Introduction
With the passage of time, development and increasing concerns for the patient care and safety requires attention. Healthcare institutions are constantly engaged in improving healthcare quality through inducing innovative healthcare practices for the provision of patient safety. For the delivery of improving quality healthcare services, it is important to ensure that the working conditions and working environment is equipped with the standard needs of the healthcare institution. Nursing remains to be core area in the healthcare organization for patient care and safety (Patricia, Mooney-Kane, & Larson, 2007). In contemporary times, with the healthcare worker shortage and reported errors in the nursing practices needs greater attention and a constant commitment to the improvement of nursing practices for the quality healthcare. Hence, healthcare administrators, clinicians and professional try to seek different ways to improve high quality and safe care efficiency. In the pediatric nursing profession, the responsibility of the nursing staff is relatively more sensitive and complex that needs to be well understood (Patricia, Mooney-Kane, & Larson, 2007). The nurses need to be provided adequate working conditions in which they can perform their duties in an effective manner assessing the organizational climate (Nicki & Mandleco, 2012). Moreover, there is greater pressure on the pediatric nursing to fulfill the standards of care of children providing health services. The present document critically analyzes the working conditions and work environment for the nurses assess methods, tools, standard related to quality, culture and safety principles developing innovative ways for innovative quality improvement.
1. Teamwork, interdisciplinary communication, human factors, basic safety, unsafe practices, and ethical principles.
Healthcare organizations have different environment and culture. Teamwork in different healthcare organization requires a communication intervention to promote teamwork. For the improvement of the healthcare, it is important that the safety culture of the organization should be developed through daily boards and whiteboards. It is one of the methods that can be used by the nursing staff to communicate important notes regarding safety culture. Auerbach, Shegal & Blegen (2012) highlight US Department health and human service department in which is stressed that the teamwork training should be given to the nurses so that they can manage with the organizational culture (Auerbach, Sehgal, & Blegen, 2012). For this, explicit patient engagement methods can be used to improve the patient perception, it would also enhance communication with the patient and physician. In the pediatric nursing, it is important that the nurses need to have a sound knowledge of the ethical issues that may be raised and the right intervention that should be taken. Therefore, it is important that the team building intervention should be stimulated within the groups through standardizing its nursing practices. The effectiveness of the communication is the most important aspect that should be well supported through increase familiarity that can be done through deploying didactic and role modeling approaches. Gausvik, Lautar, Miller, Pallerla & Schliadecher (2015) state that the interdisciplinary communication in nursing practices needs to be structured as it improve the operations and engages patient and family that promotes patient care in an effective way (Gausvik, Lautar, Miller, Pallerla, & Schliadecher, 2015). In childcare, interdisciplinary communications play a vital role as the parents have a greater preference to take the decision that is right for the children. According to American Nurses Association (ANA), the pediatric nurses should ensure that the safe and unsafe practices should be well briefed to the patient and the parents (US Department of Health and Human Services, 2009). The issues of consent remain to be one of the major ethical dilemmas in the nursing practices that need to be adequately addressed through initiating effective communication. It is important to understand the ethical principles in the nursing practices, i.e., autonomy, beneficence, non-maleficence, fidelity, justice, and paternalism.
2. Accountability for nurses, evidenced-based plans based on trend analysis, and quantifies the impact on quality and safety.
Nurses are accountable for their professional conduct including their actions and decisions that need to be regulated with the nursing practices. At the state level, role and responsibilities of the nurses should meet the criteria and requirement of the state regulation, in terms of their education and practice. According to the American Nurse Association, it is defined that the nurses are accountable for the standards of nursing practices that they should responsibility fulfill (Ball & Bindler, 2013). These standards need to be adequately met to provide standards of care at competent level using nursing process and foundation clinical decision-making. Because of emerging complexity in the healthcare environment and technological development nurse, there is greater emphasis laid on the evidenced based practices, quality improvement, and informatics. Hence, the nurses have also participated in the leadership roles for the execution of the right decision. Because of complex practices and delivery system, there is a federal mandate that needs to be fulfilled to ensure that the nurses meet clinical education and leadership capacity (Ball & Bindler, 2013). These factors have taken over traditional nursing practices as the nurses need to understand these emerging needs to deliver quality care and safety to patients (Ball & Bindler, 2013).
3. Analyze information about quality initiatives recognizing individual s and inter-professional healthcare teams to improve health outcomes.
Quality initiatives are taken by the nursing practices to improve the health of patients. Team-Based Care approach is adopted by pediatric nursing practices to deploy a positive impact on the health of children. Quality health care initiatives are taken by the healthcare centers and institutes to get the desired health outcomes. Quality health improvement strategies such as Plan Do Study Act, Six Sigma, and Root cause analysis are few of the initiatives taken by the individuals and professional health care teams to improve health. The pediatric nursing department is actively involved in the quality initiatives strategies to deploy the health care to achieve the desired health outcomes.
4. Discuss transparency, reporting of errors, cultural responsiveness, and safe, timely, effective, efficient, equitable, and patient-centered care.
Nursing practice is human based profession that is prone to have errors and mistakes. However, there is greater emphasis laid on transparency and effective reporting of errors. It is essential that the nurses should communicate actual results and share right information to the patient. The issues of consent need to be adequately met while presenting the information to the rightful person. There should be no misinterpretation or amendment in the information being conveyed. Incase if the errors have occurred the professional are required to report adequately the errors or any cultural responsiveness should be communicated timely. The working environment in healthcare organization may be different for what it is important to take training and provision of the standard working environment should be ensured to the nurses. The other essential aspect that needs to be well understood is timely, effective and efficient information that should be communicated to the physician, patient and family members for the provision of effective patient care. Therefore, it is important that the patient-centered care should be centralized in the nursing practices and the consent of the patient should be prioritized.
5. RN fit for duty/impact of fatigue and distractions in care environment on patient safety.
The RN at their duties often reports fatigue and sleepiness as they have longer and odd shifts in which they have to perform. These factors are arising mainly because of tiredness, lack of energy and exhaustion because of any physical or cognitive functioning. Fatigue and sleepiness may lead to errors and mistakes while performing their duties. Hence, it is ensured that the professionals have an adequate sleep to ensure that their working hours are aligned.
6. Explain effective communication and collaboration strategies that lead to healthy, safe interdisciplinary teams
Interdisciplinary communication is core element that needs to be integrated in healthcare practice to promote teamwork for a healthy and safe practice. For effective communication, it is important that the interdisciplinary team rounds should be made among the group of health care professional. It enables them to come together for patient care (Auerbach, Sehgal, & Blegen, 2012). It specifically promotes communication between nurses and physicians that significantly promotes patient outcome. Through this, the nurses can discuss daily progress and take advice to improve patient care. There can be structured interdisciplinary bedside round (SIBR) that can also be done to assess the condition of the patient (Gausvik, Lautar, Miller, Pallerla, & Schliadecher, 2015). It enables the nurses, physician together to meet with the family members and patient promoting acute care. Through, SIBR the nurses can take support of the healthcare professionals as well as the physical and occupational therapist to improve patient care assistance. Taking advice and discussing the conditions with the professionals enables to nurses to take a wider approach to bring innovative practices (Gausvik, Lautar, Miller, Pallerla, & Schliadecher, 2015). Collaboration not only impacts the patient care but it also leads to higher level of nursing job satisfaction through interdisciplinary relation, as it creates a supportive environment for the nurses to take adequate actions to promote care.
7. Guided by Dr. Jean Watson’s (2012) theory of human caring science critically evaluate how caring can be integrated into all levels of nursing practices
The theory of human caring science as explained by Dr. Jean Watson states that nursing care plans should be integrated into all areas of nursing practices such as pediatric nursing care. The core principles of the theory emphasize on the practice of loving-kindness and equanimity. The care plans of pediatric nursing practices. A detailed assessment is the basis of nursing practices. Human caring science implemented by the care plans ensures the basic growth and development of children. Core concepts such as relational caring for pediatrics, transpersonal caring relationship and multiple ways of knowing are implemented by nursing practices to meet client desires. There are models of nursing practices that promote the human caring science in pediatrics nursing practices. A firm connection is established between nurse and client by practicing the core concepts of human caring science. Human values such as kindness, concern, and love for others are integrated into the pediatric nursing care plans. Caring processes, therapeutic relationship is maintained by the nursing practices. Pediatric nursing care plans deploy the provision of comprehensive health care to children (Watson, 2011).
References
Auerbach, A., Sehgal, N., & Blegen, M. (2012). Effects of a multicentre teamwork and communication programme on patient outcomes: results from the Triad for Optimal Patient Safety (TOPS) project. BMJ Quality Saf, 22, 118-126.
Ball, J. W., & Bindler, R. C. (2013). Pediatric Nursing Caring For Children. New York: Pearson Education.
Gausvik, C., Lautar, A., Miller, L., Pallerla, H., & Schliadecher, J. (2015). Structured nursing communication on interdisciplinary acute care teams improves perceptions of safety, efficiency, understanding of care plan and teamwork as well as job satisfaction. J Multidiscip Healthcare, 8 (2), 33-36.
Nicki, L., & Mandleco, B. L. (2012). Pediatric Nursing: Caring for Children and Their Families. Mason: Cengage Learning.
Patricia, W., Mooney-Kane, C., & Larson, E. (2007). Nurse Working Conditions and Patient Safety Outcomes. Medical Care, 45 (6), 571-578.
US Department of Health and Human Services. (2009). Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville: US Department of Healthcare Research and Quality.
Watson, J. (2011). Human Caring Science. Burlington: Jones & Bartlett Publishers.
