Nursing Safety Assessment

“Contratheraputic is when an individual experience unintentional or unanticipated adverse effects while the individual is on a drug regimen that is not closely monitored by a doctor” (Understanding and Managing Polypharmacy in Elderly, 2004). Screening elderly for polypharmacy is crucial because adverse side effects of some medications can imitate other problems such as confusion, incontinence, urinary retention, and falls which may cause a physician to prescribe another medication to help treat those symptoms. The Beers criteria is a list of drugs that may be inappropriate for elderly patients as the risks outweigh the benefits, an example is the use of urinary anticholinergic which could prevent one episode of incontinence every 48 hours but can cause constipation, dry mouth, dry eyes, impaired cognition and increased risk of

The purpose of this paper is to discuss how safety in the nursing profession affects the nursing education, nursing practice, and nursing research. Safety in the nursing profession means to minimize the risk of harm to patients and providers through both system effectiveness and individual performances (QSEN, 2014). Patient safety is a very important aspect in the profession of nursing. It is the nurse’s job to keep up to date with their patients and to make sure that protocol is being followed at all times. To maintain this strategy, the nurse must show proper knowledge of a nurse, skills of a nurse, and also a professional attitude.

Mandating safe staffing levels for registered nurses in acute care settings has been an important topic of discussion for many years. As the demand for registered nurses continues to rise, so does the clinical demands on the nurses currently working. If there are no specific policies in place that mandate safe and appropriate nurse-to-patient ratios for all acute care facilities, registered nurses (RNs) may be required to take on even more patients than the already high numbers currently given to many of them. Inadequate RN staffing has the potential to cause increases in adverse patient events (American Nurses Association (ANA), The registered nurse safe staffing act, 2015) as well as an increase in nurse injury (Musick, Trotto, & Morrison,

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.

Pamela F. Cipriano, President of American Nurses Association was in disbelief to see how she has tried to enforce the Nightingale pledge of keeping patients free from harm was failed because medical errors are the third leading cause of death in the United States. As of now ANA has conducted yearlong campaign named “Safety 360 It Starts with You” in order to reduce and take measurable advances to protect the welfare of nurses and workers. It is one of campaign that the ANA comes with that is in support to both the nurses and patients. However, in the real-world nurses are stress and fatigue due to patient ratio. In my workplace, which is a state hospital, they have full time nurses on call where nurses work more than 70 hours a week. The nurses

3) advocates autonomy and independence of the residents. According to the guideline states that medication review is an evidence-based intervention and this review should be performed regularly (ACSQHC 2009, p. 72). A meta-analysis was conducted in aged care facilities and the relationship polypharmacy and falls, and fall injuries were found out. Residents taking cardiovascular medications, including diuretics, antiarrhythmics, digoxin, have higher fall risks. But, by reviewing their medication, the risks of fall were reduced up to 66% (Baranzini et al. 2009, p. 228). A randomise controlled trial was conducted targeting residents in aged care facilities, and a comparison between medication-reviewed population and non-reviewed population performed. The effectiveness of medication review was statistically confirmed that reviewed population showed 38% lower number of falls than the non-reviewed population (Zermansky et al. 2006, p. 589). Therefore, in aged care facilities, falls are obviously a big problem and often harm the residents. Medication is a major factor for falls because the vast majority of residents are taking multiple medications. However, reviewing their medications, fall risks are significantly reduced. As a nurse, careful observation for the residents and frequent collaboration with pharmacists or doctors should be performed to ensure the residents

In the article published by Sirkin and Rosner (2009), it was reported that 70% of individuals above the ages of 65 years have hypertension and approximately a third of them fall every year. It was found that hypertension and fall are common in elderly and coexist in most of the cases. It has been thought that the medication that the hypertensive elderly use put them at risks fall. For instance, it has been found that psychotropic agents, antidepressants, hypnotics, anticholinergic and anxiolytics cause falls in many patients. These drugs have been reported to have serious neurological and autonomic effects among the vulnerable individuals (Sirkin & Rosner, 2009). Due to the high correlation between falls and medication, organizations are encouraged to have pharmacy staff provide an ongoing review of patient medication regimens. Through the active participation of nurses, vulnerable patients should be identified and managed according to the required plan.

Four articles were chosen with the first article being: Psychotropic medications, including short acting benzodiazepines; strongly increase the frequency of falls in elderly, written by Atrid Strien, Huiberdina Koek, Rob van Marum, and Marielle Emmelot-Vonk. The

The Nurses of the Future Nursing Core Competency model is composed of ten competencies. Some of these competencies include patient centered care, collaboration, and teamwork. One particular is safety, which I believe to be one of the most important of the competencies. Safety is minimizing the risk of harm to patients and healthcare providers. This is important to nursing because insuring the safety of a patient is a number one priority, without safety is the care of a patient successful? Nurses are the first line of defense when it comes to safety towards patients and providers. In order to ensure safety there must be a plan of action and then set the plan in motion in order to avoid unsafe outcomes.

While there is a learning curve associated with moving from paper charting to on line documentation of nursing care, there are a few measures that can decrease the amount of time spent in front of the computer. In order to avoid time spent frequently logging into the system there are security features that can be used such as finger print technology and employee badge swipe technology. Instead of writing notes on paper and then recording in the computer nurses are encouraged to complete documentation at the patient bedside at the time of patient care

Risk management and legal concerns play a major role in how nurses interact with their patients and go about their day to day work tasks. Patient safety has become one of the primary focuses in healthcare organizations around the world. “As a result of seminal reports such as To Err is Human, The Quality in Australian Healthcare Study and An Organization with a Memory, the international healthcare management agenda is currently concerned with reducing the risks to which patients are exposed in care settings” (Kirwan & Matthews, 2012).

Casarett, D., Spence, C., Clark, M. A., Shield, R., & Teno, J. M. (2012). Defining patient

Today’s healthcare is changing, and more hospitals are commencing to go paperless using computers for both medical records and charting. Computers are widely accepted, in personal and professional settings. It is an essential requirement for computer literacy. Numerous advances in technology during the past decade require that nurses not only be knowledgeable in nursing skills but also to become educated in computer technology. While electronic medical records (EMR’s) and charting can be an effective time management tool, some questions have been asked on how exactly this will impact the role and process of nursing, and the ultimate effects on patient safety and confidentiality. In order to

Purpose: It has been well established that use of Antipsychotics (APs) and Benzodiazepines (BZDs) in the elderly population is associated with increased incidence of adverse effects including sedation, falls, and cognitive impairment. The Veterans Health Administration (VHA) introduced the Psychotropic Drug Safety Initiative (PDSI) to improve evidence-based psychotropic drug prescribing for Veterans with mental illness. This initiative aims to address possible issues with pharmacotherapy such as overprescribing, clinical management, and inappropriate indications.1 The purpose of this project is to assess the impact of recommendations made by a pharmacist on the utilization of APs and BZDs in patients with dementia.

Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role. Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature