Governance for Safety and Quality in Health Service Organisations
Dwyer, A.J., Becker, G., Hawkins, C., McKenzie, L., Wells, M., 2012. Engaging medical staff in clinical governance: introducing new technologies and clinical practice into public hospitals. Aust. Health Rev. 36, 43-48.
The authors evaluate effective and successful clinical governance process for introducing new technologies and clinical practice into Melbourne Health (MH), a major tertiary teaching hospital. The researchers use data collected through feedback from committee members, surveys of medical staff and head of units. The findings, while limited, demonstrate an effective and successful clinical governance process for introducing new technologies and clinical practice
…show more content…
The limitations of the article are: first, that the interpreted results of the data are incomplete at the time of evaluation. Second, new technologies are originating from procedural and surgical specialties but they only have minority of the surgical head of units responded to the survey.
Johnson, M., Tran, D., Thuy, Young, H., 2011. Developing risk management behaviours for nurses through medication incident analysis. International Journal of Nursing Practice 17, 548-555. doi:10.1111/j.1440-172X.2011.01977.x
In this article Johnson et al. analysed the medication incidents to identify risk management behaviours that might assist nurses to reduce medication errors. The authors used mixed methods design blending both quantitative and qualitative to analyse nursing related
…show more content…
Safety and quality of nurse independent prescribing: a national study of experiences of education, continuing professional development clinical governance. J Adv Nurs 70, 2506-2517, doi: 10.1111/jan.12392
In this article Smith et al. reviewed the legislation in England passed in 2006 that enabled nurses with independent prescribing qualifications to prescribe across a list of available medicines with the exception of some controlled drugs in the UK. It is claimed to be the first and largest study implementation of the important safety quality mechanism for non-medical prescribers in the wake of 2006 legislation changes. The authors use data gained through cross-sectional national survey questionnaires to determine if the educational preparations for nurse independent prescribers are sufficient and to find out current professional development, clinical governance and professional regulation approaches in place in NHS Trust in England. The respondents are nurse independent prescribers (NIP) and non-medical prescribing (NMP) leaders in England. Their research focuses on assessing the core competency of safe and effective role of nurse independent prescribers. The article is highly readable. There is a logical progression in explaining the rationale of the data collection and study design. The results are supported statistically and important findings were presented in a simple tabular form. This source is recent and includes many
It is the nurse’s and pharmacist’s job to be cautious and aware of every medication they are administering by using their critical thinking skills and applying what they know to every situation. Although it is important for these individuals to be able to advocate for their patients, it also imperative that prescribers be aware of the impact they have on their patients as their actions have a domino effect. In conclusion, it is not the responsibility of a single profession to maintain safety in medication administration. It is the responsibility of everyone involved in the patient’s care. Each person who takes steps to improve the process and promote the patient as the number one priority is doing their part in refining how the healthcare system views medication
In the UK, nurse prescribing was born out of the need to increase efficiency in the NHS by making best use of its resources. Nurse-led services are one means of improving healthcare provision and a string of legislative change has gradually broadened the scope of nurse prescribing in the UK. (Courtenay et al 2007).
The standard from the National Safety and Quality Health Service (2012) that I believe has the highest risk associated for a graduate nurse is Standard 4 Medication Safety (Bain). If best practice outlined in this standard is not abided by, then medication errors occur and may lead to poor outcomes for patients. These outcomes include longer hospitalisations, increased costs and death (Cheragi et al., 2014).
The focus on prescribing within nursing profession was first brought into discussion by Royal College of Nursing (RCN) in 1980 but has proven to be cornerstone after was part of the government agenda as a result of Cumberlege report in 1996.This report outlined the need for
Nurse prescribing was first recommended, by the RCN, in 1980 and became part of the government’s policy agenda in 1986 with the Cumberlege Report (DH 1986). Further, the Crown Report (DH 1989) advocated prescribing by trained community nurses from a limited formulary. Legislation was introduced in 1992 -The Medicinal Products: Prescription By Nurses Act, 1992 followed by secondary legislation,
Prescribing Practices by Nurse Practitioners and Primary Care Physicians: A Descriptive Analysis of Medicare Beneficiaries. Journal of Nursing Regulation, 8(1):21. ISSN: 21558256 Sabatino, J. A., Pruchnicki, M. C., Sevin, A. M., Barker, E., Green, C. G., & Porter, K. (2017). Improving prescribing practices: A pharmacist-led educational intervention for nurse practitioner students. Journal of the American Association of Nurse Practitioners.
For nurses extending their role to include prescribing there is much to consider. Revelay (1999) states that, accountability involves an individual giving an account of their actions with the rationale and explanation given for these actions. The decisions regarding boundaries of practice are firmly placed in the hands of the individual practitioner (Carlisle 1992). Accountability means being able to justify any actions and accepting responsibility for them, and is an integral part of nursing practice (Rowe 2000) The NMC Code of Professional Conduct (2004) states that a nurse is personally accountable for her practice, has a duty of care to patients and must work within the laws of the country.
Nurses are at the center of the health care industry, and are in a sole position of power. The academic area of my life involves being a pre-nursing student. In this discourse community we share collective goals such as studying, earning excellent grades, achievement into nursing school, and eventually becoming a nurse. Nurses are very important to society; their remarkable discourse community stands out in the health community. Their work provides trustworthiness to the provided of drugs and information given from doctors. Healthcare will always be needed, and with healthcare we need people who are well train in their field to be on top of their game and be knowledgeable about the healthcare. We might not always trust that our doctor knows what they are prescribing us but we can trust that our nurses have the knowledge of what they distribute. There are general fallacies among the field of nursing and several things to think about before following the path of a
This article will look at two articles and focus on aspects of safety medication administration in nursing practice by the staff nurses. This is interesting area because the previous report on the medication administration error in the UK shows that approximately 5.6% of doses administered to adult hospital patients and it has been estimated that 0.6-1.2% of medication administration errors may lead to severe harm even death (Mcleod et al, 2013). Leape et al (1995) indicated that nurses were responsible for 86% of all medication error interception, regardless of the original errors. The nurses play the important role in identifying the causes of medication errors and preventing medication administration errors in nursing practice in order to provide safe care toward the service users (Henneman et al, 2010). The Medicines and Healthcare Products Regulatory Agency (MHRA 2004) documented that the health professionals need to effectively and safely use medicines to ensure patients get the maximum benefit from the medicine; meanwhile minimizing the potential harm. This article will be critiqued on the different types of evidence which explored safety medication administration in the nursing practice toward service user. Using evidence is important in nursing practice because it can help nurses in addressing questions related to best possible care and improve patients’ outcome. It is embedded within the code the nurses are expected to use best possible evidence in the nursing
As a leader in the workplace, medication errors mostly occur when the workplace is understaffed with a patient load of full nursing cares that require more attention and care than patients who are independent. Due to being understaffed with a patient load of 13 to 2 nurses, medication errors occur more often as nurses are being rushed to finish all cares within their work timeframe. To decrease medication errors it is important to implement more staff during medication rounds, thus giving nurses additional time to concentrate and assure that the correct medication and dose is being given to the right patient ( ). The 6 medication rights are important to implement into every workplace as it decreases the chances of administrating medication to the wrong patients ( ). The medication right include; ______________________________________________________________ ( ). Medication errors have important implications for patient safety and in improving clinical practice errors to prevent any adverse events (
Each year, roughly 1.5 million adverse drug events (ADEs) occur in acute and long-term care settings across America (Institute of Medicine [IOM], 2006). An ADE is succinctly defined as actual or potential patient harm resulting from a medication error. To expound further, while ADEs may result from oversights related to prescribing or dispensing, 26-32% of all erroneous drug interventions occur during the nursing administration and monitoring phases (Anderson & Townsend, 2010). These mollifiable mishaps not only create a formidable financial burden for health care systems, they also carry the potential of imposing irreversible physiological impairment to patients and their families. In an effort to ameliorate cost inflation, undue detriment, and the potential for litigation, a multifactorial approach must be taken to improve patient outcomes. Key components in allaying drug-related errors from a nursing perspective include: implementing safety and quality measures, understanding the roles and responsibilities of the nurse, embracing technological safeguards, incorporating interdisciplinary collaborative efforts, and continued emphasis upon quality control.
In today’s current fast-paced and demanding field of heath care, medication administration has become complex and time-consuming task. Approximately one-third of the nurses’ time is used in medication administration. There is much potential for error because of the complexity of the medication administration process. Since nurses are the last ones to actually administer the medication to the patient therefore they become responsible for medication administration errors (MAE). Reasons for MAE may include individual factors, organizational factors or system factors. This paper will discuss the root causes analysis of MAE and strategies to prevent them.
The administration of medication can be associated with a significant risk with it is recognized as a central feature of the nursing role. It should continue in order to avoid a possible medical malpractice continuous care. Nursing staff have a unique role usually given to patients to manage their medication and responsibilities, then they can report these identified medication errors. Some of the most distinguishable events can be related to errors in professional practice, prescribing, dispensing, distribution, and education or monitoring. Since medication errors can arise at any state of the administration process, it is essential for nursing staff to be attentive of the most commonly encountered errors. For the most part, the common of the perceptible aspects related with medication errors are due to minimal awareness about hospital policies, inappropriate implementation or latent conditions (Farinde, n.d).
Nurses are responsible for multiple patients on any given day making medication errors a potential problem in the nursing field. Medication administration not only encompasses passing medication to the patients yet begins with the physician prescribing the medication, pharmacy filling the correct prescription and ending with the nurse administering and monitoring the patient for any adverse effect from the medication. According to the National Coordinating Council for Medication Error Reporting and Prevention (NCCMERP), ‘A medication error refers to any preventable event that may cause or lead to inappropriate medication use or patient harm while the medication is in the control of the healthcare professional,
As clinical site co-ordinator with many years of clinical experience I feel competent in the drug administration via a variety of routes. Generally the patients I attend have become acutely unwell with most prescriptions not having the third eye of a pharmacist and most drugs being delivered intravenously. It is imperative therefore that the prescription and drugs always be thoroughly checked which relies on good communication throughout. Furthermore, most emergency drugs have a protocol for administration developed by the hospital. However within this situation the nurse is generally the last defence before any medication error actually occurs, therefore it is the nurses responsibility to ensure the prescription is correct and to challenge prescription written