Role of quality and safety in nursing science

This analysis purposes to determine the role of quality and safety in nursing science.  To realize this goal, the paper starts by defining quality and safety measures in addition to describing their connection and role in modern nursing science.

Quality and Sustainability Paper Part One – Quality and Safety (WEEK TWO)
Quality and Sustainability Paper Part

The Quality and Sustainability Paper is a practice immersion assignment designed to be completed in three sections. This is part one of the assignment. Learners are required to analyze and apply quality and/or safety measures specific to contemporary nursing science.

General Guidelines:

Use the following information to ensure successful completion of the assignment:

  • You are required to use APA style for these writing assignments.
  • This assignment requires that you support your position by referencing at eight scholarly resources.

Directions:

Write a paper (1,250-1,500 words) discussing the role of quality and/or safety in nursing science. Include the following:

  1. Define quality and/or safety measures and describe their relationship and role in nursing science today.
  2. Provide a contemporary example of how quality or safety measures are applied in nursing science.
  3. Identify the quality and/or components needed to analyze a health care program’s outcomes.

Solved

Role of quality and safety in nursing science

Introduction

Provision of quality healthcare in today’s competitive healthcare industry remains a key challenge to many healthcare professionals across the whole world. Providers find it c to challenging to successfully and effectively resolve the increase patient demands.  Nursing, in particular, is faced with the need to improve processes in order to guarantee both high quality care and safety of patient. Studies indicate in spite of the advances in technology, there are flaws in quality as well as safety of care. Consequently, this analysis purposes to determine the role of quality and safety in nursing science.  To realize this goal, the paper starts by defining quality and safety measures in addition to describing their connection and role in modern nursing science.

Quality and Sustainability Paper Part
Quality and Sustainability Paper Part

Quality and Safety Measures in Modern Nursing Science

            With medical errors being ranked at number three in the leading causes of death in the US, all stakeholders in healthcare acknowledge the prevalence of avoidable harm to the patient (McMains, 2016). By definition, healthcare quality describes the magnitude to which services in healthcare offered to individuals and populations raise the prospect of achieving the desired health outcomes which are also consistent with existing professional knowledge (Allen-Duck et al., 2017). Similarly, safety measures refer to all those strategies implemented with the primary focus being to enhance patient safety in order to prevent errors adverse impact in the process of receiving healthcare. Aaronson et al (2015), aver that the increasing cost of injuries and non-communicable diseases in various countries of the world has highlighted the need for effective emergency care in order to improve the rate of both morbidity and mortality in injuries and acute illnesses. As emergency care demand continues to increase major stakeholders in health continue to stress on the need to develop and strengthen emergency care systems in settings with scarce resources.  Experts in healthcare consider quality healthcare as the general umbrella within which patient safety is to be found (Allen-Duck et al., 2017). 

            The Institute of Medicine (IOM) view of quality in healthcare has been distilled to mien the optimal equilibrium between realized possibilities together with a charter of norms and values (Broccoli et al., 2018). Over the years quality indicators include but are not limited to death, disease and disability where discomfort and dissatisfaction but the IOM has in the 21st century elaborated that in addition to these 5Ds measured indicators, quality healthcare is also one that patient-focused, safe, effective as well as being equitable efficient and timely (Manzanera et al., 2018).

            In the context of emergency, having quality assurance systems that are well developed would lead to significant improvements in the standards of care provided in the ED.  Relevant literature supports that addressing waiting time longer two hours is bound to greatly reduce the rate of patients who leave without being seen as well as increase patient satisfaction rate for patients who visit the ED (Liu, Masiello, Ponzer, & Farrokhnia, 2018). The reduction of the rate of LWBS will also be achieved through enhanced patient safety measures where the health professionals focus on a system of ED care delivery that proactively prevents errors, learn from the errors that have happened and then create a culture of patient safety that incorporates all the workers and staff as well as the patients (Broccoli et al., 2018).  The patient safety practices include bar coding, human resource management and computerized physician order entries amongst others (Liu, Masiello, Ponzer, & Farrokhnia, 2018). Guaranteed quality health care and implementation of effective patient safety measures are linked to modern nursing science in nurses are able execute surveillance and coordination both of which decrease adverse outcomes.

Contemporary example

            Healthcare providers have to remain committed to quality objectives in their health policies. According to Manzanera et al (2018), quality assurance coupled with patient safety is can be analyzed from different perspectives which are directly related to each other. Research studies examining ED processes followed by requisite changes can have a great impact on wait times and the resultant patient (Broccoli et al., 2018). In modern nursing science some of the quality guarantees practices and patient safety measures are considered to a function of several measures. 

            The first of the measures is the professional’s empathy or attitude. Patient satisfaction is in and if itself a good predictor of quality cares since patients judge their care from the manner in which they were treated as a person instead of the medical treatment that they received (Broccoli et al., 2018). As a result most organization regards caring and comforting behaviors to play an important role in developing patient and family satisfaction within the ED.  Creating the impression of a professional too busy to help or properly respond to the questions is discouraged such that the professional has to strike a balance in caring for patients even as they concentrate on health technologies that are functionally designed to cure instead of caring for patients (Zocchi, McClelland, & Pines, 2015). Another quality and safety measure entails the timeliness of care within the ED. Saya et al (2014) note that reducing the waiting time to 2 hours or less is associated with decreased rates of LWBS. This emanates from the central principal in care which holds that the first healthcare professional to see the patient has the capacity in assessing, treating and discharging the patient safely. For the acutely ill patient together with those who require complex care are attended in a separate care areas while those with minor complaints are attended to in order of their arrival. Having a dedicated staff in the right numbers prevent lineup development.

            The third and last quality guarantee and patient safety measure to be discussed due to the scope of this paper is the technical competence of the clinicians form the MDs to RNs. Perceived technical competence in skills counts in addition to the clinician listening to the patient with minimal and only when necessary interruptions, answer their questions and explain the treatment they are administering (Smeds-Alenius et al, 2016). In a nutshell, these quality guarantee and patient safety measures underscore the fact that the art of caring is directly linked to patient satisfaction where speed cannot be taken to be an excuse for being rude, disrespectful and having an uncaring attitude within the ED. Be that as it may, patients desire to seen quickly and treated promptly as prolonged wait times only serve to heighten the anxiety of the patient and loss of self-control.  For those in pain getting pain relief in the shortest time matters just as does the cleanliness and comfort of the waiting room together with the privacy accorded in the ED. Other quality guarantee measures are controlled noise levels and overcoming language barriers.

Quality and Sustainability Paper Part
Role of quality and safety in nursing science. 

Analyzing Health Care Program’s Outcomes

Tzelepis et al (2015) note timeliness and efficiency constitute two of the six aspects of quality health care recommended by IOM. Patients who opt to leave the ED either before seeing the physician(commonly referred to as left without being seen- LWBS0, after being seen  but prior the treatment(also left before receiving treatment-LBRT)  or those who leave against medical advice  (LAMA)  represent a significant indicator of the quality of care found in a facility’s ED (Mataloni et al, 2018). In the context of this essay, the contents are heavily biased towards the LWBS specifically with regard to the length of wait time either more than 2 hours or less than 2 hours.  In 2012 the US national quality forum included LWBS rates as a component of 10 indicators of performance. Studies also report that the percentage rates of LWBS vary not just between hospitals but also countries where it was estimated to be between 1- 15% in the US, 1 to 10% in Australia and about 3% in England. Asia according to Mataloni and fellow researchers posted the lowest being Taiwan with a mere 0.1% and 0.36 % in Hong Kong. The researchers further noted that in terms of hospital’s pediatric facilities reported the lowest followed by public hospitals and then teaching hospitals in comparison to theirs. The typical; profile of the LWBS patient was described as being young males with a lower urgency triage categorization and longer waiting times. Patients, who arrived at the ED without transport assistance, came at night or weekends also do have a higher risk of LWBS.

However, those patients who did not wait long enough to see the patient for whatever reason sought alternative medical care through their personal doctors or EDs of other facilities and tend to have a higher risk of re-visiting an ED within 2 days when compared with those who completed the treatment (Davenport, O’Conner, Szychowsky, Landry, & Hernandez, 2017).  Tzelepis et al. (2015) also argue that prolonged wait times within the ED have been linked to increased rates of morbidity and mortality and lowered patient satisfaction The LWBS patients also had increased risk of death within the first week going by the models that were adjusted for these individuals. Based on these and other studies, this research paper purposes to conduct a study that seeks to answer the PICOT based question that states-

How does emergency department wait time greater than two hours compared to those less than two hours affects the rate of LWBS (leave without being seen) or patient satisfaction rate?’.

Conclusion

As a practice immersion exercise, the Quality and Sustainability paper comprises three parts the first of which addressed quality and safety by defining these two concepts and explaining how they are linked nursing science. Part one also offered a contemporary modern example of how quality and patient safety are applied in nursing science and concluded with identifying the quality of  wait time in the ED as the key component that can be improved upon in order to reduce the rate of LWBS and patient satisfaction.

References

Allen‐Duck, Angela, Jennifer C. Robinson, and Mary W. Stewart. “Healthcare quality: A concept analysis.” In Nursing forum, vol. 52, no. 4, pp. 377-386. 2017.

Broccoli, M. C., Moresky, R., Dixon, J., Muya, I., Taubman, C., Wallis, L. A., & Hynes, E. J. C. (2018). Defining quality indicators for emergency care delivery: findings of an expert consensus process by emergency care practitioners in Africa. BMJ global health3(1), e000479.

Davenport, P. J., O’Conner, S. J., Szychowsky, J. M., Landry, A. Y., & Hernandez, R. (2017). The relationship between emergency department wait times and inpatient satisfaction. Health Marketing Quarterly, 34(2), 97-112

Liu, J., Masiello, I., Ponzer, S., & Farrokhnia, N. (2018). Can interprofessional teamwork reduce patient throughput times? A longitudinal single-centre study of three different triage processes at a Swedish emergency department. BMJ open8(4), e019744.

Manzanera, R., Moya, D., Guilabert, M., Plana, M., Gálvez, G., Ortner, J., & Mira, J. J. (2018). Quality Assurance and Patient Safety Measures: A Comparative Longitudinal Analysis. International journal of environmental research and public health15(8), 1568.

Mataloni, F., Colais, P., Galassi, C., Davoli, M., & Fusco, D. (2018). Patients who leave Emergency Department without being seen or during treatment in the Lazio Region (Central Italy): Determinants and short term outcomes. PloS one13(12).

McMains, V. (2016). Johns Hopkins study suggests medical errors are third-leading cause of death in US. Hub.

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