A critical exploration of the complexities of maintaining patient safety and the contributing factors influencing patient safety and quality care

Critically appraise the principles of risk management in maintaining a safe care environment.

Critically evaluate how human factors can influence and impact upon behaviour within teams and the way in which this can affect health and safety.

Critically justify/defend methods used to instigate positive change to promote safety and quality of care.

You are required to and critically explore the patient safety challenges arising from a shortage of staff. You will need demonstrate an understanding of patient safety and risk management and how human factors can contribute to these maintaining and improving patient safety . You will also explore and advocate methods for creating conditions which develop and nurture a culture of safety .

You are required to underpin your work throughout by referring to appropriate literature.

Introduction (indicative 250 – 300 words)

The introduction should provide a summary which allows the reader to quickly get an understanding of the assignment.

Anchor the topic in context:

· Set the stage by providing clear insight of the issues to be addressed.

· State the specific areas to be examined and the main points to be discussed.

· Summarise your findings.

You will add more detail in the main body of the assignment.

Discussion (indicative 2400-2500 words)

You will need to address all 3 learning outcomes in the discussion.

When you explore context focus on what matters most, keep in mind that context sets the criteria against safety will be assessed. For example, where did the incident occur- primary secondary/care environment; hospital department/ clinical area; why is the significant [i.e., is it a high-risk area]? What is the significance of day/time of admission?

LO1 [750 to 800 words]:

To address this outcome, you will need to explore the meaning of ‘patient safety.’ You will also need to explore the relationship between patient safety, risk management, quality care and quality improvement

Explore the following:

The concept of ‘safe, quality care’?

Safety management and risk management

Traditional approaches to patient safety [i.e. Safety 1] and the emerging concept of resilient healthcare [i.e. Safety 2]

Remember you should be critically appraising the principles of risk/safety management in maintaining a safe care environment

LO2 [750 to 800 words]:

To address this outcome, you will explore the impact of staff shortage using human factors approach to maintaining patient safety.

This will require you to consider organisational factors, individual factors, and the job/work/environment factors. You will need to critically evaluate the interplay between individual, environment, organisation in relation to staff shortage and how they impact patient safety.

Individual: You will need to look at the relationship between the human factors and the individual and how these impact on the task, other work colleagues and the organisation.

Environment: You will need to consider the relationship between the individual/workforce and the job.

Organisation: You will need to look at the organisation. Consider the effect on individuals doing their jobs.

· Professional accountability

· Poor morale, Stress, fatigue burnout

· Civility

· Workload

· Patient mortality rates/skill mix

· Organisational culture

· Teamwork

Choose carefully. You should not attempt to cover all factors listed above. Remember, you should be exploring the interplay in relation to staff shortage and how they impact patient safety.explore in dept the interplay between staff shortage and Poor morale, Stress, fatigue burnout

LO3 [750-800 words]:

To address this outcome, you should explore changes that could be made to the working environment to maintain patient safety and quality care.

For example:

Continuous Learning and Improvement

Collaborative Environment

Leadership Support

Psychological Safety

Teamwork

Patient-Centred Care

Remember to justify/defend your chosen methods in relation to instigating positive change to promote safety and quality of care.explore in dept how a collaborative environmencould help maintain patient safety and quality of care

Conclusion (indicative 250-300 words)

The conclusion is a short section that ‘ties together’ your work. You need to make sure you do not introduce added information in this section- remember you are drawing together what you have said in the main body of the assignment:

· Summarize & draw together the key points from the main body.

· Identify the significance/implications of your findings.

· Link your conclusion to the wider context of nursing.

· Reiterate learning gained for future practice.

· Consider the main message you want your reader to take away- ensure your conclusion is clearly supported by the evidence presented in the essay.

· Refer to the learning outcomes and end on a well-reasoned, logical note.

Vignette:

Joseph, an elderly male patient with shortness of breath is admitted to the Acute Medical Unit (AMU) on a Friday afternoon following GP referral. The unit has 32 beds, and has been busy all day, with a shortage of nursing staff. The unit has increasingly been relying on temporary staff using Bank and Agency cover due to a high staff turnover.

One Registered Nurse from a nursing agency nurse is currently on duty. This is their first time working on AMU. Permanent members of staff also on duty are the Registered nurse in charge, two other staff nurses, two Health Care Assistants, one 3rd year student nurse and one first year student nurse.

The Society for Acute Medicine (SAM) advises a minimum nursing ratio of 1:6 trained nurse to patient ratio. The Unit does not meet this recommendation.

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