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A. Discuss a systems-level safety concern in a healthcare setting by applying the situation, background, assessment, recommendation (SBAR) format by doing the following:
Describe a healthcare-related situation (S) prompting a systems-level patient safety concern that has the potential to impact multiple patients.
Analyze background (B) information about the concern by doing the following:
a. Describe the data that support or would support the need for change.
b. Explain how one or more national patient safety standards apply to this situation.
Assess (A) the impact of the safety concern on the patient(s), staff, and the organization as situated in the identified healthcare setting.
a. Explain how the safety concern affects value for the patient(s) and the healthcare setting.
Recommend (R) an evidence-based practice change that addresses the safety concern.
a. Discuss how this recommendation aligns with the principles of a high-reliability organization.
b. Describe two potential barriers to the recommended practice change.
c. Identify two potential interventions to minimize the barriers from part A4b to the recommended practice change.
d. Discuss the significance of shared decision-making among the healthcare settingâs relevant stakeholders in implementing this recommendation.
e. Describe an outcome measure that could be used to evaluate the results of the recommendation.
f. Describe the care delivery model currently being used in the healthcare setting.
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Sample Answer
SBAR for a Systems-Level Safety Concern in a Healthcare Setting
S – Situation:
Description: Frequent medication errors, specifically instances of wrong medication administration, are occurring on a medical-surgical unit within a community hospital.
B – Background:
Data Support:
Recent internal audit reports reveal a significant increase in medication errors on the unit over the past quarter.
Root cause analysis of these errors points to several recurring factors:
High patient acuity and workload for nurses.
Distractions in the medication administration process (e.g., phone calls, interruptions).
Poor medication labeling and packaging.
Lack of standardized medication administration procedures.
Full Answer Section
National Patient Safety Standards:
The Joint Commission Standards: These standards emphasize the importance of safe medication practices, including proper medication reconciliation, accurate medication administration, and the use of safety checks.
National Patient Safety Goals: The Joint Commission’s National Patient Safety Goals specifically address the need to improve the accuracy of patient identification and medication administration.
A – Assessment:
Impact on Patients:
Medication errors can have serious consequences for patients, including adverse drug reactions, prolonged hospital stays, and even death. 1 Â
1. www.studocu.com
Impact on Staff:
Frequent medication errors can lead to increased stress, burnout, and decreased job satisfaction among nurses.
Impact on the Organization:
Medication errors can result in increased costs due to prolonged hospital stays, legal liabilities, and reputational damage.
Value for Patients and the Healthcare Setting:
Implementing effective medication safety measures enhances patient safety, improves patient outcomes, reduces costs, and strengthens the organization’s reputation for quality care.
R – Recommendation:
Recommendation: Implement a bedside medication verification process using a combination of barcode scanning technology and independent double checks.
Alignment with High-Reliability Principles: This recommendation aligns with the principles of high-reliability organizations by emphasizing standardization, redundancy, and a strong safety culture.
Potential Barriers:
Resistance to change: Nurses may resist the implementation of new procedures and technologies.
Cost of technology: Implementing barcode scanning technology and integrating it with the electronic health record (EHR) can be costly.
Interventions to Minimize Barriers:
Engage staff in the change process: Involve nurses in the planning and implementation of the new medication administration process to address their concerns and gain their buy-in.
Provide comprehensive training and ongoing support: Conduct thorough training sessions on the use of barcode scanning technology and the new medication administration procedures.
Pilot test the new system: Conduct a pilot test on a smaller scale to identify and address any potential issues before full implementation.
Shared Decision-Making:
Involve all relevant stakeholders in the decision-making process, including nurses, pharmacists, physicians, and hospital administrators. This will ensure that all perspectives are considered and that the chosen solution is feasible and sustainable.
Outcome Measure:
Track the number and types of medication errors before and after the implementation of the new medication administration process.
Monitor patient outcomes, such as length of stay and readmission rates.
Conduct surveys to assess staff satisfaction and perceptions of medication safety.
Care Delivery Model:
The current care delivery model likely involves a traditional nurse-patient assignment model.
Consider implementing a team-based approach to patient care, which can improve communication and coordination among healthcare providers.
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