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Patient safety, which is the preclusion of damage to the patients, is the cornerstone of high-quality healthcare. The emphasis of this phenomenon is on the development of a healthcare system that prevents injury to the patients, learning from past errors, and building an organizational culture of well-being that includes healthcare experts. Evidence indicates that nurses are in the center position and play a significant role in improving the eminence of healthcare services by adopting patient well-being strategies and interventions (Mitchell, 2008). In complex health care organizations, nurses manage errors in two ways; containment or reduction. Containment of a mistake involves taking the necessary actions to limit the negative impacts once an incident occurs (Spath, 2011). On the other end, the reduction of an error involves acting appropriately to hinder the occurrence of the error. Therefore, every year, the Joint Commission collects information and data concerning emerging safety matters from widely known stakeholders and experts. Then, the Joint Commission uses the data as the foundation for the national patient safety goals for each precise healthcare program. As a result, the analysis conducted in this essay focuses on reviewing the Joint Commission’s 2020 National Patient Safety Goals (NPSGs) and describing how a caregiver can speak up if the individual sees a breach in patient safety. Furthermore, the analysis provides an in-depth insight into how publicly reporting quality data can protect the public.
The aim of NPSGs is to improve patient safety by concentrating on the difficulties in healthcare safety and providing strategies on how to unravel them. The Joint Commission highlights the need to develop the exactness of patient recognition as one of the patient safety objectives for the hospital programs in 2020. To achieve this, a nurse or physician must use two or more patient identifiers when offering care, services, or treatment (The Joint Commission, 2020). They include a phone number, name, assigned identification number such as medical record number, date of birth, photo, address, or even social security number if available. The two identifiers must be directly associated with the patient and must match the service or treatment to the specific patient. Another NPSGs goal relates to promoting the efficiency of communication between healthcare professionals (The Joint Commission, 2020). Dysfunctional communication between healthcare professionals is likely to result in medication errors, death, avoidable patient injury, delayed patient care, or extended inpatient stays. Therefore, to eliminate such problems, the caregivers should report serious results of tests and analytical processes on a timely basis.
The 2020 Joint Commission NPSGs also addresses the prevalent issue of medication errors. It is an error that occurs in the process of medication use, such as the wrong dosage prescribed, failure to give medication, or wrong dosage administered. However, healthcare organizations can avoid these errors through proper labeling of all drugs and their respective containers. Elsewhere, healthcare providers should reduce the harms associated with clinical alarm systems. Noises from alarms can cause miscommunication among the caregivers, interference with the patients’ ability to sleep, and also irritation to the visitors. Therefore, the Joint Commission considers the identification of the most important alarm signals to manage to accomplish patient safety. Also, the Joint Commission has adopted the risk of healthcare-associated infections (HAI) as a national patient safety goal. The causes of HAIs are microorganisms such as viruses, fungi, bacteria, or parasites during the process of receiving care in a healthcare facility – for example, in a nursing home, or a surgery. Therefore, to achieve this goal, a health organization must conform to the current Centers for Disease Control and Prevention (CDC) and World Health Organization hand hygiene guidelines. The firm must also incorporate an organizational culture that involves hand hygiene, monitoring of the compliance levels, and providing feedback.
The Joint Commission’s NPSGs also requires healthcare organizations to identify the safety risks inherent to their patient populations and reduce the risk of committing suicide (The Joint Commission, 2020). The risk is mainly high among patients with mental problems or behavioral health conditions as their primary reason for care. The decision to admit a psychiatric patient in a health care facility is mainly because of the danger they portray towards others and themselves (Sakinofsky, 2014). Therefore, to comply with this NPSG, hospitals conduct an environmental risk assessment and ascertain the physical features that can assist suicidal attempts. However, the caregivers can mitigate suicidal thoughts through one on one monitoring and removal of objects that can cause self-harm. Lastly, there have been several incidences where surgeons make mistakes during surgeries, such as operating the wrong body part, or even the wrong patient. The errors in surgical operations can occur before or after the procedure. Therefore, before the surgery, the healthcare providers must confirm the patient’s identification and match it with the intended surgery to be done. Also, before the process begins, the surgeon should mark the correct and exact spot to be operated on the patient’s body. During the surgery, the caregivers involved must take time out where they will recheck the patient’s identity, site of operation, and the type of procedure underway.
As indicated earlier, healthcare professionals are the frontline caregivers and the main party in ensuring patient safety. Therefore, they must speak up if they witness a breach of patient safety guidelines. Speaking up is the bringing up of issues by health care experts upon recognizing a risky action(s) of others within the healthcare teams in a hospital setting for the benefit of patient safety (Okuyama et al., 2014). They can achieve this particular goal by learning effective communication and teamwork skills that will assist in observing early signs of unsafe practices in care delivery. The willingness of teams or entities to speak out when they have fears depends on the organizational system and personal beliefs about the perceived efficacy. However, healthcare providers can raise their concerns to either of their peers, such as supervisors or managers. Another strategy to speak out is whistleblowing, which mainly applies when the incident or breach has been detected (Tarrant et al., 2017). Also, healthcare professionals can raise their concerns through formal reporting, which is the most effective strategy to resolve issues on unsafe practices.
On the other end, public reporting is also a strategy for improving the practice of healthcare services. It involves the provision of data and information concerning the quality of identifiable professionals and providers to the general public (Cacace & Berger, 2019). In doing so, it protects the people as they can use the information to select healthcare providers and professionals of high quality and expertise. The reports are usually in the company of an audit, feedback, and external quality assessment statements, which address the quality levels in different areas of care. Therefore, the public is protected since these reports provide incentives to caregivers to change pathways and improve their care.
Cacace, M., Geraedts, M., & Berger, E. (2019). Public reporting as a quality strategy. In: Busse
R, Klazinga N, Panteli D, et al., editors. Improving healthcare quality in Europe: Characteristics, effectiveness, and implementation of different strategies [Internet]. Copenhagen (Denmark): European Observatory on Health Systems and Policies; 2019. (Health Policy Series, No. 53.) 13. https://www.ncbi.nlm.nih.gov/books/NBK549281/
The Joint Commission. (2020). National patient safety goals are practical in July 2020 for the
hospital program. https://www.jointcommission.org/-/media/tjc/documents/standards/national-patient-safety-goals/2020/npsg_chapter_hap_jul2020.pdf Accessed July 22, 2020
Mitchell, P.H. (2008, April). Defining patient safety and quality care. In: Hughes, R.G, editor.
Patient safety and quality: An evidence-based handbook for nurses. Rockville (MD): Agency for healthcare research and quality (US). https://www.ncbi.nlm.nih.gov/books/NBK2681/#:~:text=Conclusion,that%20reduce%20such%20adverse%20outcomes.Okuyama, A., Wagner, C., & Bijnen, B. (2014). Speaking up for patient safety by hospital-based
health care professionals: A literature review. BMC Health Services Research, 14, 61. doi.org/10.1186/1472-6963-14-61.
Sakinofsky, I. (2014, March). Preventing suicide among inpatients. Canadian Journal of Psychiatry, 59(3), 131–140. doi.org/10.1177/070674371405900304
Spath, P.L. (2011). Error Reduction in Health Care: A systems approach to Improving Patient Safety (2nd edition). Jossey-Bass.
Tarrant, C., Leslie, M., Bion, J., & Dixon-Woods, M. (2017). A qualitative study of speaking out
about patient safety concerns in intensive care units. Social Science & Medicine (1982), 193, 8–15. doi.org/10.1016/j.socscimed.2017.09.036
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