This week every year, we give recognition and encourage all to learn more about healthcare safety. We need to focus on the safety of our patients because it is estimated that medical harm is the leading cause of death to patients worldwide.
We must establish a safety culture by maintaining a commitment to safety at all employment levels within organizations.
Some ways we can improve patient safety are:
- The staff must listen to the patient’s needs. Resident care and considerations must come first. Who in this world knows our residents better than they do? No one.
- The supervisors must know the overall expectations and what their actions should be to promote resident safety in the organization. Do you have an appointed safety champion in each department and patient care area with whom your staff feels comfortable sharing information or asking questions?
- We as leaders must support the education of safety processes in our facilities with an expectation that all staff will be oriented before working with patients or spending time in their assigned departments regarding the safety processes.
- Ongoing monthly, quarterly, and annual education plans. Safety policies such as incident notifications and suspected abuse should be reviewed quarterly. Safety issues can escalate over time when the staff is only educated on these policies once a year. Another area of frequent education is detecting changes in conditions. This should be a topic that the directors of nursing address monthly with all nursing staff.
- We must frequently audit the compliance of the staff in all departments with procedures such as hand hygiene and wearing personal protective equipment as needed for different conditions of residents in the facility. We need to study reports that will tell us our monthly infection rates. Know what an acceptable threshold is and maintain that as the expectation. When that expectation is unmet, we have an issue to deal with immediately. All staff should know the expectations and their responsibilities to maintain them.
- Encourage teamwork and good communication—set examples of open communication with the staff. If possible, take a nonpunitive response to mistakes. We should never think a safety issue is due to one employee. Have the plan to educate all if there is one; there is more than likely more.
- When working on staffing issues, consider consistent assignments. Focus the team on what will give the most staffing stability in the building. It is excellent customer service when the patients and families are comfortable with the person caring for them. Knowing that resident-centered care comes first with each individual caring for them is reassuring.
- Fully investigate and use root cause analysis to implement appropriate interventions for any identified safety issues. There may be multiple issues identified at the same time. Assigning sub-committees to each problem may assist in obtaining solutions quicker for each case.
- When a safety issue is identified, we need to inform the QAPI team. We need to set up a process improvement plan (PIP) for each case identified, and here is where we will set up a committee for each issue identified.
- Frequently audit all safety compliance programs to ensure they run smoothly. If not, we get caught with our pants down. I would much rather find an issue myself than have a surveyor find it, such as setting your eyes on the water temperature logs each month to ensure they are being completed accurately and that something has been done about any temperature out of range. When a surveyor asks to see your facility’s safety logs, don’t let it be the first time you are also looking at it.
With an estimated 40% of patients experiencing harm and 80% of those harms being preventable, this is a dedicated time for each of us to grow our staff’s awareness of patient safety.
In my career, I have been through many surveys as the Director of Nursing. Surveyors know that issues are always going to be in every facility; they only want to see what you did to correct the situation. Don’t hide the work you are doing. Be proud of your safety processes, your auditing tools to identify issues, and what you did to correct the problems identified. Once you put a plan in place, continue to audit it regularly to ensure that corrective action is still working.
It is not usually a process that fails; it is usually the human error of not following the process that causes the issues. Auditing regularly will help you catch human errors before the process crumbles.