Key messages for nursing regulation from the National Patient Safety Foundation report Free from Harm: Accelerating Patient Safety Improvement.
Additionally, because efforts in the past have focused primarily on hospitals, the panel suggested improvement efforts must be across the healthcare continuum. Patient safety must be seen as a public health issue. As the report indicates, to continue progress in patient safety and to keep patients free from harm, a commitment by all stakeholders, including nursing regulation, will be needed.
The expert panel developed eight recommendations with specific action steps, some of which may impact the regulation of healthcare and healthcare providers. These recommendations are aimed at forging a path forward in order to prioritize further improvements in the safety and quality of care. The recommendations are aimed at making fundamental, widespread improvement in patient safety and are to:
1. Ensure that leaders establish and sustain a safety culture;
2. Create centralized and coordinated oversight of patient safety;
3. Create a common set of safety metrics that reflect meaningful outcomes;
4. Increase funding for research in patient safety and implementation science;
5. Address safety across the entire care continuum;
6. Support the health care workforce;
7. Partner with patients and families for the safest care; and
8. Ensure that technology is safe and optimized to improve patient safety (NPSF, 2015).
The key messages for nursing regulation include:
* Although many improvements in patient safety have occurred, much work remains;
* Improvements need to be across the healthcare continuum;
* When investigations of violations of Board of Nursing (BON) Rules are initiated, there needs to be consideration of the safety culture of the organization that employed the nurse, including:
** Full disclosure of errors when errors occur;
** Bedside report and rounding;
** Patient involvement in root cause analysis;
** Active and engaged Peer Review Committees;
** Existence of organizational patient advisory councils; and
* Public awareness of the mission and patient safety consideration of the BON.
The eight key recommendations made by the expert panel offer an opportunity for the BON to evaluate the Board Rules, resources, and tools in consideration of current best-practices in patient safety. The crosswalk in Table 1 provides an evaluation of the Board Rules, resources, and tools that demonstrates alignment with the key recommendations made by the expert panel.
In summary, improving patient safety has become a national initiative, calling on all stakeholders, including patients and their families, to engage in ensuring a safer experience within the health care system by being an informed participant with the interdisciplinary care team. This requires continuous learning and clear communication of information among providers, organizations and patients, with the goal of promoting a safe patient care environment. Nursing regulators and nurses have a key role in improving patient safety. The BON routinely engages in the evaluation and analysis of updates and recommendations for healthcare improvement, compared to current rules and regulations for evaluation of continued pertinence and relevance, as evidenced by the NPSF recommendations and BON crosswalk. The BON remains committed to engaging in a proactive approach to nursing regulation that demonstrates integrated awareness of key environmental changes.
National Patient Safety Foundation. (2015). Free from Harm: Accelerating Patient Safety Improvement Fifteen Years after To Err Is Human. Boston: National Patient Safety Foundation.
Institute of Medicine. (1999). To Err Is Human: Building a Safer Health System. Washington DC: National Academy Press.
The Texas Board of Nursing. (2010). Differentiated Essential Competencies of Graduates of Texas Nursing Programs. Austin: The Texas Board of Nursing.
The Texas Board of Nursing. (2015). Rules and Regulations Relating to Nurse Education, Licensure and Practice. Austin: The Texas Board of Nursing.
Table 1--Crosswalk of NPSF (2015) Recommendations to 217.11. Standards of Nursing Practice and Differentiated Essential Competencies of Graduates of Texas Nursing Programs (DECs) NPSF Recommendation Standard of Practice Relationship 1. Ensure that 217.11.(1)(S): Standards are leaders Make loosely establish & assignments related. B sustain a that take into speaks broadly safety culture consideration to "safe knowledge, environment" skill and that is an ability element of safety culture. 217.11.(1)(B): Promote a safe environment 217.11.(1)(N): Clarify any order or treatment as needed 217.11.(1)(T): Accept assignments that take into consideration knowledge, skill and ability 2. Create 217.11.(1)(P): Loosely associated- centralized & Collaborate with the speaks to coordinated client and members collaboration oversight of patient of the healthcare safety team 3. Create a common 217.11(2)(A)(v) & Evaluating responses set of safety (3)(A)(v): Assist in to nursing metrics that reflect the evaluation and/ interventions using meaningful outcomes or evaluate client's a systematic responses approach 4. Increase funding N/A N/A for research in patient safety & implementation science 5. Address safety 217.11(1)(B): Promote safe across the entire Promote a safe environment; clarify care continuum environment orders; consult to achieve continuity 217.11.(1)(N): of care Clarify any order or treatment as needed 217.11(1)(A): Follow all laws, rules and regulations 217.11.(1)fT): Accept assignments that take into consideration knowledge, skill and ability 6. Support the 217.12(6)(F): Disruptive health care Misconduct that is behaviors; workplace workforce based upon an action violence that is threatening or violent behavior in the workplace 7. Partner with 217.11(1)(P): Collaboration with patients and Collaborate with the patients and others; families for the client and members Education safest care of the healthcare team 217.11(1)(F): Promote/ participate in education to clients and families 217.11(1)(B): Promote a safe environment 8. Ensure technology 217.11(1)(H):Obtain Orient & train on is safe & optimized orientation/ new equipment & training for technology competency as needed NPSF Recommendation DECs Relationship 1. Ensure that I A-D: II D; > Scope of leaders III A-F: practice establish & Be a member of sustain a the profession > Responsibility safety culture and a patient & accountability safety advocate, > Safe providing compassionate, patient comprehensive centered care, nursing care through adherence to all laws, scope of practice, responsibility and accountability for quality, promoting the development of nursing practice, and ensuring continuing competence through life- long learning. 2. Create I A-D; II A-C : Be a > Scope of practice centralized & member of the coordinated profession, > Responsibility & oversight of patient providing patient accountability safety centered care in collaboration with the healthcare team and through adherence to scope of practice, responsibility and accountability for quality, promoting the development of nursing practice, and ensuring continuing competence through life-long learning 3. Create a common II C: Report, > Assessment data to set of safety analyze and identify problems, metrics that reflect synthesize data for formulate goals, & meaningful outcomes the development of develop plans of goals/outcomes in care collaboration with the healthcare team. 4. Increase funding NA N/A for research in patient safety & implementation science 5. Address safety I A; II D; III A-F; > Scope of practice across the entire IV A-G: Be a member care continuum of the profession by > Provide safe, functioning within compassionate care the scope of practice in > Knowledge of NPA & accordance with all Rules laws and rules, providing patient > Collaboration, centered care in the communication provision of safe, compassionate nursing care, advocating for patient safety when accepting assignments and seeking instruction as needed, and collaborating with the healthcare team in the promotion of optimal health. 6. Support the NA NA health care workforce 7. Partner with II D-H; III A-F; IV > Develop, patients and A-G: Provide patient implement, & families for the centered care , evaluate care with safest care safe, compassionate, patients & families quality nursing care, advocating for > Communicate, patient safety when collaborate; communicating Referrals; Advocate important patient data and information with the healthcare team to collaborate in the formulation of goals that promote optimal health. 8. Ensure technology IV E: Be a member of > Using technology is safe & optimized the healthcare team to support decision- by communicating making patient data using technology to support decision- making and improve patient care.
|Printer friendly Cite/link Email Feedback|
|Publication:||Texas Board of Nursing Bulletin|
|Date:||Jul 1, 2016|
|Previous Article:||Texas Board of Nursing meeting schedule.|
|Next Article:||What do nurses know about choosing wisely?--What the survey data reveals ...|