Accreditation

                                       

     The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) sends shivers down the spine of health care workers and sends everyone running to lock med cabinets, cap IV lines, post all necessary signs, answer all questions with "Let me find that out for you" and cross all their T's and dot all their I's. But, wouldn't you rather be a patient at a hospital that was accredited by JCAHO?!

That's like going to a restaurant that is not approved by the Health Department. I was at a very popular Chinese restaurant in California years ago. When we were standing in line a huge cockroach came from the back and walked through the restaurant. Everyone just put their feet up on the table supports as a little old lady from the back came out with her rolled up newspaper and killed it. I can tell you that it didn't stop anyone from eating there.... including me and my friends!

                     

Things would be different for me now though! And, I certainly would not want to be a patient in a hospital that doesn't take safety and responsibility seriously.

The Joint Commission standards include topics such as cleanliness, medication safety, surgical safeguards, patient identifiers, quality improvement policies, infection control and medical response and alarms. Each one of these topics equates to patient safety and reduction in medical errors.

                                   

The math is simple, A (quality improvement) + B (Standards/Accreditation) = C (patient safety). Okay so this equation doesn't really have a positive outcome, but you get the idea.

I have spent the semester learning about how to provide the safest and best quality of care to my patients by striving to learn more on a regular basis, being knowledgeable about procedures and patient safe handling, and abiding by the rules and protocols set up for health care professionals. Accreditation puts a seal of approval on a hospital's activities to let the patient know that the hospital they are trusting with their care is doing all they can to provide the best care.

                                                    

It has been a great semester of learning and focusing on patient care as a trusted and important responsibility, not just another job. What a great opportunity we have as nurses to make a difference in the lives of others by taking our responsibilities seriously and always providing patient-centered care and focusing on the patient perspective. It has been so helpful to read through class material, especially case studies and be reminded of how important it is to stay alert on the job.

Thanks for a great semester!!! I can't believe I'm almost there!!!

                    

A Voice Heard...

                          

If you were given the wrong medication at the hospital.... wouldn't you want to know? If a mistake happened during your surgery... would you want to know why? If a doctor or nurse mishandled your procedure.... would you want to know what happened?

I would imagine that most people would answer "yes" to all of those questions. So let's ask these questions....

If you caused someone pain or made them sick ...  would you want the chance to apologize? If you made a mistake that affected someone else.... wouldn't you want to step forward, explain what happened, and apologize?

Again, I would think that most people would answer yes.

This week we learned about another aspect of Quality & Safety. We reviewed how medical errors affect those that were a participant in the error whether they were the patient or part of the healthcare team.

Through nursing school we have read many case studies about patients who experienced a healthcare error. We once participated in a scenario reenacting a lawsuit that took place against a nurse who made an error that cost a patient her life. My friend played the nurse on the stand. I felt so bad for the whole situation. I had so much sympathy for the patient and their family. What an incredible loss. I also felt sympathy for the nurse. She had dedicated her whole life to nursing. She was a really great nurse and person... but she made a mistake. People are hurt on both sides of the coin when an error in medicine takes place.

                      

We read and discussed a case study this week that involved an error in medication administration that almost cost a patient her life. When all was said and done, she just wanted answers but no one wanted to talk with her.
                     

There was one person who stood out and aside from the rest. He was the anesthesiologist that made the mistake. He felt the need to reach out to the patient and find healing for him and for her by apologizing and discussing the event. That connection was the beginning of healing and moving forward for the patient, anesthesiologist and for others like them.


                                

My take home from this lesson is threefold. I will strive diligently to provide safe and effective care for patients. I will always take responsibility for my actions. I will apologize and communicate with those that may have been wronged. Maybe one more.... I will remember that my patients are people that need to be listened to and heard.


One more week and then one more semester and it's OVER!!!! I will keep learning, I will keep reading. I will keep studying. I will keep improving!

                                 

Working Together.... Safely!

I loved the quote from the beginning of chapter 13 this week, it states:

"All health professionals should be educated to deliver patient-centered care as members of an interdisciplinary team, emphasizing evidence-based practice, quality improvement approaches, and informatics."

A vision for health professions education, articulated 

by the Institute of Medicine, 2003

Now don't you want the hospital you or your family will visit to abide by this precept.... I do!

Patients will receive excellent and safe care when everyone is working together and properly educated and up-to-date on best practice methods and procedures.

As we have been continuing to focus on quality improvement, this week's chapter covers educating health care workers on improving care where they work. I think new nurses or those who are continuing their education have an advantage in this area because we are in the process of learning more about our industry and how it can run more effectively and safely. It's not about going through the motions, it is about refining how the motions work in order to facilitate effective procedures and quality and safety in patient care. 

                              

The clinical microsystem involves the patient, family, care givers and other interdisciplinary team members. This is the core of patient care. This is where policies, procedures, safety measures and even hazards really matter. This is the target for improvement. 

                                                

We are taught from the very beginning in nursing school to look at our patients holistically. We can do the same with our job. Sometimes I walk away from work feeling like I am getting paid to be a drug pusher. I hate that feeling and that's the wrong perspective on the situation. On those particular days I can have up to six post surgical patients, most of which had their knees or hips replaced. They are in pain, they are hurting. 

                                         

I have had more success at work when I consult with more experienced nurses, the pharmacists and my supervisor in finding the best combination of pain control methods available to these patients. I have found that combining all our opinions, along with the patient's perspective, can effectively control pain, whether that be a certain combination and schedule of pain meds or other options like positional changes, ice therapy, and movement. It has recently been discovered that having patients walk sooner after hip and knee replacement surgeries can reduce pain substantially and aid in healing. Who would have thought that. But, by combining forces with several team members, this was found to be effective. 

I have and will continue to take what I have learned from this quality and safety class and apply it to my everyday experiences at work. We should always be moving in the forward and upward direction to do all we can to improve our skills, abilities and techniques in providing quality and best practice care for our patients!

                           

.....And just for fun ....

                                

This is how I felt on my first night solo when I received a new admit, my fifth patient, during the first hour on shift!