The most pressing issue in the 21 st century is to ensure healthcare systems are safe and provide quality care. The Institute of Medicine in 2003 established critical competencies to promote delivery of patient-centered care. The competencies emphasized working as a team and collaboratively with care based on evidence through continuous quality improvement ( Sherwood & Zomorodi, 2014) . The Quality and Safety Education for Nurses (QSEN) project in 2007 redefined the core competencies with new sets of skills, attitude, and knowledge that change how nurses operate. This case study addresses a clinical situation where Nurse Mary Jones wants to engage new employees with a quality committee's activities. The case study presents a plan for Nurse Jones to engage seasoned staff and new nurses with implementation and ongoing QSEN safety competencies review in the ICU.
Four Safety Elements Plan
Safety is an essential component in QSEN because without it a team cannot move forward and lives can be put in jeopardy. Nurse Jones should ensure the new nurses as well as the seasoned staff nurses understand the essentials of critical thinking and adopt safe practices that develop the foundation of trust and transparency. According to Sherwood & Barnsteiner, (2017), transparency promotes system changes and creates a supportive and safe environment.
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The first safety element to be included initially in the plan include analyzing the common barriers to the active participation of patients and their families in the processes of their own care. The element is essential because active patient involvement and patient-centered care enhances patient empowerment and improves their confidence in overcoming and managing illnesses. Active involvement is an important path to patient recovery because it is often difficult to help individuals who do not want to be helped.
The second element is the description of practice scope as well as the roles of every member of the healthcare team and analysis of strategies for managing and identifying overlaps in roles and accountabilities. The element is important to inform every staff of their involvement in the healthcare team. Description of the scope of practice will empower staff by allowing every team member to play a role in helping patients to achieve health goals.
The third element is the description of human factors, unsafe practices, and other basic safety design principles. The element is essential in promoting the delivery of safe and reliable care to patients. Awareness of human factors allows healthcare staff to conduct safe practices to eliminate or reduce patient harm and errors.
The fourth element is to provide a description of processes employed in analyzing the causes of errors and allocation of accountability and responsibility. The element is essential in empowering healthcare staff to value roles and responsibilities in error prevention. Process description can eliminate blames and enable review of events as a team. The healthcare team can implement measures to promote efficiency and safety of patient care by reviewing hazards, near misses, and errors.
Time Frame
A reasonable time frame of implementing the four safety elements would be one year. Every element will be allocated two-months, where the team focus on the element and strive to perfect it. The four elements will be brought together after eight months. Nurse Jones will ensure the other four months are utilized in integrating the four elements into the nursing practice on the ICU. The first day of the two months allocated for every element will consist of an orientation to the competency using examples from ICU up-to-date applicable scenarios. Two days after the orientation will be allocated for unit training where the new staffs will be teamed with the seasoned nurses to provide mentorship on all the competencies. Nurse Jones and the seasoned nurses will have the responsibility to accurately provide help and answer questions when applicable. Some days will be allocated for staff to conduct performance review among themselves and express their attitude and perceptions regarding completing the competencies. Nurse Jones will monitor the progress of implementing the competencies into the practice of individual nurses as well as a team throughout the allocated four months.
Evaluation of Plan
Nurse Jones will hold meetings once at the end of every month while continuing to monitor the progression of the implementation over the next four months. The meetings will be held with staff to discuss how they feel about the competencies. The evaluation will enable Nurse Jones to understand the training progress sustainability and provide staff opportunities to ask questions and air grievances related to the information. Jones will use the meetings to evaluate success and identify areas that require improvement for each element. Patients or their families will complete monthly surveys to measure the effectiveness of the plan.
Sustainability of Plan
The plan will be highly sustainable. The plan will enable every staff to act as a team and grow together. The proposal is very realistic because it concentrates on one element at a time to eliminate chances of overwhelming individuals among the team. The plan will enable every individual in the team to perfect all the four elements and support one another in the process. The elements addressed by the plan benefits a patient as a whole, therefore, the plan will promote safety and quality of care.
Reference
Sherwood, G., & Barnsteiner, J. (2017). Quality and Safety in Nursing: A Competency Approach to Improving Outcomes. Journal of Nursing Regulation , 3 (4), 64.
Sherwood, G., & Zomorodi, M. (2014). A new mindset for quality and safety: the QSEN competencies redefine nurses’ roles in practice. Nephrology Nursing Journal , 41 (1), 15-22.
