The problems of the continuous quality improvement of rendered care and safe working conditions of the nursing personnel are among the most urgent for health care systems as they directly influence not only the health of nursing staff but also the quality of rendered health care in general and, as a result, the health of patients. The factors, which put the activity of the nursing staff under threat, include the threat to be infected while working with biological liquids, chemical reagents (disinfectants, medicines, wastes of anesthetizing gases); the threat to be radiated (x-ray devices, waste of isotopes, radioactive allocations of patients after their isotope research (urine, excrements, emetic masses); the threat of physical violence and stress as a result of the impact of an adverse psychological situation (Stone, Hughes, & Daily, 2008). The given essay discusses the implementation and support of safety systems in the nursing environment and the continuous quality improvement of the work of the nursing personnel.
The innovative activity in the nursing process is considered to be the basis of the daily practice directed at the improvement of patient care quality and depreciation of health system services. The need for innovative solutions and continuous quality improvement (CQI) is very high as health systems strive for ensuring available, safe, and effective services at the simultaneous control of the growth of their prime cost. Innovators and practicing nurses play an important role in the realization of innovative projects. Recently, the professional functions of the nursing personnel intensively change in accordance with new tasks of the improved health care system. Therefore, the activity of the nursing personnel has to conform to the changing requirements of the population to qualitative medical care.
According to the Emergency Nurses Association in the United States, focused on the issues of nurses’ safety in the workplace, most often, the cases of violence occur in the emergency service, the psychiatric office, and intensive care units. At the same time, the departments of obstetrics and gynecology and also surgical and pediatric offices are the most favorable for the nursing staff safety (Hughes, 2008, p.2). However, not all cases of violence become known because many nurses are convinced that violence in the workplace should be taken for granted within the work. According to the research published in the Journal of Clinical Nursing, three-quarters of the interviewed nurses regularly suffer from violence in the workplace. Around 90% of nurses suffer from verbal violence, and more than half of respondents were attacked during the treatment of patients (Stone et al., 2008).
In the article “Practice Implications of Keeping Patients Safe,” Page (2008) states that nursing interventions into patient safety require necessary changes in the health care system at all levels, namely:
(1) the experience of patients during their interactions with individual clinicians; (2) the functioning of small units (microsystems) of care delivery such as surgical teams or nursing units; (3) the practices of organizations that house the microsystems; and (4) the environments of policy, payment, regulation, accreditation, and other factors external to the actual delivery of care that shapes the context in which health care organizations deliver care.
Medical experts consider that the development of CQI among nursing staff is called to promote the strengthening of the scientific basis of the nursing process, leading to an increase of nurses improving the quality of nursing care. The CQI of nursing staff depends on the changes of such external and internal conditions of their activity as the growth of the volume of the medical information and the speed of its updating, the emergence of the highly active medicine and the hi-tech diagnostic methods, treatment, and care, as well as the increase in knowledge. Therefore, the development of the safety systems and CQI of the nursing personnel in the United States are called to maintain the scientific base of the nursing practice, thus, increasing the number of researches directed at the nursing practice.
According to Stone et al. (2008), the CQI requires the introduction of innovative technologies in the post-degree education, one of which includes the accumulative system professional development (ASPD). It represents the organization of the stage-by-stage individual training of nursing workers for the purpose of the deepening of their theoretical knowledge and the improvement of the quality of the practical activities allowing realizing individual interests and professional requirements already available for them. These training programs are aimed at spreading the professional knowledge and the increase of nursing safety (Stone et al., 2008).
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The CQI promotes the growth of the activity and insistence of all workers, their creative approach to the solution of tasks facing them. The successfully applied programs of continuous quality improvement can completely change any medical institution, make it innovative, and increase the level of the professional satisfaction of workers.
According to Clarke and Donaldson (2008), the CQI among nursing staff is aimed:
· To develop a strong orientation at a patient;
· To continuously improve all processes, using a cycle “plan, make, check, and act”;
· To involve nurses in the process, applying the cycle “approve, learn, support and glorify their progress”;
· To make decisions on quality improvement, allocating the most important purposes for improvement;
· To develop the conscious understanding of true motives;
· To encourage the free statement of opinions and ideas (Clarke & Donaldson, 2008).
The care environment has elements, which negatively influence the health of both medical personnel and patients. Patients are found in the vulnerable environment, affected by external factors such as the state of health, stress, or fatigue of the nursing staff. They suffer physically and psychologically both from the disease and the care environment unusual for them. It is necessary to eliminate the influence of risk factors on a patient and to create such conditions, which will ensure safety for a patient (Stone et al., 2008).
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Being one of the main skills necessary for qualitative nursing activity, effective communication in the nursing profession leads to healthy, interdisciplinary teams. The nursing business, along with the benevolent, technically competent implementation of the medical procedures and manipulations, means the communication of the nurse with the patient experiencing the physical and psychological difficulties, suppressed, scared, or aggressive (Hughes, 2008, p.4). The value of the psychotherapeutic effect, possible at effective communication can surpass all the other treatment methods. The skills of communication are necessary for effective interaction with the nurses, doctors, and other experts participating in the nursing process. They help to avoid the misunderstanding in nursing interactions, thus making it more professional and safe.
The tasks assigned to the nurse make her work many-sided and rather difficult. The impact of a large amount of the adverse risk factors connected with the conditions and the nature of the nursing work negatively influence the state of health of both health workers and patients. The adverse effects of the risk factors lead to the development of intra-hospital infections, the development of various diseases, disabilities, and life threats. The unfavorable conditions of the care environment lead to the appearance of the interhospital diseases and the violation of the safety of patients and the nursing staff. The ability to control the safety at the workplace is one of the most important conditions of nursing.
The correctly organized work of the nursing personnel will help the patient to quickly adapt to the care environment and cope with a disease without any harm to the health. Nurses have to eliminate the impact of risk factors on patients and create the conditions which will ensure safety to the patient during the treatment period. The organization of the work of any hospital is directed at the creation of a safe environment both for the patients and for health workers. Thus, it is important for nursing personnel to participate in the creation and development of safe systems in the workplace. Also, there is a correlation between the introduction of innovative technologies into the practical activity of the nursing staff and the CQI. The more technological and safe the process is, the more time is paid to the patient, the higher the quality of the nursing service is. The application of the innovative technologies in the everyday nursing practice does this work more professional and comfortable, provides safety, reduces the expenditures, and allows realizing the treatment process.
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Thus, all the problems connected with the creation of the safe working conditions of health workers are represented in several points. It is low knowledge of the nursing staff about the potential threats, the formal execution of the protective measures, the lack of the personified accounting of the incidence of health workers, and the insufficient number of the devices ensuring the safety of workers. The nursing personnel contributes greatly to the creation and development of safety systems, which can protect the life and health of nurses.