Safety is a small measure that can make a big impact on a patient in the clinical setting. In some cases, it can even cost patients their lives. According to the Online Journal of Issues in Nursing, safety is defined as a tool to minimize risk of harm to patients and providers through both system effectiveness and individual performance (Barnsteiner, 2011). Safety problems can range from the nurse not knowing how to work certain equipment, or the nurse recording values wrong because he or she is distracted. Either way, these safety issues impact the clinical setting in a negative way. In order to have a functional, safe clinical environment, time and money must be spent to keep the hospital in working order and the nurses in the correct mindset. …show more content…
URFOs are any objects that are left in a patient related to any invasive procedure. Common objects typically left behind are soft goods such as sponges or towels, small miscellaneous items like broken pieces of instruments, needles and other sharps, and full instruments like malleable retractors (Wong, 2013). In the last five years, the Pennsylvania Patient Safety Authority estimated that the average cost of care for a patient with a URFO was $166,000 (Wong, 2013). The price tag of $166,000 is typically the total cost of legal defense, and surgical costs that were not reimbursed through Medicare or Medicaid. Not only is this mistake expensive, it can also have a negative effect on the patient socially, mentally, and even physically. In September 2012, a woman in Kentucky started experiencing severe abdominal pain after a hysterectomy. After a CT scan it was revealed that the patient had a surgical sponge left behind by the team that performed the surgery. This sponge caused such a severe infection that the woman had to have a bowel resection (Wong, 2013). This woman then suffered from social isolation, disability, and severe …show more content…
The first thing a nurse can do is to always remember that they are a patient advocate. In the situation of an OR nurse watching a doctor perform surgery, being a patient advocate is key. The nurse’s patient is unconscious and cannot speak for themselves. Watching to make sure that whatever part of the body is being worked on is thoroughly inspected and all tools used in the surgical procedure are accounted for is one of the most effective ways that a nurse can intervene. Being a patient advocate also means telling the surgeon when a nurse happens to find something left behind. This advocacy would create an environment of communication to promote communication between all team members. Nurses can also count the surgical items being used. “To prevent leaving surgical items inside patients, the Association of perioperative Registered Nurses recommends counting all sponges, sharps, and related miscellaneous items at five different times: (1) before the procedure to establish a baseline, (2) before closure of a cavity within a cavity, (3) before wound closure begins, (4) at skin closure, and (5) at the time of permanent staff relief of either the scrub person or the circulating nurse (Treadwell, 2013). Communication with the operating room staff and checking the number of surgical
Situational awareness that includes keeping an eye on the sharp at all times, focusing on the task at hand, avoiding passing sharps by hand and watching for sharps in bed linens, on the floor and in waste containers can also help to limit injuries. One of the most important steps in preventing sharps injuries is proper disposal that includes personally disposing of used devices, putting sharps into rigid containers, not overfilling sharps containers and keeping fingers away from the openings of sharps
At this time, the surgeon inspects the wound and the team conducts the count without interruptions (Norton et al., 2012). Among other required charting documentation are the nursing outcomes or Perioperative Nursing Data Sets (PNDS). These outcomes are responsibilities nurses are expected to implement while a patient is in their care. One item of the PNDS states "the patient is free from signs and symptoms of injury due to extraneous objects" (Rothrock, 2015, p. 207). It is the responsibility of the OR nurse to make sure facility policy is followed to ensure that a patient does not leave the OR with unintentional items remaining inside their operational site or sites. If there is a situation where an item is not located and the patient is stable, the OR nurse should have the surgical field halt activities. The team should then locate the missing item. When found, activities can resume. If the missing item is not found, then other facility protocols, such as intraoperative radiograph are obtained and reviewed by a physician to determine the location of the item. All these steps should be performed prior to the patient being closed or removed from the OR.
In the 1990’s, the American Nurses Association (ANA) identified indicators which brought about the development of the Nursing’s Patient Safety and Quality Initiative (Miller & Soule, 2008). These indicators were specific to nursing,
The Perioperative Nursing Data Sets (PNDS) are professional guidelines developed and maintained by the Association of Perioperative Registered Nurses. These guidelines outline the expectations for the OR nurse to carry out while a patient is in their care. One item of the PNDS states "the patient is free from signs and symptoms of injury due to extraneous objects" (Rothrock, 2015). Counts including sponges, sharps,
Unlike physicians who spend approximately 30 to 45 minutes per day with a patient, the presence of nurses at the bedside is essential throughout the day. Apart from attending the patients, they regularly interact with families of the sick and other healthcare practitioners, such as physicians and pharmacists. Given their constant presence at the bedside, nurses play a critical role in maintaining patient safety by continuously observing patients for deterioration or improvement of health. They also help in the detection of medical errors, identification of near misses, and discovery of weaknesses that might be inherent in some systems (“Nursing and Patient Safety,” 2017). Since the role of nurses is crucial to the maintenance of patient safety, it is logical that increasing their workload is bound to adversely affect their ability to deliver quality work and safe services.
The issue of patient safety and nurse satisfaction can be a complex web of issues that can be improved by changing the nurse environment. Nurses seek a better and safer environment to practice to be allowed to provide good care and not risk critical mistakes that can have perilous consequences. Nursing as a profession needs to seek a way to elevate these hospitals to the performance of the Magnet and provide justice to all patients and not just the ones who select Magnet.
There’s multitude of articles addressing the dilemma of safe nursing and its breach of quality and safety in patient care. Previous to 2014 the Institute of Medicine (IOM) reported on two ground-breaking studies, Arriess referred to: “To Err is Human: Building a Safer Health System and Crossing the Quality Chasm: A New Health System for the 21st Century” (2014, p. 3),
More often then we realize patient safety has been over looked in more ways then one. The patient is the center of attention
The article makes the point that maintaining safety is not only a priority for nurses, but several individuals, organizations, educational institutions, and other systems. This opinion allows for the importance of safety to be noted, not only by nurses, but by all people. The specific purpose of this article was to research first year nursing students
A significant finding in health care that Emanuel et al. (2015) gave emphasis to relates to the acknowledgement that hospitals are not necessarily safe places for healing. Rather, they pose significant risk of patient harm. Such findings have prompted attention to be given to patient safety. However, even with the increasing recognition of patient safety, the implementation of policies and practices linked to patient safety have proved challenging (Emanuel et al., 2015). A view that Emanuel et al. (2015) advanced is that it is possible to reduce errors by redesigning processes and systems through human factor principles. With this in mind, nursing staffing has become an area of interest in promoting patient safety.
The campaign would emphasize the six aims’ acronym, ‘STEEEP’, and the seven patient safety goals for hospitals on posters in every room. (Cherry, 2008, p.381) This serves as a constant reminder to all healthcare employees the importance and regularity that should be taken. Secondly, quarterly training meetings would add specific training for nursing staff in regards to safety. Within these pieces of trainings, nursing staff will learn how to implement the six aims’ acronym, STEEEP, into their daily routines. S-safe, nurses shall prevent patient injuries. T-timely, nurses shall reduce the wait time for patients that could be considered in a critical state. E-effective, nurses shall only perform services to a patient that have are science-based. E-efficient, nurses shall prevent wastefulness in regards to supplies, equipment, and energy. E-equitable, nurses shall treat all patients with no discrimination; every patient is treated with equal quality care. And, P-patient centered, nurses shall always put the concerns of the patient first, and be considerate towards their individual beliefs, values, and preferences. (Cherry, 2008, p.381-382) During the training, they will discuss the seven patient safety goals and how important it is to follow set guidelines. Guidelines are in place to keep patients safe from healthcare staff
In my medical career foundations, my instructor who was a registered nurse, always spoke of different scenarios she encountered (of course never violating privacy acts) about medical errors performed by the doctor or physician assistant that resulted in disadvantages or longer recovery periods for the patient. She discussed these scenarios as being everywhere from a doctor misreading patient charts, to performing on the wrong side of the brain resulting in paralysis, to massive scar tissue after recovery because the surgeons error in an incision site. As we did our clinical rounds throughout a few hospitals in the county, my classmates and I, being in different departments, heard about varieties of different complications of surgical procedures
The New England Journal of Medicine performed a case-control study to identify risk factors for instruments and sponges after surgery. They were able to gather data and information from surgeons and the patients with a retained foreign body. After interviewing patients and surgeons they conducted possible risk factors such as: change in nursing personnel during surgery, fatigue in surgical team due to length or lateness of procedure, excessive blood loss, urgency of surgery, and lack of complete count of surgical tools. Surgeons that were interviewed included a few more risk factors such as: body mass index, unexpected intraoperative developments, the amount of people working in the surgical team, and more than one procedure performed at a
A primary concern for patient’s wellbeing is safety. Current research shows that safety is highly compromised in the healthcare setting. Hence, many medical facilities have developed committees to monitor patient safety (Wallace, 2013, p. 49). Nurses are the last line of defense to ensure safety of a patient (Taylor, et al., 2014). They are the ones that have the most patient interaction. When a patient is presented to the hospital, the first thing the nurse does is assess the situation of the patient. Nurses are responsible for assessing, delivering the appropriate medications, and assisting with activities of daily life (ADL’s). It is important for a nurse to monitor and assess for risks that can jeopardize
Issue: A pattern of staffing exists in North Carolina in which nurses and ancillary staff are burdened with an excessive patient load. This nurse to patient ratio sometimes consists of one nurse to eight or one ancillary staff to 15 patients compromises patient care and safety.