Improving Patient Safety Using The Sterile Cockpit Principle During Medication Administration

Patient safety is number one in hospitals. Every staff member that comes into contact with a patient should always have the question, “Will the patient be safe?” in the back of

Mulloy, D. F., & Hughes, R. G. (2008). Patient safety & quality: an evidence-based handbook for nurses. Rockville, MD: Agency for Healthcare Research and Quality. Retrieved from http://www.nlm.nih.gov/books/NBK2678/

The reason Sterile Processing interests me is because it is a career that I stumbled upon in my early twenties and come to know and love. The lack of knowledge the public has when it comes to this department is troubling. It is a key department of every hospital and clinic as they are responsible for infection prevention; yet most people could not tell you who they are and what they do. There are many challenges these professionals see on a day to day basis and require a very intricate skill set. I am a Sterile Processing Manager, responsible for a 30 person team on implementing safe practices for reprocessing medical devices and instruments. I often at the interview process, come across applicants

Flames of evolution in patient care have been fanned into a wholesome revolution in the nature of nursing care due to the ever changing healthcare needs and demands of patients. This has led to a paradigm shift from generalized patient care to a patient centered approach. The increase in interaction and individualized patient management has improved healthcare delivery. However, on the flipside, this has not come with new challenges. Healthcare providers are increasingly being exposed to new health hazards as new and sophisticated treatment approaches are developed. Injuries due to sharps are of significance in nursing practice. The International Healthcare Workers Safety Center (2010) reports that an average of 27.97 per 100 licensed beds sharps injuries occurred in 2007 while in 2008 17.2 per 100 licensed beds sharps injuries were recorded. According to Centers for Disease Control and Prevention (2010), 385,000 healthcare workers are injured due to sharps annually in the United States. This puts the healthcare personnel at risk of contracting infections such as Hepatitis C and B from contaminated objects. In regard to this concept, this paper will explore sharps safety at the clinical site with a view of using evidence based practice to creating awareness on the need for sharps safety in hospital settings.

Significance: Because nursing is the largest health care profession and nurses provide most of the patient care, and as an acute nurse, I can relate to how unsafe nurse staffing/low nurse-to-patient ratios can have negative impact on patient satisfaction and outcome, can lead to medical and/or medication errors and nurse burnout. It can also bring about anxiety and frustration, which can also clouds the nurses’ critical thinking. Most patients might not know the work load on a particular nurse and can assume that her nurse is just not efficient. Doctors also can become very impatient with their nurses because orders are not being followed through that can delay treatments to their patients. There is also delays in attending to call lights resulting in very unhappy patients who needed help.

The Quality and Safety Education for Nurses (QSEN) Institute developed six core competencies: patient-centered care, teamwork and collaboration, evidence-based practice, quality improvement, safety, and informatics (Quality and Safety Education for Nurses Institute, 2017). At my facility, it is clearly evident that they have adopted these six core competencies to improve patient quality and safety. My facility created the Office of Patient Experience which supports care that is safe, of high quality and high value. Patient satisfaction is a top priority which is why our guiding principle is known as “Patients First”. Through teamwork and collaboration, we deliver care that is patient-centered by working together in multidisciplinary rounds on the inpatient units. Also, the nursing education department supports quality, safety and consistent nursing care through a database of policies and procedures developed using evidence-based research. Lastly, the nursing informatics department is working towards making our EPIC system more patient-centered. They are doing this by decreasing the redundancy in charting for the nursing staff and finding ways to improve processes which automate tasks. This in turn will reduce the time that the nursing staff spends with their computer and increase the time that the nursing staff can spend with their patients.

The use of simulation allows students to experience hypothetical clinical scenarios without threat of harm to patients. One of the objectives of running the simulation is to allow to experience and learn from various scenarios that they will likely encounter on the nursing floor and provide an opportunity to apply theory into practice. Prior to this simulation, we were introduced to several literature covering concepts on nursing responsibilities when floating, impaired nursing, diversion of medication, reasonable suspicion, and the AACN standards for establishing and sustaining healthy work environments. Such concepts help the nurse to practice her profession safely and transform into a leader that can initiate and influence change towards the success of an organization.

In the classroom, it is very important to have lab safety. In a hospital pharmacy, lab safety is essential to ensuring a safe dosage to each patient. Throughout my time interning as a pharmacist at the UVM Medical center, I was often observing how much pharmacists used DoseEdge software. DoseEdge automated system that assists the process of dose routing and preparation. This product of Baxter has allowed the tasks of pharmacy change. The focus of my project was “How does current and future technology affect efficiency and accuracy in pharmacy practice?”. Through my research of Baxter’s website, articles about their product, and reports of advancing technologies in pharmacy, I found that DoseEdge is very successful in productivity and safety in the workplace. Before DoseEdge, everything was required to be prepared by hand. This required a lot of responsibility for for pharmacists and technicians to make the correct dosage in the quickest manner. Medicine is very important to a hospital, so it is very important to have the most efficient way in preparing and distributing it. This allows pharmacist to have a better way of double-checking the preparation of drugs. In each IV hood, there is an overhead camera that takes pictures of what drug and how much of it the technician is using. Pharmacist can view multiple orders all by computer without the need of being physically next to the technician. There are also requirements to have two pharmacists check the same order for high risk drugs like chemotherapy. This

Breeding, et al. (2013) states that there are a number of published documents addressing the quality, safety, and explicitly medication safety within ICUs worldwide. A large proportion of these studies focused on specific interventions such as: (1) creating “No interruption zones”; (2) addressing drug incompatibilities; (3) implementing automatic drug dispensing systems or electronic prescription of medications; or (4) implementing an ICU pharmacist role (Breeding, et al., 2013, p. 59). It is essential for multidisciplinary teams to be formed for medication safety promotion within this population. These teams would include physicians, pharmacists, and nurses (to also include advanced practicing nurses [APRN], such as nurse practitioners [NPs] or clinical nurse specialists

The National Patient Safety Goals were created in response to the IOM article, To Err is Human: Building Safer Health Systems. These goals were written to address patient safety and are tailored depending on the health care setting to which they are written for. They address system wide solutions rather than focusing on whom or how the error was made. Medical errors have been noted as being the 8th leading cause of death in the U.S. with the most frequent of these errors being medication related (Johnson, K., Bryant, C., Jenkins, M., Hiteshew, C., & Sobol, K. 2010). Therefore a great focus on these goals is needed across the health care continuum. The goals are updated and amended on a regular basis using evidence-based research, in response to areas with high errors in patient safety.

The safety of medication administration has become a universal issue and crucial for one 's wellbeing. The majority of hospitalized patients are treated with medications (Agyemang & While, 2010). The medical treatment of patients has a direct effect on the patient 's quality of life. Srinivasan declared "patients have a right to know they are receiving safe care" (as cited by Zhani, 2012, p. 1). The purpose of this paper is to identify current quality and safety issues in healthcare, share the impact the issues have on health care delivery, identify quality improvement strategies, and to reveal a plan to implement quality improvement strategies.

Healthcare is a busy, fast paced environment. Nursing Managers have a difficult job of juggling staffing and patient acuity to assure safe and appropriate patient care without over or under staffing. Nurses providing direct patient care voice they are too busy to complete all the required tasks during their shift, such as documentation. However, there are tools available to help increase nurse productivity while providing safe, efficient patient care.

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

The broad research problem leading to this study is the belief that nursing shortage in facilities leads to patient safety issues. The review of available literature on this topic shows strong evidence that lower nurse staffing levels in hospitals are associated with worse patient outcomes. Some of these outcomes include very high patient to nurse ratio, fatigue for nurses leading to costly medical mistakes, social environment, nursing staff attrition from the most affected facilities. The study specifically attempts to find a way to understand how nurse

Since the perception of patient safety has arisen, many medical organizations were striving to improve medication safety. Emory Healthcare, the largest and most comprehensive health care system in Georgia, was one of them who were seeking ways to prevent medication errors. In recent years, some