Why Is Safe Quality Care Important

Essay Question 5 Define and describe the importance of “safe and quality care” by using/incorporating one of the models described in the Amer book.
Safe care is the first and foremost step in providing quality health care. However, safety alone does not ensure high quality nursing care. Risks and threats to safe quality care are abundant in the hospital setting. From overworked and under staffed nurses to ineffective communication, error causing factors makes safe quality care hard to come by and patient care is often compromised. In this essay I will be discussing safe quality care and Transforming care at the bedside (TCAB) project. TCAB is a model of change that supports nurse-driven solutions designed to develop quality nursing care that includes efficient use of time, evidence-based practice, and multiple strategies to improve processes in health care. TCAB empowers nurses to address threats to quality and safe care by using rapid cycle change to improve care.
Safe Quality Care
Safe quality health care is assumed to be the goal of all health care providers including nurses. Safety is the minimum standard required for care and is clearly defined as little or no risk for harm. Quality on the other hand is much more loosely defined. According to Amer “Quality and Safety for Transformational Nursing”, quality of care is defined as a measure of the ability of a provider for individuals and populations that increase the likelihood of desired health outcomes and are consistent with current professional knowledge.
The quality of health care can best be carried out by doing the right thing, at the right time, in the right way, for the right person, and getting the best possible results. Quality care should be safe, effective, patient-centered, timely, efficient and equitable (Amer 2013). Although ideal, being perfect all of the time is impossible and human error is inevitable. The Institute for Healthcare Improvement estimated in 2007 that every day there are 40,000 incidents of medical errors. The IHI also stated that at least 1.5 million medication errors occur each year in the United States that were preventable. That translates to an average of at least one medication error per day per patient (IHI 2007). Other preventable occurrences could be infections cause by hospital exposure to pathogens and negligent safety practices that cause falls. Some factors that could lead to healthcare workers to make mistakes include understaffing, long hours, no breaks, ineffective communication, physicians illegible hand writing, failure to check the 5 rights of medication administration (the right patient, drug, dose, route, and time), distractions, and many more. Reviewing adverse events can help identify factors that contribute to the high number of preventable occurrences and a clear delineation of strategies that identify and minimize risks of adverse events must occur.
Transforming Care at the Bedside
Transforming Care at the Bedside (TCAB), a five year project, began in 2003 when Robert Wood Johnson Foundation (RWJF) and the Institute for Health Care Improvement (IHI) affiliated to create models of change that begin at the bedside with direct nursing care to transform work processes, quality of care, and staff satisfaction on medical-surgical units. Between 2003 and 2008, 10 hospitals throughout the USA participated in this nationwide project (Dearmon, Roussel, Buckner, Mulekar, Pomrenke, Salas, Mosley, Brown, & Brown 2013, American Organization of Nurse Executives and the Robert Wood Johnson Foundation 2008). The project focused on medical-surgical units because of the incidence of adverse events are highest in that area. Threats to quality and safe care that were addressed in TCAB included harm from falls, high staff turnover rates, high levels of nonnursing activity, ineffective communication between nurses and teams, medication administration adverse events, and code with poor outcomes. Over the time of the project a comprehensive model to address these risks were developed. TCAB identified a framework for change in patient care environments in 4 main categories: Safety and reliability, care team vitality, patient centeredness, and increased value. An example of one of the innovations to reduce adverse events such as wrong surgery site is preforming a time-out prior to surgery to review patient name, data, and surgical procedure. The common aims were to create early detection and response teams, such as rapid response teams, prevent adverse drug events and falls, and build an environment that lessens the risk of adverse events. These types of innovations were tested for a short time and evaluated, then either adopted or dropped. TCAB proved that simple changes such as interprofessional rounds and collaboration can drastically decrease adverse events (Amer 2013, American Organization of Nurse Executives and the Robert Wood Johnson Foundation 2008)
Conclusion.
Patient care can be improved when frontline nurses identify problems and implement incremental system solutions focused on safety. Nurses need the knowledge and tools to begin to affect change in their environments. Such changes can increase the efficiency of nursing care, help nurses spend more time with patients, and create safer environments. Implementations of care models such as TCAB can have a dramatic impact on safety and quality
care.
References
Amer, K. (2013). Quality and safety for transformational nursing: Core competencies. Boston: Pearson.
American Organization of Nurse Executives and the Robert Wood Johnson Foundation (2008) Partnering to disseminate transforming care at the bedside.
Dearmon, V., Roussel, L., Buckner, E. B., Mulekar, M., Pomrenke, B., Salas, S., Mosley, A., Brown, S., & Brown, A. (2013). Transforming care at the bedside (TCAB): enhancing direct care and value-added care. Journal of Nursing Management, 21(4), 668-678
Institute for Healthcare Improvement (IHI). (2007).Protecting 5 million lives from harm. Cambridge, MA.