NURS 1001- Nurses Role in Organizational Safety

Content

1. Quality Care
2. Safety
3. Discrimination in Healthcare

Quality Care

• Patient-centered
• Safe
• Effective
• Timely
• Equitable
• Collaborative
• Comprehensive
• Continuous improvement

Accrediation Canada

“Accreditation is an ongoing process of assessing health care and social services organizations against standards of excellence to identify what is being done well and what needs to be improved” (Accreditation Canada, 2023).

• Accreditation process
• Standards
• Continuous improvement

Professional Standards

“Authoritative statements that a profession uses to describe the responsibilities for which its practitioners are accountable (Kily, 2005; Peters, 1995).

• College of Nurses of Ontario (CNO)
• Practice Standards
• Practice Guidelines

Best Practice Guidelines

Best practice guidelines (BPG) are systematically developed, evidence-based documents that include recommendations for nurses, interprofessional health teams, educators, leaders and policy-makers on how to improve outcomes for people and their support networks.” (RNAO, 2023)

• >50 BPG
• 9 Health sectors

Nurse Sensitive Outcomes

Patient outcomes that are directly influenced by nursing care

Examples:

• Patient satisfaction
• Patient safety
• Medication errors
• Length of hospital stay
• Readmission rates

Leadership Impacting Quality Care

Effective leadership impacts quality care by:

• Prioritizing quality improvement
• Promoting safety culture
• Strong communication
• Being accountable
• Using evidence informed decision making
• Being regulatory compliant
• Being a role model

Safety

Patient Safety

“the reduction of risk of unnecessary harm associated with healthcare to an acceptable minimum” (Potter & Perry, 2022).

Healthcare Excellence Canada (2020) Six Core Safety Competencies for HCP

• Patient safety culture
• Teamwork
• Communication
• Safety, risk and quality improvement
• Optimize human and system factors
• Recognize, respond to and disclose patient safety incidents

Nurse Safety

Well-being and protection of nurses in the workplace

Strategies to promote nurse safety:

• Safe staffing levels
• Training and education
• PPE
• Ergonomics
• Violence prevention
• Physical safety
• Fatigue management
• Professional development

Organizational Safety

Creating a culture that prioritizes safety at all levels, across all departments

Strategies to promote organizational safety:

• Proficient leadership
• Safety commitment
• Safety policies and procedures
• Reporting systems
• Root cause analysis for critical events
• Performance metrics
• Audits
• Infection control

Positive Workplace Culture

Characteristics of positive workplace culture:

• Respect and inclusivity
• Clear communication
• Teamwork and collaboration
• Empowerment
• Recognition and appreciation
• Fairness and equity
• Organizational values
• Conflict resolution
• Safety

Sentinel Event

“A sentinel event is a patient safety event that results in death, permanent harm, or severe temporary harm. Sentinel events are debilitating to both patients and health care providers involved in the event.” (The Joint Commission, 2023).

Safety Culture (Nurse)

• Zero violence policies
• Prevention of nurse-fatigue
• Foster key values
• Staff health and well-being

Safety Culture (Patient)

Everyone involved is committed to maintaining a safety environment.

Three components:

• Just culture
• Reporting culture
• Learning culture

Nurses Role in Safety Culture

• Assessing risks
• Patient safety
• Reporting incidents
• Collaboration
• Advocacy
• Personal safety
• Research

RNAO HWE BPGs

• Collaborative Practice Among Nursing Teams
• Developing and Sustaining Effective Staffing and Workload Practice
• Developing and Sustaining Nursing Leadership
• Embracing Cultural Diversity in Health Care: Developing Cultural Competence
• Professionalism in Nursing
• Workplace Health, Safety and Well-being of the Nurse

HWE Framework

Occupational Health Nurse

• Disability management
• Health and safety programs
• Health promotion initiatives
• TB maintenance
• Health assessment
• Health education
• Outbreak surveillance

Discrimination in Healthcare

Cultural Safety

• Cultural awareness and competence
• Self- reflection
• Respect for cultural identity
• Equity and social justice
• Non-discrimination
• Recognition of trauma and historical context.
• Reporting and accountability

“Othering”

“Othering, is described as a social process whereby a dominant group or person uses negative attributes to define and subordinate others” (Roberts & Schiavenato, 2017).

Impact on patient safety

• Miscommunication
• Bias and stereotyping
• Patient engagement
• Access to care
• Disparities in care

Gender Discrimination

Women

• Less likely to have senior/leadership roles
• Pay inequities
• Workplace violence and sexual harassment

Men

• Disproportionate heavy lifting assignment
• Exclusion from some areas of nursing
• Mistaken identity

Racism

Impacts of racism in healthcare

• Health disparities
• Access to care
• Quality of care
• Implicit bias
• Maternal mortality
• Mental health disparities
• Structural racism

Systemic Racism

• Attitudes and structures
• Early colonization values
• Unconscious bias
• Confronting stereotypes

Nurses Role in Preventing Discrimination

What is the nurses role to address racism and discrimination?

• Self awareness
• Advocate
• Cultural Competence
• Report incidents
• Anti-racism education
• Support for colleagues
• Policies and procedures
• Promote equity
• Engage with community

CNO’s Code of Conduct

Principle 2 : Nurses provide inclusive and culturally safe care by practicing cultural humility

Empowering Nurses to Change the System

A Call to Action

1. Acknowledge the problem
2. Become educated
3. Make a commitment

Summary

We have explored many issues related to safety, racism, discrimination, and patient care. We discussed the specific impact to nurses and patients when in unsafe healthcare organizations. We highlighted the importance of the nurses role when eliminating stereotypes and systemic racism. Workplace safety culture can impact the overall wellness and role satisfaction for nurses and positively impact patient care.