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What factors reduce patient safety in nursing ? In addition to inadequate staffing levels , contributors to patient safety concerns are wide-ranging , including supply chain factors and product standardization that impact efficiencies and time to devote to patient care :
• Increased workload
• Poor work environment
• Limited staff experience , education or competency
• Lack of material resources
• Poor communication
• Poor care transitions
• Limited skills mix of staff on the unit
• Lack of teamwork 4
“ The nursing discipline is vital to quality healthcare . It ’ s no wonder the shortage has created a problem . But I want to make it clear that nursing is not the problem . It ’ s a complex problem .”
— Donna Matocha , DNP , MSN , VA-BC , Medline Manager of Clinical
Resources — Acute Care
“ You may have nurses fresh out of nursing school who have no experience in the ICU taking care of three patients on ventilators ,” says Christine Dean , MSN , RN , Medline Medical Science Liaison . “ You may have to cut corners and you ’ re going to have to sacrifice certain aspects of care because there ’ s no other option .”
Reversing the trend while coping with staffing issues feels like an impossible feat , but there are strategies for preventing errors of omission . As Donna Matocha , DNP , MSN , VA-BC , Medline Manager
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of Clinical Resources — Acute Care , explains , “ The nursing discipline is vital to quality healthcare . It ’ s no wonder the shortage has created a problem . But I want to make it clear that nursing is not the problem . It ’ s a complex problem .”
1 . Standardize processes and products Do you have protocols that were developed with frontline nurse input ? Are the protocols easy to access and follow ? This will help increase engagement and reduce variations in care .
Nurses and caregivers are constantly going to the stock room multiple times to gather items for changing a central line dressing or inserting a Foley catheter , and this is where a bundled approach helps :
• Provide all necessary items for a particular procedure or treatment in one package . This reduces the likelihood of forgetting critical components and steps .
• Encourage standardized practices by providing a consistent set of supplies for specific procedures
• Save time during preparation and procedures
• Enhance patient safety by including items designed with infection control measures
• Simplify training and orientation by providing a visual guide to the required supplies
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What are the effects of errors of omission ?
• Infections , increased length of stay , readmissions and even death 5
• Complications such as pressure injuries , falls and ventilator-associated pneumonia
• Decreased patient satisfaction
• Decreased employee satisfaction 6
“ Bundles make it easier to complete all the steps in a given procedure ,” says Dean . “ For example , if a nurse forgets to prep a patient ’ s skin before changing a dressing , the doors to infection are open . With a bundle , the skin prep is included .”
2 . Institute multidisciplinary rounds These rounds — conducted at least once a day — play a significant role in preventing omissions of care in nursing by promoting effective communication , collaboration and comprehensive patient management . Nurses can ask questions , provide insights and updates , and be prepared for each patient ’ s plan for the day .
• Promote a comprehensive patient assessment . Experts in different disciplines share their knowledge and insights , which helps identify potential
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care needs that might be overlooked if only one discipline is involved .
• Enable better information sharing . Nurses can provide crucial insights about patients ’ daily care routines , vital signs , medication administration and any observations about changes in condition .
• Support early identification of issues . Nurses may notice subtle changes in a patient ’ s condition that other team members might miss . For example , is a pressure injury starting to form ? By participating in rounds , nurses can raise concerns early , leading to prompt interventions and preventing complications .
• Provide skill sharing and training . Nurses can share their expertise with other team members and learn from them as well . This knowledge exchange helps prevent omissions due to lack of knowledge or experience .
• Contribute to continuity of care . Nurses have a clearer understanding of the patient ’ s overall care journey . This reduces the risk of fragmented or disjointed interventions .
3 . Streamline onboarding and training of travel nurses and new hires “ We know many hospital education departments were cut because of COVID-19 ,”
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