Health care is an essential basic need in which its safety and quality must be maintained at high standards at all times. If quality and safety of the health care is compromise, this can led to huge disasters such as lost of lives and patients who are receiving treatment might develop complications due to the disruptions of care plans they were subjected to by their health practitioners. Thus, is very important for any health care facility to make sure the safety and quality of services given to client is of high standards at all times. Hence, the staffs working at any health facility should have adequate educate on how safety and quality can be maintain at all times to reduce patient’s suffering, stay at the facility and more importantly reduce or eliminate chance of readmission (ANA, 2014). However, practically this phenomenon of maintaining 100% high quality and safety standards at all times at any health facility is becoming quite impossible to implement. This impossibility is mainly brought by the shortage of staffs. The current staffs at the health care sectors cannot meet the demand for health. The demand for health care is skyrocketing and the health care staff is shrinking at alarming rate which is getting out of control on hands of policy makers. The staffs who are currently discharging their duties are facing a huge work load and overtime working is increasing uncontrollably due to the huge demand has been cause by the increase in population. Thus, working overtime often combine with the huge workload is putting pressure and exhaustion at the current health practitioners. Thus, the quality and safety of the health care is in great danger since the current staffs cannot attend to every patients needs and due to fatigue. Thus, medical errors are bound to happen often if urgent measures are not taken to address this problem. Therefore, due to this reality on the ground, the policy makers such institute of medicine have put in place mechanism to make sure the new graduates especially nurse have the right knowledge and competency on how to navigate through these challenges and offer quality and safe care to client which address all the crucial needs of the client and the health practitioner is satisfied with his/her work. Some of these mechanisms and models are QSEN competencies and KSAs. These models prepare nurses to have adequate competences which are crucial in discharging their duties effectively whereby safety and quality are emphasize. Additionally, these model aims at providing care which optimal outcome is the main focus.
The Quality and Safety Education for Nurses (QSEN)
The primary goal of this initiative is to incorporate and emphasize on health care safety and quality right from nursing education at college level to health institutions in service delivery to different clients. This initiative calls for redesign of the health care system in an effort to make it efficient to offer care to all patient from outpatient to end of life patients in a complex environment (Dolansky & Moore, 2013). This education program is design to equip nurses with adequate information and expertise on how to improve the health care and be in position to meet patients needs they provide care. QSEN addresses six areas of competences i.e. patient-centered care, evidenced-based practice, teamwork and collaboration, informatics and quality improvement (Dolansky & Moore, 2013). In order for this initiative to work nurses have to take the initiative themselves and apply them in their day to day engagement from the individual level to the health care system as whole.
Quality improvement
In this initiative competence, nurses are called upon to insist on using the data available to monitor the progress of the patient and the outcome of the care being given to a patient. Additionally, nurses must actively look for methods and procedure which can be used to bring about change which guarantees high quality and safe service delivery to patients and improve safety and quality of these services (QSEN Institute, 2014). The nurses should carry out intensive and extensive research and test various methods in an effort to look for ways to improve the quality and safety of the services offered to patient. Thus, nurses are called upon to assess the indicators which show services quality improvement such as Volume of patient admissions indicators, mortality rate indicators, utilizations of staffs and equipments indicators and preventable complications indicators (AHRQ, 2013). Health providers must look at these indicators and assess whether there is room for improvement.
KSAs
This acronym stands for knowledge, skills and abilities (CDC, 2015). Knowledge; is the amount of information a nurse has about his/her areas of expertise as to how to carry or perform a certain task. Skill statements this is the capability to manipulate things or data manually or mentally. This is having the proficient to carry out task or operate machines within certain duration without compromising quality and quantity of the task. Attitudes, these are capabilities, behaviors and personal attribute that are essential in executing certain tasks, collaborate with others nurses or occupy a certain position in a health care facility. These personal attributes are what many health institutes look for in new graduates before they are considered to fill a certain position in the health organization. Therefore, it is essential for nursing graduates to develop these unique capabilities while in school base training, attachments, internships or during practical lessons while in college. Mastering these qualities is what makes graduates unique and increase the chances of graduates securing employment. Additionally, these skills will equip the nurses with adequate information and capabilities on how to restore or improve on the safety and quality of the services delivered at the work place by assessing the work environment and remove barriers in delivering quality and safe services to patient.
Attitude
Health care providers must acknowledge that, quality and safety improvement is both a collective responsibility and a continuous process which should be incorporated in all the day to day activities (QSEN Institute, 2014). A nurse should be in a position to appreciate other workers and patients values and their effort in improving outcomes of care delivery at the facility. Moreover, a nurse should be in a position to identify unwanted variations that are threats to safety improvement and have positive attitudes towards measurements taken to curb these unwanted practices and variations which are threats not only to patient alone but also the safety of the health care providers. Lastly, a nurse should appreciate the importance of working with colleagues as a team to create a good working environment and where everyone’s contribution towards quality improvement is recognized.
Quality improvement and nurses Attitude are the most crucial aspect of the Quality and Safety Education for Nurses (QSEN). This is because the quality improvement is a continuous process with no ends, thus, nurses should have the right attitude as they embark on the journey of continuous improvement of quality and safety. Additionally, nurses should appreciate the importance of data which are essential in monitoring the progress made by their institution on quality improvement. The work design and schedules should be design with an aim of quality improvement. The electronic records which are currently being implemented by many health institutions are essential instruments which can be use by health institution to check the progress made by the institution in enhancing quality. The records can show the mortality, morbidity, and admissions rates to name a few. On the other hand, health institutions have develop and adopt various quality improvement methods such as the Six Sigma, flowcharts and other diagrams which depict quality improvement process and the areas which need improvement.
Article review
Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses by Saima Hinno, Pirjo Partanen and Katri Vehvila¨inen-Julkunen
The article acknowledges that staff shortages in the health sector are global phenomenon which affects almost every country in the world. According to the article, higher number of nurses in a health institution results in best outcomes on patients. The high number of nurses enables an institution to well utilize nursing expertise and resources in delivering patient care and manage the resources. Thus with well utilization of nursing professional and resources, there is guarantee of provision of high quality services which enhance optimal outcome and the prevalence of patient fall is reduce drastically. According to the research when ratio of patients is high compared to that of nurses ratio, the work load on the nurses is high and this bring about work dissatisfactions on the nurses. This result in poor services delivery and the quality of services is compromised. Additionally, high work load make nurses to neglect other areas of nursing care such as talking to patient family to update them on the patient situation or carry proper record keeping. Thus, adequate measures should be taken to increase the number of registered nurses in health sector if quality and safety of patient care is to be maintained
Nurse Staffing and NICU Infection Rates FREE by Jeannette A. Rogowski, PhD; Douglas Staiger, PhD; Thelma Patrick, PhD, RN; Jeffrey Horbar, MD; Michael Kenny, MS; Eileen T. Lake, PhD, RN
According to the article there is a drastic fall in the number of nurses in the United State especially in the NICUs which is against the national guidelines on the staffing. As result of this understaffing, the quality of care has deteriorated and this has increased the rate of infections in the NICUs. However, the population which is vulnerable to these infections is infants. The infants due to staff shortage they are at higher risk of nosocomial infections; this prevalence is high among infants with very low birth weights (Lake et al., 2013). According to the article blood infections and other infections such as cerebrospinal fluid are relatively to occur within the first three days after the birth of the infant. Thus, in order to reduce the infections and provide quality care to infants, the article recommends increase of nurses in this department to meet the needs of the infants and reduce the prevalence of infections. Thus, hospitals should make prompt and sound decisions when it comes to nursing allocations in this department. There is need to increase the nursing care to this vulnerable group i.e. infants. According to the article, this area has been widely been ignored by the management in most health care due to the cost. Hence, the critically ill patients i.e. infants, have no adequate personnel to look at their needs. This negligence and understaffing has exposed the infants to variety of infections which results in more complications hence providing care to infants has become nearly impossible. Thus, the mortality rate at this unit keeps on increasing due to understaffing and negligence. Therefore, the health care facilities need to devote resources and nursing care to increase the quality of service given to this vulnerable group to reduce prevalence of infections and mortality rate.
References
AHRQ. (2013). Fact Sheet on Patient Safety Indicators. Retrieved from http://www.ahrq.gov/professionals/systems/hospital/qitoolkit/a1b_psifactsheet.pdf
ANA. (2014). Safe Staffing Literature Review. Retrieved from http://www.nursingworld.org/mainmenucategories/thepracticeofprofessionalnursing/nursestaffing/2014-nurse-staffing-updated-literature-review.pdf
CDC. (2015). The Importance of KSAs. Retrieved from http://www.cdc.gov/hrmo/ksahowto.htm
Dolansky, M. A., & Moore, S. M. (2013). Quality and safety education for nurses (QSEN): The key is systems thinking. OJIN: The Online Journal of Issues in Nursing, 18(3).
Hinno, S., Partanen, P., & Vehviläinen‐Julkunen, K. (2012). Nursing activities, nurse staffing and adverse patient outcomes as perceived by hospital nurses.Journal of clinical nursing, 21(11‐12), 1584-1593.
Rogowski, J. A., Staiger, D., Patrick, T., Horbar, J., Kenny, M., & Lake, E. T. (2013). Nurse staffing and NICU infection rates. JAMA pediatrics, 167(5), 444-450.
QSEN Institute. (2014). QSEN. Retrieved from qsen.org/competencies/pre-licensure-ksas/
