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Key Principles of Patient Safety (Nursing)

by Christy Davidson

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    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.


    About the Lecture

    The lecture Key Principles of Patient Safety (Nursing) by Christy Davidson is from the course Health Care Organizations (Nursing).


    Included Quiz Questions

    1. Patient safety measures
    2. Nurse safety measures
    3. Highly reliable measures
    4. Beneficence measures
    1. Governing body
    2. Nursing leadership
    3. Culture of Safety
    4. Learning and decisional support
    1. Nursing leadership
    2. Governing body
    3. Culture of Safety
    4. Learning and decisional support
    1. By allowing the nursing staff to regulate the unit flow
    2. By allowing unit staff to pick their nurse-to-patient ratios
    3. By not enforcing the set staffing guidelines
    4. By allowing staff to change shifts without approval
    1. What support systems do you have in place for your newly licensed RNs?
    2. What is the pay for this position, and how much is offered for overtime shifts?
    3. What are the fall precautions for patients on this floor?
    4. How long is the orientation period for this position?
    1. Culture of Safety
    2. Highly reliable organization
    3. Governing body
    4. Learning and decisional support

    Author of lecture Key Principles of Patient Safety (Nursing)

     Christy Davidson

    Christy Davidson


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