The Use Of Simulation For A Safe Environment For The Patient And A Healthy Work Environment

The first consideration a registered nurse should determine is if “The Right Task (Cherry 355-356)” is being delegated to the right staff member. Delegation to the right staff member must be in their scope of practice and have proven to competent to complete. An individuals’ scope of practice will be set forth by the facility in which they work. In addition to individual facility polices the nurse must adhere to the scope of delegation set forth in the Nurse Practice Act of Maryland. Per the Nurse Practice Act of Maryland the task to be delegated must be “within the area of responsibility of the nurse delegating the act (Code of Maryland Regulations 10.27.11.03).” An example of incorrect delegating would be having an unlicensed individual, CNA or LPN to

Inadequate nurse staffing is commonly cited as a factor in unanticipated hospital events (ANA, 2015), whereas higher staffing levels are related to lower rates of negative patient outcomes (Registered Nurse Safe Staffing Act [RNSSA] of 2015, 2015; MN study links nurse staffing to patient outcomes, 2015). For example, inappropriate nurse staffing can result in increased infections such as pneumonia, shock, cardiac arrest, and urinary tract infections (Stanton, 2004), longer hospital stays, medication errors, falls, injuries, and death (ANA, 2015; Stanton, 2004).

It is no secret that communication is key when providing direct patient care in a skilled nursing facility. However, there is a noticeable lapse in the communication between the care team when providing care to the individual or groups of individuals. Two main parts of any care team are the registered nurse and the certified nursing assistant, as these are the two people whom have the most direct and impactful roles with residents in a skilled facility. The Registered Nurse and the Certified Nursing Assistant play similar roles in providing patient care, but have different roles in its entirety. The role of the Registered Nurse (RN) is defined as having the competency and skill to provide direct and indirect health care to individuals, their families, and communities around them. Services are also provided designed to give out medications, to promote comfort or healing, promote healing, and to also provide the dignity of their patients and patient’s families (American College of Rheumatology, 2015).

Nurses play many roles in the healthcare field, can have many duties to fulfill under their licensure. It is important for a nurse of any degree, or licenses to know all of the duties that can be performed under their scope of practice. Olin (2012) states, “Scopes of practice are the same for every nurse at a basic level and very different by specialty.” Therefore, it is important to understand the scope of practice, that the nurse is licensed for. A nurse has many roles under the scope of practice that the nurse is licensed under. There are times when a nurse is asked to perform a task that isn’t under the nurse’s scope of practice and guidelines, and it is very important not to fulfill the task at hand if it

healthcare organization accrediting bodies, and to maintain credibility with patients and peers alike, must adhere to the National Patient Safety Goals. As stated by Ulrich and Kear (2014), "Not only are nurses responsible for providing safe patient care, we are also responsible for creating an environment in which others can provide safe patient care, and for being the last line of defense when needed between the patient and potential harm. Having a deep understanding of patient safety and patient safety culture allows nurses to be the leaders we need to be in ensuring that our patients are always

When nurses are held to a professional standard, staffing becomes safer and more efficient. The professional standard created by the American Nurses Association Code of Ethics (ANACEN) for Nurses is commonly used. The standard is made up of nine points that ensure patients will receive the highest quality of care. The purpose of the standard is to determine whether nurses have the assets, abilities, responsibility, and expertise to make judgments concerning professional practice and optimum care for patients and families (Clevenger, et al. 2005). The goal of safe staffing is to provide optimal care for patients and the patients’ families, so facilities should invest in nurses with a high degree of professionalism who can

Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.

Managers must always maintain an open door policy for staff, with no fear of reprisal, when voicing any concern. Patient safety should always be the top priority. When dealing with an impaired nurse, the first step in “the nurse manager’s role in the process is removing the nurse from patient care is essential, which will assist the nurse in focusing on the care and treatment of the disorder and the sooner patients are protected” ("A Nurse Manager’s Guide," 2014). In addition, the nurse manager should occasionally review and become familiar with any facility policies or procedures on this topic and ensure that confidentiality is always

Nurses’ are to ensure patient safety in all aspects of care provided. Sometimes, this is found outside of what is considered “actual” care, such as a physical assessments and administration of medications. Every day nurses’ are given assignments to follow, which includes which patients to take care of. What happens when this assignment is unsafe for all involved? Administrative Codes have been established by each state Board of Nursing to guide nurses’ in different situations. Safe Harbor Peer Review assists nurses to know how to handle an unsafe assignment.

With over 1 years experience working in various wards throughout St Vincent’s Hospital as well as my placements throughout my diploma studies, I have gained a high level of knowledge of various elements of safety, effectiveness, and efficiency in nursing processes. I have been responsible for delivering a high quality of patient care, by completing tasks included but not limited to the following:

The first case scenario presented in this project reflect the significance of gaps between nursing programs and textbooks, organizations’ policies and procedures, published literature, and the actual practice. Some of the gaps refer to nursing programs and textbooks based on an ideal nursing profession, the autonomy of healthcare organizations to establish their specific policies and procedures, traditional policies and procedures unsupported by evidence-based practice (EBP), and the individual and organizational barriers that influence the breach between the published literature and the real-world. Literature review was used to demonstrate the negative personal and professional consequences triggered from these gaps when the nurse is employed in the healthcare system. In addition, the paper suggests how improving a “Culture of Safety”, preventing an unsafe environment, and promoting Continuous Quality Improvement activities enhance the overall health care quality and safety. The second case scenario provides guidelines to the ethical dilemma of the impaired nurse, signs and symptoms of impairment, ethical and legal obligations, common reasons for not reporting, and failing to report consequences.

It allows the scenario to be flexible and present different outcomes. It is a safe space for students to experience mistakes without a patient being harmed. “Simulations can introduce students to the process of being able to perceive characteristics and aspects of patient care situations that may alter the manner in which nursing care is provided” (Bambini, Washburn, & Perkins, 2009). These simulations are great additions to theory, as they put an action with a lesson.

Throughout this course, I received exposure to valuable lessons that I can use in my clinical practice of patient care. One experience generated the greatest impact in my ability to provide safe, high-quality patient care – lab simulation. Lab simulation stands as a technique that “allows the educator to control the learning environment through scheduling of practice, providing feedback, and minimizing or introducing environmental distractions” (Durham & Alden, 2008, p. 222). Simulation is a technique used to prepare students for real experiences in clinical practice; simulation stands as an opportunity for students to provide nursing care in a simulated, safe environment. From personal experience, I can claim that lab simulation positively impacted me in various mannerisms – increased my confidence, assisted in my stress management skills, improved my care management of a patient, transferred my skills learned in the simulation to the clinical setting, improved my communication skills, and enhanced my critical thinking abilities.

What is key here is that the nurse is able to embrace their role as a leader, regardless of the setting. Yes doctors are the ones who right the orders, but the nurses are the ones who implement said orders and spend a great deal of their time with patient interaction. Understanding this is what allows the nurse to create and maintain a safe and appropriate environment for patient care.

Nursing students have a lot to learn about the nursing profession but one of the more complex nursing functions for them to comprehend is that of delegation. Delegation is the act of assigning other competent staff members a specific task. Although this may sound easy to do it requires enhanced clinical judgment and accountability for patient care. Since nurses possess specific skills and competence in performing their role they must delegate tasks appropriately. To delegate properly one must understand one’s state nurse practice act which outlines nursing’s legal responsibility, authority, and accountability for patient care. While each state’s nurse practice act may vary they, all include the duty to do no harm and therefore all nurses