Posted: October 6th, 2023

NSG 3370 Role of the Nurse in Quality and Patient Safety Paper

NSG 3370 Assignment: The Role of the Nurse in Quality and Patient Safety Paper

Guidelines

The Role of the Nurse in Quality and Patient Safety Paper should focus on the utilization of Evidence-Based Practice to improve quality and safety of patients. It should be supported by the 2023 National Patient Safety Goals and literature. The paper should be objective, and not opinion based.
Choose one clinical problem from the list below that could use improvement. Describe the clinical problem and provide support from the literature. Do not write about personal experiences of you or personnel (coworkers, supervisors, etc.) in your practice or of ongoing project in your facility.

Bedside report issues

A literature search should be performed. Locate at least 3 articles of studies published in peer-reviewed, scholarly journals and published within the last 5 years. DO NOT use unpublished Master’s theses or unpublished doctoral dissertations, as these sources are not published in a journal but available from a repository. The published journal articles should be studies related to the topic, which should be used as resources to support the clinical problem, the National Patient Safety Goal and the Process Improvement Tool. Use the journal articles to write and give support to the paper. A chapter from text may also be used as an additional resource to support the information but IS NOT included in the review of the literature. However, the specific chapter author must be cited and referenced according to APA guidelines.
Choose a specific 2023 National Patient Safety Goal that applies to the clinical problem. Identify the specific NPSG by number as given by the Joint Commission (see document below). Describe and relate how the specific NPSG applies to the clinical problem.
Choose a Process Improvement Tool listed below that would be appropriate for implementation. Describe the tool, and how the tool could/should be implemented. You will find more information on each Tool in Chapter 22.
flowcharts
Pareto chart
cause and effect diagrams
run charts

Follow APA 7th Edition Guidelines for formatting.

Parts of the Paper

The Introduction is the first section of the paper and starts on the first page after the title page. Describe the purpose of the paper. Describe the chosen clinical problem and cite supporting information about the clinical problem in general terms.
Describe the Clinical Problem seen in clinical nursing practice that you chose for the list. Explain the deficits, lack of quality or risk to patient safety related to the clinical problem. Use references to support the problem. Cite descriptions and supporting information. Do not write about personal experiences as described previously.
Relate/link the problem to a 2023 National Patient Safety Goal . Describe the specific NPSG with number and relate the goal to the clinical problem. Cite the sources and supporting evidence.
Propose a recommended Process Improvement Tool . Choose 1 of the tools listed below and describe/discuss with rationale for using the tool.
flowcharts
Pareto chart
cause and effect diagrams
run charts
Use Chapter 22 in Cherry and Jacob 7th edition textbook to assist in choosing an appropriate tool. Modify the chosen tool to apply to the clinical problem. Describe the tool and cite the tool and supporting evidence. Describe how the tool can be applied to the clinical problem and meet the chosen NPSG to improve patient safety and quality of care.
Write a Review of Literature for supporting evidence for the problem, NPSG, and tool. This review should include at least three (3) current scholarly EBP articles published within the last 5 years (at least one should be primary research, i.e. a study; more is preferable) from peer-reviewed journals. DO NOT use a Master’s theses or doctoral dissertation found in a repository. See the previous information under #3. An organization (The Joint Commision, CDC, etc.) may not be included in the review but can be used in citations for support. Provide a brief summary of information (at least 2 paragraphs) about the each of the 3 chosen scholarly sources chosen for the review of literature and that would provide EBP evidence for the solution to this problem or need for change. Use the APA manual and the document “Writing a Literature Review” to assist you. Cite the information throughout the review.
The Conclusion for the paper follows the literature review. Summarize the topic and give recommendations for the problem and for implementation of the tool and accomplishment of the appropriate NPSG. Cite the information to support the information.
The Reference page should be a separate page and should contain all references used within the paper. Format the references correctly – see the APA manual.
Submit the paper through the link in the Module in Canvas The link in the Module is already linked to Turnitin. Do not go to turnitin.com as the paper will not appear as a submission in Canvas and the gradebook for the course and cannot be graded. Turnitin is an anti-plagiarism site and will show similarities and whether the paper contains information taken directly from published sources.

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The Role of the Nurse in Quality and Patient Safety: Addressing Issues with Bedside Reporting
Bedside reporting serves important functions for patient care including engaging patients, verifying information accuracy, and planning care (Maxson, Derby, Wrobleski, & Foss, 2012). However, barriers such as time constraints and ineffective communication skills can undermine benefits (Friesen et al., 2013). When suboptimal, care fragmentation and safety lapses may occur (Street et al., 2015). The purpose of this paper is to examine bedside reporting issues through an evidence-based lens, relate the problem to quality and safety goals, and propose an improvement tool.
Research shows bedside reporting positively impacts patient understanding, recall of care plans, and nurse relationships (Street et al., 2015). However, barriers inhibit benefits (Friesen et al., 2013). Specifically, time constraints due to high patient volumes hinder bedside reporting (Street et al., 2015). Additionally, lack of standardized practices and distractions in clinical environments undermine information exchange and patient involvement (Maxson et al., 2012; Friesen et al., 2013).
This issue relates to National Patient Safety Goal 02.02.01 which states improving communication effectiveness among caregivers (The Joint Commission [TJC], 2023). Ineffective bedside reporting fails to properly communicate patient information between nurses, negatively impacting continuity of care.
A cause and effect diagram would help identify root causes impacting bedside reporting quality (Kumar & Antonenko, 2014). This tool categorizes causal factors to systematically address high-impact change ideas. For example, solutions targeting lack of standardized practices through nurse training or protected time allotments for bedside reporting may strengthen effectiveness.
A study evaluating a bedside reporting program showed improvements in information exchange, patient involvement, and continuity (Maxson et al., 2012). Focus groups identified inconsistent practices and distractions as barriers (Friesen et al., 2013). Interviews found time constraints hindered bedside reporting (Street et al., 2015).
In conclusion, addressing bedside reporting issues requires a multifactorial improvement approach guided by evidence. A cause and effect diagram could help identify root causes to develop targeted solutions strengthening communication and patient safety.
Friesen, M. A., Herbst, A., Turner, J. W., Speroni, K. G., & Robinson, J. (2013). Developing a patient-centered ISBARR handoff tool. Journal of Nursing Care Quality, 28(3), 206–212. https://doi.org/10.1097/NCQ.0b013e31828b8a0f
Kumar, S., & Antonenko, P. (2014). Connecting practice, theory and method: Supporting professional doctoral students in developing conceptual frameworks nursing assignment answers. TechTrends, 58(4), 54–61. https://doi.org/10.1007/s11528-014-0771-y
Maxson, P. M., Derby, K. M., Wrobleski, D. M., & Foss, D. M. (2012). Bedside nurse-to-nurse handoff promotes patient safety. Medsurg Nursing , 21(3), 140–145.
Street, M., Eustace, P., Livingston, P. M., Craike, M. J., & Kent, B. (2015). Communication at the bedside to enhance patient care: A survey of nurses’ experience and perspective of handover. International Journal of Nursing Practice, 21(2), 166–177. https://doi.org/10.1111/ijn.12271
The Joint Commission. (2023). National patient safety goals. https://www.jointcommission.org/standards/national-patient-safety-goals/hospital-national-patient-safety-goals/

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Study Notes.

The Role of the Nurse in Quality and Patient Safety in the USA

Nurses are essential to ensuring quality and patient safety in health care settings. They are the largest segment of the U.S. health care workforce and have the most direct interaction with patients of any health care professional . They monitor patients’ conditions, detect and prevent errors, administer medications, coordinate care, educate patients and families, and advocate for patients’ rights and needs . Nurses also influence patient safety across the entire continuum of care by collaborating with other health care professionals, such as physicians, pharmacists, radiologists, and social workers.

Nurse Staffing and Quality of Care

One of the key factors that affects the quality and safety of patient care is nurse staffing. Nurse staffing refers to the number and mix of nurses assigned to care for a specific group of patients at a given time. Adequate nurse staffing is crucial for ensuring that nurses can provide safe and effective care to their patients. Several studies have shown that higher nurse-to-patient ratios are associated with lower rates of adverse events, such as infections, falls, pressure ulcers, medication errors, and mortality . Conversely, lower nurse-to-patient ratios are linked to increased workload, stress, burnout, turnover, and dissatisfaction among nurses, which can compromise the quality and safety of patient care .

However, nurse staffing is not only determined by the number of nurses per patient, but also by other factors, such as patient acuity, staff skill mix and expertise, physical layout of the unit, availability of technology and resources, and patient turnover . Therefore, nurse staffing should be flexible and responsive to the changing needs and demands of patients and health care settings. Moreover, nurse staffing should be based on evidence-based standards and guidelines that take into account both patient outcomes and nurse well-being .

Nurse Education and Quality of Care

Another factor that influences the quality and safety of patient care is nurse education. Nurse education refers to the level and type of formal education that nurses have completed to obtain their license or certification. Higher levels of nurse education are associated with better patient outcomes, such as lower mortality rates, shorter lengths of stay, fewer complications, and fewer readmissions . For example, a study by Aiken et al. (2017) found that every 10% increase in the proportion of nurses with a bachelor’s degree or higher was associated with a 7% decrease in surgical mortality.

The reason why higher levels of nurse education improve patient outcomes is that they enable nurses to develop more advanced knowledge and skills in clinical practice, critical thinking, leadership, research, and quality improvement . Nurses with higher levels of education are more likely to provide evidence-based care, identify and solve problems, implement changes, collaborate with other health care professionals, and advocate for patients . Therefore, increasing the educational level of nurses is an important strategy to enhance the quality and safety of patient care.

Nurse Empowerment and Quality of Care

A third factor that affects the quality and safety of patient care is nurse empowerment. Nurse empowerment refers to the degree to which nurses have autonomy, control, influence, and support in their work environment. Empowered nurses are more likely to provide high-quality care to their patients because they have greater motivation, satisfaction, commitment,
and engagement in their work . Empowered nurses are also more likely to report errors or near misses, participate in quality improvement initiatives,
and implement evidence-based practices .

Nurses play a vital role in ensuring quality and patient safety in health care settings. They have multiple responsibilities that directly or indirectly affect patient outcomes. However, nurses also face multiple challenges that can hinder their ability to provide safe and effective care.

Nurse empowerment can be enhanced by creating a positive work environment that fosters trust, respect, collaboration, communication, and learning among nurses and other health care professionals. A positive work environment can also be achieved by providing nurses with adequate resources, feedback, recognition, and opportunities for professional development. Furthermore, nurse empowerment can be promoted by involving nurses in decision-making processes that affect their practice, such as policies, procedures, schedules, and budgets.

By doing so, nurses can improve their practice, enhance their well-being, and ultimately benefit their patients. It is essential to address the factors that influence the quality and safety of patient care, such as nurse staffing, education, and empowerment. In conclusion, prioritizing nurse empowerment and creating a supportive work environment is crucial for the overall improvement of patient care and the well-being of nurses.

Works Cited

: Phillips, Jessamyn, et al. “Nursing and Patient Safety.” PSNet, 21 Apr. 2021, https://psnet.ahrq.gov/primer/nursing-and-patient-safety.

: “The Importance of a Nurse’s Role in Patient Safety.” HPU Online, 29 Aug. 2023, https://online.hpu.edu/blog/nurses-role-in-patient-safety.

: “The Nurse’s Role in Patient Safety nursing assignment answers .” Cureatr, 9 Aug. 2018, https://blog.cureatr.com/the-nurses-role-in-patient-safety.

: “Patient Safety in Nursing.” Relias, https://www.relias.com/blog/how-nurses-can-help-improve-patient-safety.

: Aiken, Linda H., et al. “Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study.” The Lancet, vol. 383, no. 9931, 2014, pp. 1824-1830.

: Laschinger, Heather K.S., et al. “Empowering nurses for work engagement and health in hospital settings.” Journal of Nursing Administration, vol. 41, no. 10, 2011, pp. 407-416.

: Armstrong, Kirsten J., and Sandra L. Laschinger. “Structural empowerment, magnet hospital characteristics, and patient safety culture: making the link.” Journal of Nursing Care Quality, vol. 24, no. 1, 2009, pp. 55-62.