Key Principles of Patient Safety (Nursing)

00:00 Welcome back, everyone.

00:02 According to Maslow's hierarchy of needs, everyone has fundamental physiological needs such as food, water, sleep, and shelter.

00:11 Now once those needs are met, we move to the topic of today's video: Safety.

00:17 Patient safety is defined by the Institute of Medicine as the prevention of harm to patients.

00:23 The prevention of harm can be defined as freedom from accidental or preventable injuries produced by medical care.

00:30 Now, there are four system levels involved with patient safety.

00:35 The first is the individual clinician or the nurse, the physician, someone who is working by themselves.

00:42 Second, we think about microsystems or the unit where you may work.

00:46 Third, the entire organization.

00:49 And, finally, we're talking about the global environment of policy, payment, regulation, accreditation, and all other factors external to the actual care of the patient.

01:00 Now working conditions have an impact on safety.

01:03 Nursing personnel actually represent the largest component of the health care workforce.

01:08 Registered nurses provide health care to individuals in virtually all locations in which health care is delivered.

01:15 Nurses though are in short supply and competition for them is strong.

01:19 So the work environment of nurses definitely has an impact on patient safety.

01:24 But there are areas for improvement.

01:26 First, we need to work on the extended work hours and fatigue experienced by nurses.

01:33 We need to address mandatory overtime.

01:36 Also, regulation of nurse staffing levels.

01:40 Now protecting patient safety in organizations has many aspects.

01:44 First, governing boards that focus on safety, leadership and evidence-based management structures and processes, effective nursing leadership, adequate staffing, organizational support for ongoing learning and decision support, mechanisms that promote interdisciplinary collaboration, work design that promotes safety.

02:03 And, finally, organizational culture that continuously strengthens patient safety.

02:09 Now let's go into each one of those right now.

02:12 Governing boards.

02:13 These are knowledgeable about the link between management practices and patient safety Their emphasis is on patient safety to the same degree as financial and productivity goals.

02:26 When you think of executive or overall leadership, they provide ongoing vigilance in balancing efficiency and patient safety.

02:34 They demonstrate and promote trust in and by nursing staff.

02:38 And they actively manage the process of change.

02:42 Additionally, they engage nursing staff in nonhierarchical decision-making and work design.

02:49 They establish the organization as a learning organization.

02:54 When you move to nursing leadership, they participate in executive decision-making.

02:59 They represent nursing staff to management.

03:02 They achieve effective communication between nurses and all other clinical leadership.

03:08 Additionally, they facilitate input from direct care nursing staff into decision-making.

03:14 They also command organizational resources for nursing knowledge, acquisition, and clinical decision making.

03:20 When we think about adequate staffing, it's established by sound methodologies as determined by the nursing staff.

03:27 And it provides mechanisms to accommodate unplanned variations in patient care workload.

03:33 It enables nursing staff to regulate nursing unit workflow.

03:37 And it's consistent with best available evidence on safe staffing thresholds.

03:42 Moving to learning and decision support, this uses preceptors for novice nurses.

03:47 It also provides ongoing educational support and resources to nursing staff.

03:53 It provides training in new technology.

03:56 It provides decision support at the point of care.

04:00 Moving to interdisciplinary collaboration, use interdisciplinary practice mechanisms, such as interdisciplinary patient care rounds.

04:09 Provide formal education and training in interdisciplinary collaboration for all healthcare providers, so that everyone knows how to work together from different disciplines.

04:18 Moving to work design, that defends against fatigue and unsafe and inefficient work design.

04:25 It tackles medication administration, handwashing, documentation, and other high-priority practices.

04:32 The culture of safety, an organization regularly reviews organizational success in achieving formally specified safety objectives.

04:41 And it fosters a fair and just error-reporting, analysis, and feedback system.

04:47 And, finally, the organization trains and rewards workers for safety.

04:53 Remember, nurses are in a key position to improve patient safety.

04:58 So, in thinking about what we've covered today, I'd like you to consider this question.

05:03 What are the eight principles which help protect patient safety within organizations? Governing boards that focus on safety, leadership and evidence-based management structures and processes, effective nurse leadership, adequate staffing, organizational support for ongoing learning and decision support, mechanisms that promote interdisciplinary collaboration, a work design that promotes safety.

05:36 And, finally, organizational culture that continuously strengthens patient safety.

05:41 I hope you've enjoyed today's video on patient safety in nursing.

05:44 Thanks so much for watching.