The Surgical Intensive Care Unit (SICU) in the hospital section admits critically ill patients who have just had or potentially need surgery. The multidisciplinary team at SICU provides close supervision and monitoring for the patients and deals with a multitude of conditions. Since the unit deals with critical situations, the nursing personnel must establish a patient treatment and safety practice that allows nurses to handle various healthcare issues.
What is a Culture of Patient Safety
The framework of patient safety is based on seven main factors – leadership, evidence-based practice, teamwork, communication, learning, just, and patient-centered culture (Sammer & James, 2011). The cooperative interaction between these factors allows the nursing personnel to provide the best level of service to the patients. However, as in the scenario of Hospital Hope, which will be described next, the absence of an established patient safety practice poses a threat to the security of the patients. In this case, the nursing personnel is pushed to establish a culture that will allow for high-quality patient care.
Patient safety is regarded as one of the essential practices in the nursing field. According to WHO (2021), it is crucial to provide high-quality, safe patient care since it allows patients not to lose trust in the medical field. The patient safety culture consists of practices, beliefs, “processes, procedures, behaviors, technologies, and environments in health care” (WHO, 2021), facilitating high-quality care and lowering the risks of accidental harm. In order to limit the sources of potential injuries in the hospital, those in the medical field must work together to create an evidence-based patient safety culture.
Summary of the Hospital Hope Scenario
In the hypothetical scenario described by Sammer and James (2011), a 73-year-old widow Mrs. Jackson is admitted to Hospital Hope, a local suburban hospital with a good reputation. Mrs. Jackson is an active and healthy family woman, active in her community, and a mother to two adult daughters (Sammer & James, 2011). As an uninformed individual, she is not aware of the dangers of the statistics of hospital-acquired infections or central-line-associated bloodstream infections (Sammer & James, 2011). When she is admitted for diagnosis because of a documented systolic heart murmur, asymptomatic until recently, she is given aortic valve replacement surgery and then placed in SICU (Sammer & James, 2011). However, while in SICU, she develops three different conditions stemming from the lack of patient safety culture in Hospital Hope. Although Mrs. Jackson recovers, she worries about her daughters and grandchildren about the onset of hospital pneumonia, a central line infection, and hypoglycemia (Sammer & James, 2011). The resultant physical, mental, and financial strains could have been avoided if the hospital had an established patient safety practice.
What Caused the Changes
Cultural change, no matter the scale, requires a paradigm shift. Therefore, it was vital for the personnel to not only receive instructions from the leaders on how they should change their behavior but change their attitude. Apart from the training required for the personnel to adequately respond to various crises in the hospital, they must monitor and recognize any potential risks and problems. The nursing leaders in Hospital Hope conducted a questionnaire that showcased the perceptions the staff had of the existing patient safety culture. The patient safety survey resulted in under 50% affirmative responses on the subject of existent culture in the hospital. Therefore, it was clear that changes had to be made, and managed by the leaders.
What Were the Changes Made
The first step toward improving patient safety in the hospital was measuring the existing structures. The next step the leadership took was joining the Institute for Healthcare Improvement (IHI) in an attempt to become an evidence-based organization (Sammer & James, 2011). Then, further research into the problematic safety areas in the hospital was made, which required teamwork from the nurses. The communication between the staff and the hospital’s leadership allowed for an efficient flow of information and learning. Recognizing the problem areas and learning from the previous mistakes permitted the team to improve patient safety, hence advancing the level of patient care. The collaboration of the different professionals led to a mutually beneficial change and growth rooted in fairness to all patients.
Which Framework I Would Use
Evidence-based practice is the most efficient and beneficial framework for the creation of a patient safety culture, in my opinion. According to this framework, the problem must be assessed, reviewed, and solutions must be found based on the issues that have arisen in the past. The conjunction of leadership, teamwork, communication, a learning culture, a just culture, and a patient-focused culture allows for informed decisions and lasting practice. The administration must take on the role of innovators; however, consider the everyday experiences of the other staff for the most effective changes. It is essential to remain patient with the results since it is likely that the changes will not be instant.
The changes, as mentioned above, must entail a paradigm shift in the hospital. Therefore, it is vital to communicate between the different layers and departments in the facility for the most inclusive solution. It is most crucial to remember that the policies must be patient-focused and guarantee decreased hospital risks. The integration of such policies would benefit both the patient and avoid the various levels of stress and the hospital that would avoid fixing the mistakes made. Although various scenarios and frameworks are helpful in theory, the leadership of the hospital needs to adopt an approach for the specific situation of the facility.
Sammer, C. & James, B. (2011). Patient safety culture: The nursing unit leader’s role. OJIN: The Online Journal of Issues in Nursing, 16(3), Manuscript 3.
World Health Organization. (2021). The third draft of the Global Patient Safety Action Plan.