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This week's graded discussion topic relates to the following Course Outcome (CO). • CO2: Demonstrate leadership strategies that promote safety and improve quality in nursing practice and increase collaboration with other disciplines when planning patient-centered care within systems-based practice. (PO2) • CO7: Compare and contrast the professional nursing roles for ADN/diploma through PhD/DNP prepared nurses in providing cost-effective, quality healthcare in structured and unstructured systems How do nurses promote patient safety and improve quality at your workplace (or previous clinical setting)? What changes would you suggest be made on your unit or facility to improve a nonpunitive culture of safety? As nurses, we strive to provide the highest quality of care to our patients and even their family members while also ensuring their safety and our work environment. Just like how we are life long learners, our work environment must also continuously promote safety and improve quality care. In my current workplace, almost every policies and protocols that we have are implemented for this purpose. For example, we always use at least two identifiers to verify correct patient before performing a task or procedure with a patient, such as obtaining blood specimen or administering medication. We also give importance to the actions of our staff members including proper hand hygiene to prevent cross contamination and infection. These simple yet very significant guides were derived from evidence-based practice and could also be found on the Hospital National Patient Safety Goals which is developed and released by The Joint Commission on Accreditation of Healthcare Organization or JCAHO, also known as the Joint Commission, and the Centers for Medicare and Medicaid Services or CMS on a yearly basis (The Joint Commission, 2019). Majority, if not all, of the health care workplace are accredited by the Joint Commission. They have been making contributions in promoting high quality health services for decades by promoting quality standards for accreditations across the United and States as well as internationally (Hood, 2018). Other ways we promote safety and improve quality care more specific to nurses are the different committees we have in our unit. Our Fall committee ensures the safety of our patients through analysis and implementation of fall precautions. Our Sepsis committee focuses on the early recognition of an infection and early interventions to prevent deteriorations of our patients; in tune with them is the CLABSI/CAUTI committee who focuses more on the central lines and Foley catheter related infections. We also have our Nursing Quality Review committee or NQR which looks over the entirety of our unit through auditing and finding out our weakest area in order to implement interventions that would improve it. I think my workplace is already well on its way to promoting safety and continuously improving quality care. If there is anything that I would suggest, it would be real-time auditing. I think it would help us to decrease errors made and even prevent them if we could have second set of eyes for specific things such as the ones we are auditing. For example, our blood transfusion audits are a month of two behind, and by the time a correction is made, it is already too late to a point that the nurses can’t even remember the event. We are recently conducting real-time auditing on our restraint charting to avoid fall outs since restraints is a very serious matter. One of the members from the NQR committee audits the patient’s chart who is on restraints, and if there is any mistake on the charting, the nurse is notified as soon as possible during the shift. It is a nonpunitive culture of safety as nurses view it as a helping hand rather than a memo or warning coming from the higher ups. References Hood, L. J. (2018). Leddy & Pepper's professional nursing (9th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. The Joint Commission. (2019, January 28). Hospital: 2019 National Patient Safety Goals. Retrieved from The Joint Commission:

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