Ensuring patient safety is among your primary duties as a nurse. It’s even codified in the ancient Hippocratic oath, sworn by all new physicians before they ever treat their first patient. Although it doesn’t actually appear in the oath in so many words, today we state this guiding principle as: “First, do no harm.” Avoiding errors while providing medical care goes a long way towards fulfilling this primary goal.\
It sounds simple enough: One of the best ways to keep patients healthy and safe is to avoid mistakes. Unfortunately, errors are all too common in our medical system. Some occur due to basic system flaws. Among these flaws are factors that may be out of your control as a nurse, such as inadequate staffing due to nursing shortages. Mistakes become ever more likely as workloads increase.
The problem is substantial. As noted in an issue of The Online Journal of Issues in Nursing, the President’s Advisory Committee on Consumer Protection and Quality in the Health Care Industry issued a report in 1998 that noted the following errors in the health care system:
• Nearly one-third of adverse reactions to medications are preventable, and up to 42% of life-threatening events in the health care space are preventable.
• One-fifth of patients in a tertiary care facility experience adverse events.
• Up to about one-third of abnormal lab results are mistakenly reported as normal.
Clearly, we have a problem when so many adverse events happen by mistake. So, what can a beleaguered, conscientious nurse do?
• Follow established rules and regulations, for starters.
Rules and procedures are implemented for a reason. While they may seem unnecessarily onerous at times, in most instances these rules are written in response to specific adverse incidents or foreseeable, undesirable outcomes. Among other rules with obvious patient safety value, rules regarding proper charting are in place to ensure effective documentation of care. Transcribing medication orders, for example, is a potentially fraught activity. Countless patients have been harmed or even killed due to simple dosing errors due to mathematical errors, inattention, or misunderstandings, etc.
Other notable rules concern patient confidentiality and proper delegation of duties. Keep in mind that, while modern HIPAA regulations hold you accountable for patient privacy under U.S. law, the concept of maintaining patient confidentiality has been enshrined in the healer’s code of conduct since the time of Hippocrates. When it comes to delegation, it’s crucial to avoid assigning an inadequately trained individual to perform a task that requires appropriate expertise. This is against the law as outlined in the Nurse Practice Act.
• Commit to lifelong learning.
Staying informed, up-to-date, and appropriately certified is one way to stay abreast of changes and maintain proficiency and expertise in your chosen field.
• Become a competent team leader.
Healthcare delivery is a team effort. RNs are often responsible for supervising the activities of LPNs and CNA’s. It’s the ultimate responsibility of the supervising RN to ensure that team members are capable of delivering the appropriate level of care a given patient may require and communication with the whole multi-disciplinary team.
According to the Agency for Healthcare Research and Quality (AHRQ), avoiding errors and ensuring a safe workplace for nurses and their patients is a multifaceted endeavor that includes everything from taking extra care with sharps, to maintaining vigilance against foreseeable events, such as the development of pressure ulcers among bedridden patients.
The report examines the opportunities for errors inherent in the patient handoff process and discusses the safe administration of medications. This comprehensive overview, available for free download online, covers all aspects of the issues involved in patient/nurse safety. It’s well worth the read if you’re so inclined. It contains chapters on everything from preventing healthcare-associated infections to fostering personal safety in the workplace for nurses.
Citations:
"Patient Safety: A Shared Responsibility." Patient Safety: A Shared Responsibility. N.p., n.d. Web. 19 Oct. 2016.