Please 1 citation for each discussion post.
Reply 1: Andrew
In 1711, Alexander Pope wrote An Essay on Criticism. The U.S. Institute of Medicine adopted a line from his essay, “to err is human” for their report on medical errors published around the beginning of 2000 (IOM). The report by the IOM was not to say that there are bad nurses (although every professional basket is known to have “bad” apples), but that nurses were working with a bad system, and the system needed revamping to increase patient safety. It is also widely known that nurses are not the only medical personnel to make mistakes. The report initiated a strong surge in policymaking and procedural changes as well as the establishment of governing bodies to evaluate the quality and safety of patient care (Ulrich, 2020). I have yet to find a nurse that began nursing to harm people (I concede there may be some out there), so I must assume, in hopes for human’s character, that we all want to practice in a way that is the safest for the patient. Establishing standards of safety and practices is no different than practicing evidence-based medicine. As we learn, we can adapt or change course to improve outcomes, whether that relates to the length of an infections, a reduction in bed sores, a reduction in patient falls, or errors in medication administration.
The policy is in place for the fact that errors are made. Even the almighty computer makes errors in their attempts to prevent humans from making one. We have to accept there are going to be errors, but we must strive to mitigate those errors. One of the ways that we bolster mitigation is through policy and improvement processes. But for mitigation to work, the process improvement and the policy must be adhered to so that evaluation and adaptation can occur as needed based on trends.
Human error can be ambiguous in meaning. Early in nursing education we learned terms such as beneficence and maleficence, and non-maleficence. As you may recall, they mean to do good for someone, doing harm, or not trying to do harm, respectively. Often times, non-maleficence accompanies healthcare related errors. Patient complaints can originate for beneficence if the “good” that is being done is not aligned with the patients views or desires. Should one be punished for trying to do good? How about trying to make sure they don’t hurt anyone? Surely we can agree those are both altruistically driven, and should be included in a reporting and a process improvement plan to reduce or eliminate a repeat incident. Maleficence however, should be punitive. If someone is doing harm in healthcare, it should carry the same punitive weight as outside of the healthcare system; murder, manslaughter, and assault for example. Walczyk & Cockrell (2022) researched and noted that there is a distinct difference between deception and being incorrect. I believe this is due to the original intent. If known policies or procedures are not followed and harm occurs, there is a liability for intentional harm because the policies and procedures are in place to protect the patient. Operating within the policies and procedures would fall under beneficence, while not operating within them and reporting errors within the policy or procedure that are noted to be a risk to patient harm, would be non-maleficence. Circumventing the established policies and procedures haphazardly would be maleficence and should be punitive in nature based on the severity of the outcome, beginning with documentation of the error, corrective action, and education.
Institute of Medicine (IOM) (2000). To Err is Human: Building a Safer Health System. National Academies Press (US).
Ulrich, B. (2020). From the Editor-in-Chief. From “To Err Is Human” to “Safer Together” — Progress in Patient Safety. Nephrology Nursing Journal, 47(5), 393–411. https://doi-org.libauth.purdueglobal.edu/10.37526/1526-744x.2020.47.5.393
Walczyk, J. J., & Cockrell, N. F. (2022). To err is human but not deceptive. Memory & Cognition, 50(1), 232–244. https://doi-org.libauth.purdueglobal.edu/10.3758/s13421-021-01197-8
Reply 2: Amy
Shared Understanding of Patient Safety Standards and Practices
A culture of safety is a term familiar to nurses who have worked through a Joint Commission Survey. Culture of safety is the phrase used to describe the expectation and goals of all health care processes (JCHO, 2022). The idea expresses a commitment from every layer of a healthcare organization to ensure that best practices are used, and safety is supported through sound policies and procedures (JCHO, 2022). This collective understanding of safety standards is needed to meet the expectations of accreditation and positive patient outcomes.
The perception of the agency’s understanding and displayed commitment to a culture of safety is essential to the safety perceptions of nursing staff (Shoemark & Foran, 2021). When nurses perceive that there is a little commitment to safety then more incidents of complications occur (Shoemark & Foran, 2021). Policies are only as effective as the procedures created to insure the policy is possible. Nurses can be a valuable resource in determining the practicality of policy as well as implementing practices.
Unfortunately, change in healthcare is often managed by small and often unrelated changes. This may reflect a resemblance to chaos theory, whereby small changes in unseen systems lend to larger changes within the whole system (Demir et al., 2019). To truly create a culture of safety change must be organized and supported on all levels. With the growing challenges of health care, it is imperative that management staff have the education, training, and knowledge to address change in a way that has the quality of bedside nursing in the forefront (Magbity et al., 2020). We need leaders who are prepared to navigate change.
Accreditation & certification. The Joint Commission. (2022). Retrieved April 27, 2022, from https://www.jointcommission.org/accreditation-and-certification
Demir, M. S., Karaman, A., & Oztekin, S. D. (2019). Chaos theory and nursing. International Journal of Caring Sciences, 12(2), 12251228.
Please 1 citation for each discussion post. Reply 1: Andrew In 1711, Alexander P
Please 1 citation for each discussion post.