Nursing

UNDERSTANDING NURSING MANAGEMENT AND ORGANIZATIONS A just culture, in contrast, allows for reporting of errors without fear of undue retribution (Gorzeman, 2008). Khatri, Brown, & Hicks (2009) suggest that transitioning to a just culture does more than improve reporting mechanisms or initiate training programs. A just culture provides an environment in which employees can question […]

MANAGING AND IMPROVING QUALITY 81 asking what is expected in the form of a solution. The nurse manager should ensure that immedi- ate patient care and safety needs are met, collect all facts relevant to the incident, and if possible, comply with the patient or family member’s suggested resolution. Sometimes, a simple apology from a

UNDERSTANDING NURSING MANAGEMENT AND ORGANIZATIONS Root Cause Analysis Root cause analysis is a method to work backwards through an event to examine every action that led to the error or event that occurred; it is a complicated process. A simplified method to conduct an event analysis follows: ● Patient—what patient factors contributed to the event?

Reporting incidents involves the following steps: 1. Discovery. Nurses, physicians, patients, families, or any employee or volunteer may report actual or potential risk. 2. Notification. The risk manager receives the completed incident form within 24 hours after the incident. A telephone call may be made earlier to hasten follow-up in the event of a major

High-risk areas in health care fall into five general categories: ● Medication errors ● Complications from diagnostic or treatment procedures ● Falls ● Patient or family dissatisfaction with care ● Refusal of treatment or refusal to sign consent for treatment Nursing is involved in all areas, but the medical staff may be primarily responsible in

  MANAGING AND IMPROVING QUALITY 77 Risk Management Risk management is a component of quality management, but its purpose is to identify, analyze, and evaluate risks and then to develop a plan for reducing the frequency and severity of accidents and injuries. Risk management is a continuous daily program of detection, education, and intervention. A

The peer review process is appropriate in the following situations: ● An adverse patient outcome has occurred. ● A serious risk or injury to a patient occurred. ● A failure to rescue incident occurred (Fujita et al., 2009). A shared governance structure facilitates the peer review process, fostering peer-to-peer accountability (Fujita et al., 2009). Furthermore,

Improving the Quality of Care National Initiatives The National Quality Forum is a nonprofit organization that strives to improve the quality of health care by building consensus on performance goals and standards for measuring and report- ing them (National Quality Forum, 2011). Additionally, the Institute of Healthcare Improvement (IHI) offers programs to assist organizations in

The system has six themes: ● Customer (patient) focus ● Data driven ● Process emphasis ● Proactive management ● Boundaryless collaboration ● Aim for perfection; tolerate failure. The first three themes are similar to other quality management programs. The focus is on the object of the service; in nursing’s case, this is the patient. Data

Managing and Improving Quality 6 Key Terms Continuous quality improvement (CQI) Dashboards DMAIC Incident reports Indicator Just culture 1. Describe how total quality management, continuous quality management, Six Sigma, Lean Six Sigma, and DMAIC address quality. 2. Describe national efforts to improve the quality of health care. 3. Explain how evidence-based practice, electronic medical records,