
engage students will include classroom activities, simulations, case studies, and group interactive
presentations. Psychomotor skills and clinical reasoning will be evaluated in laboratory, simulation,
and clinical settings. Skill check offs will be submitted by video with a self and peer evaluation.
Remediation will be required for any unsuccessful students and the peer evaluators. Frequent review
of learning outcomes will ensure appropriateness of activities. Faculty will continually assess
student's attention span and understanding of the information delivered, incorporating time for
breaks and questions every 50 minutes. Brookfield's (2006)

Joint Commission International, Centers For Medicare And...
Which organization(s) accredit this facility:
Joint Commission International, Centers for Medicare and Medicaid Services (CMS), Lab is
accredited by College of American Pathologist (CAP) (K.E., personal communication, 2016).
What community outreach/activities does this facility sponsor or support:
Ladies night out, Breast Cancer; Survivor's Day once a year; Mission Arlington, Arlington Night
Shelter, Cuisine for Healing, Health Fairs with city of Arlington and senior centers (K.E., personal
communication, 2016)
2. BUDGET:
What is the organization's fiscal year?
January to December (K.E., personal communication, 2016).
Describe the budget process and how staff members at the unit level impact the budget.
The budget process for each year begins by examining how much was spent each month. For each
month, a budget is created for the following year. Staff members at the unit level impact the budget
with supply usage.
Identify who within the organization contributes to budget development. Managers and Chief
Executive Officer (K.E., personal communication, 2016).
3. CURRENT TRENDS:
Following APA guidelines and Citing professional literature,
Discuss three or more national and local developments OR current trends in health care & discuss
how those trends influence the budget and how the organization does business.
Over the news and media is where it is more commonly heard about fraud in markets such as
banking and retail, but not a lot is

The National Patient Safety Agency and The Information Act
The National Patient safety agency (NPSA) is an organization that created as a Special Health
Authority. The function of this organization is to establish and managing patient in order to store
maintain and secured semi–current records pending to their ultimate disposal. Besides that, the
NPSA also assimilating safety–related information that can helps researcher to conduct research
about healthcare. However, the security in accessing those records involves the authorization from
the head of records agency that essential in protecting the patient records.
In September 2003, the NPSA develop a records management programme that ''tailored to the
NPSA's business needs and meets legislative and accountability requirements'' (NPSA, 2004a). The
objectives of appraisal and retention scheduling is to survey, identify and document each business
activities that carries out by NPSA, to identify the requirement for evidence of each business
function, activities and transaction of those agencies, to establish formal appraisal and retention and
disposition policies and also to establish a set of retention schedules that specify the types and time
period of each records will be held.
The NPSA appraisal policy defines appraisal as the process of evaluating the activities of the NPSA
to determine which records need to be kept to meet the NPSA's business needs and those
stakeholders and to provide accountability for the NPSA's actions (NPSA, 2004b). The concept of
the appraisal process is to

The Hospital Consumer Assessment Of Healthcare Providers...
Change of shift report is the time when responsibility and accountability for the care of a patient is
transferred from one nurse to another. This transfer involves handoff from one nurse who has cared
for the patient to the next nurse who may not know the patient. Report is informational as patient's
condition, treatment, and care planning are shared. The communication during this process is
intended to insure continuity of care giving and patient safety. First, report can have emotional
meaning for the nurse. It is a time to connect with other staff and share the emotional distress and
struggles endured over the course of shift. We nurses may take this time to complain about other
staff, patients, their families, or update ourselves on ... Show more content on Helpwriting.net ...
Jefferson wants to improve their score up to national level 94 % and new way to improve patient
safety and satisfaction. My Preceptor herself is working on the project how the nurses can improve
their communication and increase patient safety, and this is how I came out with this topic. The
Institute of Medicine in its landmark publication in 2011 highlighted the problem of patient safety
and, subsequently, efforts have been made to improve care to avoid errors. The Institute for Health
Care Improvement collaborated with the Robert Wood Johnson foundation and created an initiative
titled "Transforming Care at the Bedside" to improve patient safety. This initiative includes bringing
report to bedside ( Griffin , 2012) Bedside report increases client safety and satisfaction; creates
trust between nurse and client; reduces communication errors; and promotes accountability,
teamwork, and respect among staff ( Cairins, Dudjak, Hoffman, & Lorenz 2013; Reinbeck &
Fitzsimmons, 2013; Sandjecklin & Sherman, 2013). Case Study 1
Advocate Trinity Hospital, implemented Guide bedside shift report strategy in 2012 as part of a year
–long project. This was an initiative with American Institutes for Research (AIR), funded by AHRQ.
METHOD: As a participating hospital, Advocate Trinity Hospital 3

NDNQI Action Plan
NDNQI Analysis and Action Plan: Adams 5, Inpatient Rehab Unit
Savetria Nicole Palmer
Walden University
NURS 2006 Section 13, Topics in Clinical Nursing
September 21, 2014
Quality is a broad term that encompasses various aspects of nursing care (Montolvo, 2007). The
National Database of Nursing Quality Indicators [NDNQI] is the only national nursing database that
provides quarterly and annual reporting of structure, process, and outcome indicators to evaluate
nursing care at the unit level (Montolvo, 2007). Nursing's foundational principles and guidelines
identify that as a profession, nursing has a responsibility to measure, evaluate, and improve practice
(Montolvo, 2007). The purpose of this paper is to analyze the ... Show more content on
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Each of these interventions will positively impact patient outcomes and reduce errors. According to
The Joint Commission [TJC], proper patient identification is best practice for decreasing mislabeled
specimens (The Joint Commission as cited by Sims, 2010). National Patient Safety Goal [NPSG],
01.01.01 states that healthcare providers should use at least two identifiers to identify patients. For
example, the patient's full name and date of birth is used to properly identify a patient (The Joint
Commission, 2014). According to Kim et al., (2013), developing a standardized specimen handling
system has the potential to reduce errors.
Figure 1. Steps to properly identifying a patient for specimen collection.
Figure 1. Essential specimen handling steps. Blue items are physician–specific responsibilities; pink
items are nursing staff–specific responsibilities. Adapted from "Standardized Patient Identification
and Specimen Labeling: A Retrospective Analysis on Improving Patient Safety," by Kim JK; Dotson
B; Thomas S; Nelson KC; Journal of the American Academy of Dermatology, 2013 Jan; 68 (1): 53–
6.
The strongest intervention to reduce labeling errors is the addition of barcode technology (Brown,
Smith & Sherfy, 2011). The use of automated patient identification and specimen collection
techniques can be an additional safety net for routines that are vulnerable to error, especially when
coupled with strong systems

The Patient Safety Concern And Quality Improvement Issue (...
Falls in a health care setting are costly to the patient, the health care facility and may affect the
reimbursement that insurance gives to hospitals, yet they are preventable. Falls can be minor with
just a few bumps and bruises or they can be major which can result in death. Not only are falls
harmful to the patient but there is a lot of money and time that gets added up after a fall occurs ***
There are many factors as to why a fall could take place, but being aware of the risk that a patient is
a fall risk from the beginning can help avoid a fall from ever occurring. Accurately identifying a
patient as a fall risk and communicating to other staff within 24 hours of admission is key to help in
the prevention of falls.
Current Knowledge of the Patient Safety Concern/Quality Improvement Issue (State and National
Context)
Falls are one of the most common inpatient adverse events. According to the World Health
Organization, a fall is defined as an event that results in a person coming to rest inadvertently on the
ground or floor or other lower level (WHO 2016). In 2012, the cost of fall injuries totaled more than
$36 billion. As the population ages, the financial toll for older–adult falls is projected to reach $59.6
billion by 2020. (NCQA 2015). Fall–related injuries account for up to 15 percent of
rehospitalizations in the first month after discharge from hospital (Currie). Based on data from 2000,
total annual estimated costs were between $16 billion and $19

Communication Between Nurses And Nurses Essay
The hand over process of communication between nurses to nurses is done with the intention of
transferring essential information for safe, and patient centered care. Traditionally, this shift report
has been done away from the patient's bedside, at the nurse's station, or other place like staff's room.
In addition, the shift report used to be delivered through audio recording of the patient's information.
These reporting mechanisms did not include face–to–face reporting of the patient information, nor
involvement of patient. Therefore, information regarding the patient's care was not shared with the
patient, leaving them out of his/her own care plan. Recent studies and development of Patient
Centered Care Philosophy have challenged this belief of giving a report away from the patient. Tan
(2015) said, "Shift report must not only be restricted in nurse to nurse communication, but it must
involve patients as the recipients of care" (p. 1). Incorporating the patient into the end of shift report
is essential for providing patient centered care and patient satisfaction. Nurses at the St Jude Medical
center in the acute in–patient rehabilitation unit are not exceptional. Most of the end of the shift
report between nurses are still done away from the patient. Aim of this paper is to make a change in
the work place, which is the process of giving end of shift report at the bedside incorporating patient
and families in the acute in–patient rehabilitation unit at St Jude Medical

Essay on Standardized Safety with Tools and Checklist
The term "safety comes first" or more simply put, "safety first," is a message that patients not only
want to hear, but also want to know is the focus of the professionals that are caring for them; in
particular, when they are under anesthesia and have limited or no ability to speak up or lookout for
themselves. The National Patient Safety Agency (NPSA) has implemented two initiatives;
Rocognising and Responding Appropriately to Early Signs of Deterioration in Hospitalised Patients
(NPSA, 2007) and How to Guide: Five Steps to Safer Surgery (NPSA, 2010). Understanding that
human beings make up the healthcare professional workforce, it is evident that tools and checklist
can and will only be as good as the how people utilize and follow ... Show more content on
Helpwriting.net ...
These discoveries prompted change and allowed the National Institute of Health and Clinical
Excellence (NICE), to set standards to reduce unnecessary detriment to patients. Many tools were
introduced to assist in the consistency and accuracy of observations of patients' physiological
conditions. ViEWS (VitalPac Early Warning Score) is a standardized and high–tech scoring system
that helps recognize and respond to deteriorating patients. It is the basis of the newest warning
system, appropriately named National Early Warning System or NEWS (Featherstone, Prytherch,
Schmidt & Smith, 2010).
Conversely, the How to Guide: Five Steps to Safer Surgery is an adjunct to the World Health
Organization (WHO), Safe Surgery Saves Lives: The Second Global Patient Safety Challenge. In
this, the primary goal is to confirm that surgical teams not only communicate, but follow safety
standards in order to minimize common mistakes and insure the best outcome for surgical patients.
The standards included in this literature emphasize, "improving anesthetic safety practices, ensuring
surgery is undertaken on the correct part of the body, preventing surgical site infections, and
improving communication and teamwork" (Beaumont & Russell, 2012). The actual checklist
consists of the following 5–step process:
1. Briefing – This occurs pre–operative and is a meeting that includes all members of the surgery,
from technicians, to anesthesiologist, to nurses and surgeons. It is a

Conflict Management : Effective Communication
Conflict Management: Effective Communication In Critical Areas
Everyday nurses are confronted with responsibilities; tasks and providing care for their patients in
environments that require cooperation, and most importantly communication. In the Intensive Care
Unit (ICU) and Emergency Room (ER) where I work, tensions, acuity and a plethora of other
stressors tend to run high. In these critical areas conflicts between co–workers, patients and families
can occur rapidly and frequently. In reading Dialogue Heals these conflicts commonly experienced
by healthcare personnel are broken down into seven distinct categories with examples and a brief
example of how to communicate about the issue. Crucial Conversations: Tools For Talking When
the Stakes are High gives a thorough review of identifying, addressing and progressing critical
conversations by helping identify barriers that are often encountered when the conversation turns
vital. Communication is such an important issue, thirteen years after the initial implementation it is
still the second National Patient Safety Goal provided by The Joint Commission because of it's
effects on patient care (Davis, Lockhart, Landon & Henry, 2014). This paper will give a personal
example as to why it is important to get a dialogue open before the problem compounds and
produces adverse effects.
The event I choose to discuss happened in the ICU of a hospital I was recently off orientation in.
Upon running my rhythm strip and going over to take

Managing Staff Of A Union Environment
Managing staff in a union environment may present challenges. Secondary to a 1975 United States
Supreme Court decision, NRLB vs. J. Weingarten, Inc. 420 U.S. 251, discussions with employees
who are members of a union, in which that conversation may result in discipline, require the
manager to provide the employee with union representation during investigatory interviews if it is
requested (Phillips, 2015). Therefore, managers may not possess the opportunity to have crucial
conversations in a timely manner secondary to a delay associated with bringing together the
appropriate parties for a meeting. It is through a collaborative effort by Human Resource partners
and union representatives that employee grievances are addressed and resolved. If the parties are
unable to reach an agreement, an arbitrator may be employed to settle the issue. Nearly all employee
complaints are handled via the HR/Union collaborative process and no formal tracking of protests or
concerns is in place. One of the functions of Human Resources (HR) entails regulatory compliance
associated with for example, the Fair Labor Standards Act, which covers minimum wage
requirements and rights to overtime pay. Failure to compensate employees for all time worked can
lead to costly lawsuits, therefore, HR must assure it is following this act (Silberman, 2016). In
addition, the Federal Civil Rights law compliance, which requires hiring practices that assure the
organization is not practicing discrimination based on

Team Performance: Improve Patient Safety and Quality Essay
Outline
I. Background
II. Literature Review
III. Nursing Implications
IV. Strategies to Address Issue
V. Conclusion
Background A culture of safety requires the commitment of leadership to positively impact
outcomes. Recent emphasis on the new CMS guidelines and third party reimbursement initiatives
associated with patient outcomes, has grabbed the attention of leadership at all healthcare
organizations. Additionally, our system wide organization's employee culture of safety survey has
shown that communication and teamwork are areas were improvements are needed. Years of
research on communication and teamwork in highly reliable organizations support a correlation with
safety. (XX) One of the most important and highly ... Show more content on Helpwriting.net ...
Application of these same principles in healthcare, have been identified as a strong means to
mitigating adverse events and negative outcomes. Creating team oriented culture as an approach to
patient care can effectively strengthen the goal for enhancing communication and ultimately lead to
positive safety and quality outcomes. (XXX) The goal for our organization is to systematically
implement a formal team program beginning with training trainers and then implementing the
program starting with the high risk areas and proceeding to all patient care environments. The high–
risk environments will include Perioperative, Operative, ICU, ED and Obstetrics, with one area
selected to pilot. The programs to be utilized will be TeamStepps and Team Performance Plus.
Literature Review
A search through MEDLINE, and PubMED, with the search terms, teamwork, quality, safety,
TeamStepps, collaborative work, communication and interdisciplinary action. Initially I used the
years 1999–2013, which provided more than a thousand of articles. This was narrowed with
inclusion criteria of the dates 2005–2013, in acute care, full text, and written in English, which
produced greater than 400 articles. Further screening with the assistance of the facility librarian, for
the purpose of this

The Role Of The Nurse Leader In Quality. Katherine Ensley.
Katherine Ensley
Liberty University
Preventable hospital readmissions remain among one of the many serious quality issues plaguing the
healthcare industry today. Readmissions can carry fiscal implications, impact patient safety, and
outcomes of care (Helm, Alaeddini, Bretthauer, & Skolarus, 2016). The cost of unplanned hospital
readmissions is estimated to be upwards of $15 billion dollars annually of which $12 billion has
been associated with preventable admissions (Helm et al., 2016). It is highly recognized that as
many as 20% of Medicare beneficiaries are presently being readmitted within 30 days of discharge
(Hunter, Nelson, & Birmingham, ... Show more content on Helpwriting.net ...
They also compared the patient's ED diagnosis to the previous admission and discharge diagnosis.
Additionally, reviewers correlated the following information: site of hospitalization, type of
admission (i.e. surgical, medical, or behavioral health), the complexity of the hospitalization, and the
age of the patient. After obtaining the necessary data, reviewers worked on determining the
frequency of post–discharge ED visits that resulted in readmission, and the factors associated with
each ED visit.
MTF Action Plan
With a goal to obtain a 33% reduction in ED utilization by recently discharged patients, the MTF
devised the following strategies to facilitate care transitions and improve communication from
inpatient units to clinics and between clinics and patients. Collectively the interventions were
recognized as Project Red Light and consisted of developing a Health Insurance Portability and
Accountability Act (HIPAA) compliant process for sharing acute care admission/discharge
information with appropriate clinics and outpatient providers as well as scheduling follow–up
appointments prior to discharge or by the next business day following discharge. Other program
interventions involved utilizing a multi–disciplinary approach to discharge planning consisting of
input from Care Coordinators, Primary Care Managers, Social Workers, and Discharge Planners.
An important component of the

National Patient Safety Goals ( Npsgs )
National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is to help
accredited organizations address specific areas of concern in regard to patient safety ("Catheter–
Associated," 2015). NPSG.07.06.01 Implement evidence–based practices to prevent indwelling
catheter–associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission,"
2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing CAUTIs can
be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration,
nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.
Goal
Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd
most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter
Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end
of the year, measured by the quality department on a monthly basis, and implemented through
performance improvement factors including the interdisciplinary team through a strong focus on the
nursing leadership team.
Financial Implications
According to a study conducted in 2011 by the government, approximately 80% of urinary tract
infections associated with indwelling catheters, increase the hospital length of stay by one to three
days, and according to the Centers for Medicare & Medicaid Services (CMS), have an annual cost
of

Task 4
| Task 4 | | | Monica DeWitt | | | Current Compliance Status The hospital is compliant in with the
National Patient Safety Goals (NPSG) in the following areas: staff is using 2 identifiers when
providing care, correctly transfusing patients, maintaining a healthy patient care environment by
complying with the Center for Disease Control (CDC) and World Health Organization (WHO) hand
hygiene guidelines, continuing evidence–based best practice to prevent or reduce the risk of
catheter–associated urinary tract infections (CAUTI), identifying patients at risk for suicide. Within
the rest of the accreditation requirements the facility was compliant with the following elements:
EM–emergency management ... Show more content on Helpwriting.net ...
Labeling issues–The lack of labeling as well as pre–labeling can put the patient at risk. The unit
sited for this is the Operating Room. Annual test–This is a basic safety test that is used to ensure
patient and staff safety. The area sited was EOC. Fire Drills– This is vital to ensure staff has
practiced emergency procedures. While auditing the fire drill history it was noted there were gaps in
completing the required quarterly drill for each shift. The third shift lacked a drill in the first quarter
and the third quarter. The fourth quarter was lacking a drill during the second shift. The area sited
was EOC. The units that have the greatest opportunity for improvement include 3E, 4E, OR and
telemetry. Staffing Patterns Within the staffing effectiveness report, most data collected indicated a
downward linear trend. This downward trend is a positive outcome. However, 4E has an upward
linear trend which needs to be improved. The linear trend of nursing hours compared to the number
of falls and pressure ulcers indicate an increase in nursing hours do not guarantee drop in falls or
pressure ulcers. The performance trends show a gradual increase in the number of falls and pressure
ulcers. A closer look is needed to identify reasons for the correlation between greater nursing hours
and increased falls. This may be due to a need for increase in nursing staff and limiting the number
of hours the nurse can work

Healthcare Organizations Are Under Deep Scrutiny Essay
Delivering excellent care for health maintenance and acute illness, which meets quality, safety and
patient experience standards, while reducing costs is the focus of health care organizations across
the country (Kara, Johnson, Nicley, & Niemeier, 2015; IHI, 2016). Healthcare organizations are
under deep scrutiny by public and government sectors to meet the IHI Triple Aim to improve patient
experience, improve the health of populations and reduce cost of health care (IHI, 2016). However,
these sectors use different measures to evaluate the effectiveness of healthcare organizations.
Carolinas Healthcare System, which consists of over 900 care locations, including thirty–three
hospitals within North and South Carolina, works to meet the Triple Aim and be viewed by the
public and governmental sectors as a healthy organization. The question is how does one measure
the health of an organization? Is Carolinas Healthcare System an example of a healthy organization,
one that integrates leadership principles and concepts, utilizing fiscal responsibility within the
organization's climate, culture and behaviors? Or, is Carolinas Healthcare System an organization
without a mission, vision, goals or strategic plan, on the brink of failure and without public and
governmental approval?
Aspects to Evaluate Organizational Health
Orvik and Axelsson (2012) defined organizational health as how well an organization copes with
internal and external stressors affecting the values that benefit

Evidence & Expert Interview Paper
Evidence & Expert Interview Paper Kimberly Russell Chamberlain School of Nursing
Instructor Sniffen NR 447 Collaborative Health Care Evidence & Expert Interview Paper
Introduction I have chosen two SMART goals to research and put into action by the end of week six
of class. SMART Goal 1 is the leadership development goal and will standardize the surgical time–
out procedure to include all required elements as recommended by the World Health Organization
(WHO) and meet the requirements of the Joint Commission Universal Protocol. I chose this goal for
myself to ensure that all nurses are consistently including all required information each and every
time in the surgical time–out procedure and as a result ... Show more content on Helpwriting.net ...
They are very easy to navigate and it only took minutes to locate the information I needed for this
project. The Joint Commission and the World Health Organization (WHO) set the standards and
recommendations that hospitals follow when making their policy and procedures for patient safety
and patient care. These two websites clearly state the required time–out elements and expectations
of a surgical time–out. This information was very helpful in helping me make sure that all required
elements were included. Informational Expert My informational expert is the nurse educator of
surgical services. She has a BSN in nursing and is knowledgeable of all the current policy and
procedures and is responsible for educating all surgical staff on any new required procedures. She
was in agreement that this project would benefit our organization as a whole and falls into the
category of one of our National Patient Safety Goals. My first step was to get manager approval of
the project which was granted. My nurse educator then advised me to use the WHO website and the
Joint Commission website to get information on the required elements and expectations of a surgical
time–out. After I gathered information form the websites and reference article we met again and I
presented my findings and we discussed the

Bedside Shift Reporting On Patient Care Quality And Safety
Bedside Shift Reporting With growing concern about patient safety and satisfaction, a change in
where shift report is given has been a cause of concern. Traditionally, change–of–shift report is done
at the nurses' station or away from patients. Numerous studies have been conducted on moving the
change–of–shift report from the nurses' station or hallway to the patient's bedside. An analysis of
bedside shift reporting has revealed the benefits of increased patient satisfaction and safety as well
as several challenges of implementation of bedside shift reporting.
Literature Review Effective communication during a patient handoff is critical in ensuring patient–
care quality and safety and bedside shift reports have been found to increase patient involvement
and satisfaction (Wakefield, Ragan, Brandt, and Tregnago, 2012). Bedside shift report is viewed as
an opportunity to reduce errors and ensure improved communication between nurses (Gregory, Tan,
Tilrico, Edwardson, and Gamm, 2014). Improved communication between nurses can be beneficial
for all involved. In response to the Joint Commission's National Patient Safety Goals, bedside report
has been supported as improving patient safety, patient–centered care, and nurse communication as
well as reducing medical errors (Gregory, et al., 2014). Ofori–Atta, Biniend, and Chalupka's (2015)
article examines statistics regarding hospital care and shows that according to the Inspector General
Office, Health and Human Services

What Is A Reflection In Nursing
09/08 When I have arrived at the unit every shift, the first thing I do before receiving report and
starting my assessments is washing my hands. However, I consistently wash my hands before and
after I enter in a patient's room throughout my shift using the guidelines from the CDC to prevent
the transmission of infection in my patients. I also administered medicaments safely for all my
patients using the six rights and the three checks of med administration. I verified the patient's name,
the doctor's order in the MAR before and after I remove the meds out of the med room and at the
bedside, I verified my patient's name and date of birth against the arm band in accordance with the
initiatives for National Patient Safety Goals (NPG.01.01.01; NPG.01.01.07). This week, I managed
the care of four patients. I delegated the BP's and BS's to the NA. I did all my assessments and
documented them. I passed all the medications for all four patients on time before 2200p. On this
time, another change of shift occurs and assignments are divided to accommodate based on the
census and personnel availability by the charge nurse. I prioritized my patients based on their acuity
and ordered meds. I administered first a beta blocker and an ACE inhibitor with parameters (held if
SBP of 110 or less) for my patient with a BP of 152/77, then I administered Pro–stat 30 mg protein
drink and docusate sodium a stool softener to another of my patients. I recognized that was not easy
to manage and

Critical Study And Analysis Of Oral Care
The purpose of this document is a critical study and analysis of the oral care provided by nursing
staff as part of the Ventilator Care Bundle (VCB) and to assess whether the frequency of mouth care
performed is related to the prevention of Ventilator Associated Pneumonia (VAP) in patients
mechanically ventilated (Zilberberg et al. 2009).
The following document is a case study written by an intensive care nurse, who will explore the oral
care provided to a patient admitted in an Intensive Care Unit (ICU) and will assess the overall care
process. Additionally, the frequency, products used and techniques performed will be evaluated.
In order to evaluate if mouth care and its frequency are Gold Standard interventions to prevent VAP
... Show more content on Helpwriting.net ...
ICU patients suffer from a broad range of pathologies, requiring MV, sedation and use of multiples
devices, which do not allow patients to protect their airway (Augustyn. 2007; Kollef. 2004).
Oral care aims to supply an adequate hygiene level, which leads to reduce colonisation of dental
plaque and oropharynx and to reduce the aspiration of contaminated secretions into the lower airway
(Feider et al. 2010). Research has demonstrated that colonisation of the airway and aspiration of
colonised saliva are the two main pathogenic causes of VAP (Adib–Hajbaghery et al. 2011). Other
cause is the production of a biofilm along the endotracheal tube (ETT) which contains large
quantities of microbes that could be spread into the lungs by ventilator–induced breaths (Keyt et al.
2014; Palomar et al. 2010). Additionally, instilling saline into the ETT, suctioning secretions,
repositioning the ETT or coughing, could dislodge the biofilm into the airway and increase the risk
of VAP (Moore. 2003; Morehead and Pinto. 2002).
According to Hunter (2012, p.40) "VAP is a hospital acquired pneumonia that occurs 48 hours or
more after tracheal intubation or acute tracheostomisation". VAP is one of the most common
nosocomial infection responsible for one third of mortal respiratory infections in European ICUs
(Adib–Hajbaghery et al. 2011).
Despite of its high incidence, identifying VAP infection requires a

Description And Scope Of The Problem
Section I: Description and Scope of the Problem Universally, across international acute care
organizations with a vested interest in healthcare safety, there is recognition that clinical alarm
systems pose a hazard to patient safety (TJC, 2014; Lukasewicz & Anderson, 2015). The Joint
Commission (TJC) issued a Sentinel Event Alert in 2013 on device alarm safety which subsequently
led to the creation of the National Patient Safety Goal 06.01.01 (TJC, 2014). The alert and goal was
published with an aim at acute care hospitals because of reported adverse and sentinel patient events
and data that related to the nature of these events, indicating there is significant risk related to
clinical alarm systems. The NPSG 06.01.01 is a requirement ... Show more content on
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Lukasewicz & Anderson (2015) state there is literature that supports major themes which have been
linked to clinical alarm events as studied by various patient safety organizations, some of which
include: The Joint Commission, ECRI Institute, and The Association for the Advancement of
Medical Instrumentation, all of which noted the problem to be complex. According to TJC (2014),
the purpose of clinical alarm systems is to give a warning to caregivers that a problem exists. If the
alarm warning is not provided, not perceived or is mismanaged, the consequence can lead to an
adverse and/or sentinel event. There is a plethora of contributing factors for alarm mismanagement,
making the problem complex to understand and solve. Alarm failure can result from decreased
detectability, excessive alarms, desensitization causing missed or ignored alarms, default and alarm
parameter settings that are not appropriate for the clinical context and device design flaws (TJC,
2014; Lukasewicz & Anderson, 2015; XXX).
In order to address the multitude of clinical alarm hazards, many organizations recognize that nurses
are most directly impacted by clinical alarms, which include expectations for responses to alarms,
attitude and behavior in response to alarms, administrative support, all of which have been studied
extensively by various organizations involved in patient safety and by medical researchers
throughout the world (XXXX). As a result of this

Effective Teamwork And Healthcare Organizations Can Have A...
The benefit of teamwork is to work together effectively, which means team members need to have
professional skills, knowledge, attitudes which allow them to monitor each other 's performance
and, responsibilities toward working in a team (Buchbinder & Shanks 292–294). Physicians, nurses,
and other healthcare providers organize their activities to offer safe and efficient healthcare.
Teamwork results in less mistakes than an individual, especially when each members of the team
knows her, or his, responsibilities as well as those of other team members. Teamwork relies on each
team member and they are able to lead the needs of others and have a shared understanding of how a
procedure should occur. According to IOM, "effective teamwork in healthcare organizations can
have a positive effect on patient safety" (Baker, Day & Salas 2 ). Effective teamwork brings benefits
for patients and medical staff. When a patient 's situation gets worse, the team looks to the leader
and they will know that each person on the team can accomplish his or her duties and work with
others to improve the healthcare quality. Teamwork can develop trust among other members and
prevent them from making mistakes (Buchbinder & Shanks 293).Also, patients are more satisfied
with their care when healthcare providers cooperate and reduce anxiety among patients (Buchbinder
& Shanks 300). In spite of all the benefits of teamwork that already noted there are some challenges
which affect the teamwork,

Improvement Plan
Quality Improvement Plan Part II Lizbeth M. Gómez HCS/588 University of Phoenix Lynn S.
Kiehne, Ed. D., MHA, FACHE April 2, 2012. Quality Improvement Plan Part II This paper attempts
to explain some areas of potential improvement for the Veteran Affairs (VA) organization in a
surgical department. Describe the data that needs to be collected and the tools to be use. Also, it will
be identified and compared the types of information collected based on the different tools used.
Presenting the Quality Improvements (QI) tools needed to accomplish the goal and describe the
information obtained from it. In addition, establish how are these tools helpful for the health care
organizations. Areas of Potential Improvements for the ... Show more content on Helpwriting.net ...
This also provides flexibility in the analysis of the responses. On the other hand, standardized
questionnaire items often represent the least common denominator in assessing people's attitudes,
orientations, circumstances, and experiences. By designing questions that will be appropriate for all
respondents, it is possible to miss what is most appropriate to many of the respondents (Babbie,
1992). Some advantages of the self–administered survey are: Low cost. Extensive training is not
required to administer the survey. Processing and analysis are usually simpler and cheaper than for
other methods. The reduction in bias error. The questionnaire reduces the bias that might result from
personal characteristics of interviewers and/or their interviewing skills. Greater anonymity, absence
of an interviewer provides greater anonymity for the respondent. This is especially helpful when the
survey deals with sensitive issues such as questions about involvement in a gang, because
respondents are more likely to respond to sensitive questions when they are not face to face with an
interviewer. Some of the disadvantages are: Requires simple questions. The questions must be
straightforward enough to be comprehended solely on the basis of printed instructions and
definitions. No opportunity for probing. The answers must be accepted as final. Researchers have no
opportunity to

The Quality Of Care For Elderly People Given By The Nhs
Intro Using a case study which was highlighted in a report presented by the Parliamentary and
Health Service Ombudsman (2011), I will be identifying and reflecting on issues raised in the
complaint concerning the quality of care for elderly people given by the NHS. Throughout this
assignment, I will be using a wide variety of research sources in order to evaluate my own personal
and professional developments in accordance to the Nursing and Midwifery Council (NMC) Code
(2015). The NMC sets out professional standards and guidelines that nurses and midwives should
adhere to in order to practice and maintain a high quality of care to patients. Within this assignment,
I will be using Bortons' (1970) framework as a structure to my reflection on issues identified in the
case study. This useful reflective model consists of three main components; 'What', 'So what' and
finally 'Now what'. Bortons' model is highly recommended by Jasper (2003) as a useful model,
particularly for student nurses, as it allows beginner practitioners to reflect on their practice in an
analytical manner. In order to protect the identity of the patient's case in which I will be utilising, for
the purposes of this assignment the patient will be referred to as Mrs H. What Mrs H was a highly
intelligent woman who was able to live independently in her home until the age of 88. Due to being
partially blind and deaf, Mrs H relied on using British Sign Language and deaf–blind manual to
communicate. Her next of kin

AFT2
Executive Summary The Joint Commission is scheduled to visit Nightingale Community Hospital
for its triennial accreditation survey within the next 13 months. The purpose of this document is to
provide senior leadership with an outline of the hospital's current compliance status in the Priority
Focus Area of Communication. Recommendations for corrective action are included in this
document which are designed to bring the organization into full compliance in the areas where
deficits have been identified.
The Priority Focus Area of Communication includes 3 Joint Commission (JC) standards relative to
Universal Protocol. These 3 standards, which are components of the National Patient Safety Goals,
are aimed at ensuring the correct ... Show more content on Helpwriting.net ...
EP 5 requires a written process for patients who refuse site marking or when it is impossible or
impractical to mark the site. This written process is absent in the hospital's policy. Nightingale's
policy and process must be revised immediately to reflect all the required elements of the standard.
Hospital physicians and staff must be educated on the necessary changes and the revised process
must be put into action. Once these changes have occurred, I recommend a focused audit to ensure
full compliance with the revised policy/process.
UP.01.03.01 requires a time–out before the start of the procedure. The Site Identification and
Verification policy describes the time–out process however the policy falls short of fully meeting the
intent of this standard. EP 2 describes which team members must participate in the timeout, EP 3
requires a time–out before each procedure when two or more procedures are being performed, and
EP 5 requires documentation of the time–out. These 3 elements are missing from the hospital
policy/process and therefore revisions to the process/policy are necessary to include these 3
elements. Nightingale's Safety Report reveals increasing compliance (nearing 100%) with the time–
out process, however as mentioned above, EP 5 requires documentation of the process. In addition
to the policy revision, I recommend the development of a unique form which will be used to
document

Bedside Shift Reporting Essay
Bedside Shift Reporting
Jennifer J. Fay
Indiana State University
Bedside Shift Reporting In every profession there are changes that propel how tasks are done;
nursing is no stranger to this. One of the biggest changes that have come into nursing's daily events
is how report hand–offs are being done. Gone are the days of taped report that each off going nurse
must tape about each patient and the oncoming nurse must listen to. Nurses are now being
encouraged to move their report to the bedside, in front of the patient (Trossman, 2007). It is very
important to know how this can affect the patient and even the nurse's schedule. With every change,
there are positives and negatives that can finalize the decision to keep or forego ... Show more
content on Helpwriting.net ...
At times, it can take up to an hour to see a patient when nurses use traditional reporting. In thinking
of safety or even treatment of pain when it comes to patients, seeing a patient that soon may cut
down on patient falls and increase satisfaction with care.
In looking at another hospital's experience, Riley Hospital for Children in Indianapolis was able to
decrease their lag between shifts by 45 minutes (Trossman). The article also goes on to state that
children's families felt that "call lights were not being answered promptly, and couldn't get the
nurses attention if their child needed a pain pill or other care" (Trossman). During report time, the
healthcare staff can be far more engrossed in that part of their day rather than the call lights or a
patients needs hoping that the nurse's aides could take care of the issue until report time is over.
Having the nurse at the bedside far sooner could show patients and their families that the on–coming
nurse is readily available. Bedside reporting doesn't seem to be a new concept even though the
research is fairly new. In an article from 1978, Pepper states "bedside report ensures better
continuity of care by being more accurate and more complete than the conference report". This is
true in many ways, for example, how often are nurses in a rush to leave from a hectic day and forget
about a dressing change or IV bags? If nurses are doing a bedside report rather than the traditional
report they would

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