NRSG370 : Clinical Integration Specialty Practice

Part A

Module 1

Safety is an important parameter in determining quality care which is provided to patients with proper resources and circumstances using patient-centered care (Greene, 2012). The safety policies and strategies are imposed on the healthcare facilities so that the risk of unnecessary harms generated due to the healthcare interventions could be limited to an acceptable level. As per Chartier (2014), it is impossible to eliminate risk from healthcare processes completely but due to the presence of risk-reducing strategies, the level of harm can be reduced to an acceptable level and this level is determined by the level of knowledge about the risk, its efficiency, its context and so on, which helps healthcare professionals to limit its effect on the patient’s health (Runciman, Merry & Walton, 2017). While working in the surgical unit of the healthcare facility, I was aware of the fact that safety is one of the most crucial issues about which, the healthcare professionals need to be aware of. The healthcare professionals need to be aware of the medicational errors, surgical errors and preventable healthcare infections so that in the surgical ward, the risk related to hazardous infections could be controlled (Zimlichman et al. 2013). Further, I understand the importance of the steps to prevent errors such as wrong site, wrong person, and procedure which helps to make the healthcare process patient-centered and determines the prevention of the errors occurring in the surgical ward.

Maintaining safety issue in healthcare facilities is an important aspect for improvement f the scope of practice as it helps the new healthcare professionals to understand the effect of surgical safety standards in surgical wards. Zimlichman et al. (2013) mentions that due to the presence of serious harmful effects of the safety standards breaching in the surgical ward it is important for each of the healthcare facility to implement the vigorous efforts to implement the healthcare standards related to the surgical ward safety and reduce the safety breaching incidences in the healthcare facility (Chartier, 2014)y. Moreover, there are several issues that I identified while working in the surgical wards that contributed to the occurrence of the surgical ward infections and safety hazards. These issues were the involvement of multiple surgeons in one case that created a communication gap in the care process (Runciman, Merry & Walton, 2017). Further, implementing multiple visits in a single surgical procedure also creates a miscommunication and synchronizing care provided by the healthcare facility that leads to breach the safety issues in the surgical ward. Further, researchers Runciman, Merry and Walton (2017) also mentioned that communication is the most important aspect of delivering healthcare as communication determines the synchronized care provided by the healthcare facility and hence, particularly it is an important aspect in the preparatory condition as this process requires complete coordination between medical ward physicians, nurses and the surgical ward surgeons and nurses within which pieces of information such as patient identification, their medication state, their medical record review are transferred (Greene, 2012). Therefore, if communication is affected in this preparatory phase, then the complete process increases its risk and hazard affecting the patient health. Therefore, safety is a major concern that allows me to improve my healthcare skills and help me to achieve my rights and responsibilities as a nurse while caring for the patients (Chartier, 2014).

Module 2

Confidentiality is termed as one of the most important aspect while caring for patients as it helps the person to keep the healthcare providers to make the personal and medical information of the patient private till the moment they receive consent from the patient to share such information with his or her family or healthcare professionals (Holloway & Galvin, 2016). Confidentiality is an important ethical consideration of the healthcare procedure as in the course of medication, there are several personal pieces of information that the patient share with the healthcare professional (Nelson & Staggers, 2016). Therefore, in the absence of confidentiality, the patient-physician relationship will be affected and the patient will not be able to share any sensitive information with the healthcare professionals (Chib, van Velthoven & Car, 2012). Therefore, this ethical consideration should be followed by the healthcare facilities and professionals to create an environment of trust and belief in the healthcare facility and provide the patient with quality and honest health care. While working in the healthcare facility I was also aware of the confidentiality related ethical law, However, there are situations in which the ethical and legal implications of this confidentiality law contradict each other (Rodrigues et al., 2013). There are instances in the healthcare process when ethically it is not effective to share the personal information of the patient with his family of professionals in the facility, however, legally, not informing others harms the patient more. Researchers Chib, van Velthoven and Car (2012) also mentioned this fact that providing confidentiality to the patient is applicable till the information in nonhazardous and does not harm the patient.

While discussing the impacts that could arise from non-compliance to healthcare issues are associated with lawsuit damage, termination, criminal charges, reputation. These impacts are very much effective in affecting the career of the healthcare professionals as the breaching of any kind of ethical considerations are not accepted in the healthcare facility (Rodrigues et al., 2013). The Australian Nursing and Midwifery association determine the fact that healthcare professionals need to be completely competent to the ethical considerations, but it also provides the right of beneficence as per which, if the healthcare professional breach any law for the benefit of the patient, it will not be determined as the breaching of policy (Viceconti, Hunter & Hose, 2015). Further, it also mentioned that there are several legal and ethical responsibilities that the healthcare professionals have to maintain and safeguard the confidentiality and discretion of the patient for the benefit of the patient as well the society (Holloway & Galvin, 2016). Therefore, from an ethical point of view, this seems effective, however, in situations where such confidentiality could harm the patient both mentally and physically, the healthcare professionals need to share this information and in this situation, no such harmful implications are imposed on them (Nelson & Staggers, 2016). Hence, the lawsuit damage, criminal charges, termination, and several other negative impacts are not imposed on healthcare professionals (Rodrigues et al., 2013). Decker et al. (2013) also mentioned that prior to imposing a penalty on the breaching of the healthcare ethical considerations the board of ethics assessed all the aspect of the breaching procedure so that a complete understanding of the situation could be understood and they can use this assessment in determining the reasonableness of such breaching. Therefore, maintaining confidentiality is an important part of the healthcare process, however, it is also affected due to contradictory ethical and a legal dilemma (Nelson & Staggers, 2016).

Part B

As discussed in the previous section, I will be discussing the safety issue in the surgical ward and will reflect upon the observations and processes related to safety breaching I witnessed in the surgical healthcare ward from the perspective of the health professional. In the surgical; ward, I witnessed several issues that increased the risk related to the breaching of safety standards and increase the hazardous risks in the facility. These observations helped me to understand that it is very important to maintain effective communication in the surgical process while working with a multidisciplinary team as it will increase the chances of the patient’s health improvement. This concept and observations have completely changed my insight and perspective about illness as I was able to observe processes within the healthcare system that influences the increase in the health complications of the patient and the interventions using which the professionals were able to implement health improvement again in the care process. However, in the course, there are several issues that hindered the healthcare facility to completely eliminate the safety-related hazards and hence, it was an important aspect of the care process. Further, I was also able to witness that every healthcare professional within the surgical ward are in a pressure of completing the work within the specific time period and hence, this pressure makes then vulnerable to safety breaching.

I was able to relate to this while caring for patients in a surgical ward where I witnessed that miscommunication occurred due to the presence of multiple healthcare professionals. This affected the coordination and synchronization of the care process which is important for the health improvement of the patient. This scenario helped me to understand that the presence of multiple surgeons in a surgical ward can affect the patient negatively and hence, prior to working, it is important to build a communication with other healthcare professionals who will be working within the ward for the collective common goal of providing quality and safe care to the patient to mitigate the risk. Therefore, these are the concepts and strategies I was able to observe and implemented in my practice while working in the surgical ward.

References:

Chartier, Y. (Ed.). (2014). Safe management of wastes from health-care activities. World Health Organization.

Chib, A., van Velthoven, M. H., & Car, J. (2015). mHealth adoption in low-resource environments: a review of the use of mobile healthcare in developing countries. Journal of health communication, 20(1), 4-34.

Decker, S., Fey, M., Sideras, S., Caballero, S., Boese, T., Franklin, A. E., … & Borum, J. C. (2013). Standards of best practice: Simulation standard VI: The debriefing process. Clinical Simulation in Nursing, 9(6), S26-S29.

Greene, L. R. (2012). Guide to the elimination of orthopedic surgery surgical site infections: an executive summary of the Association for Professionals in Infection Control and Epidemiology elimination guide. American journal of infection control, 40(4), 384-386.

Holloway, I., & Galvin, K. (2016). Qualitative research in nursing and healthcare. John Wiley & Sons.

Nelson, R., & Staggers, N. (2016). Health Informatics-E-Book: An Interprofessional Approach. Elsevier Health Sciences.

Rodrigues, J. J., De La Torre, I., Fernández, G., & López-Coronado, M. (2013). Analysis of the security and privacy requirements of cloud-based electronic health records systems. Journal of medical Internet research, 15(8).

Runciman, B., Merry, A., & Walton, M. (2017). Safety and ethics in healthcare: a guide to getting it right. CRC Press.

Viceconti, M., Hunter, P. J., & Hose, R. D. (2015). Big data, big knowledge: big data for personalized healthcare. IEEE J. Biomedical and Health Informatics, 19(4), 1209-1215.

Zimlichman, E., Henderson, D., Tamir, O., Franz, C., Song, P., Yamin, C. K., … & Bates, D. W. (2013). Health care–associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA internal medicine, 173(22), 2039-204