National Patient Safety Awareness Week (March 11 – 17) focuses attention squarely on one thing at the top of every nurse’s list – keeping patients safe.
Minority Nurse spoke with Patricia McGaffigan, RN, MS, CPPS, vice president, safety programs at the Institute for Healthcare Improvement (IHI) about the ongoing issues around patient safety and how nurses can continue to implement positive and productive change.
While nurses provide a majority of care in inpatient settings, McGaffigan says the issue of patient safety extends to a wider setting as interprofessional teams are responsible for so many levels of care.
Because of the nurse’s role, they are especially able to impact patient care. “Nurses represent the largest segment of the healthcare workforce, in roles that range from the bedside to the boardroom,” says McGaffigan. “One specific and relatively easy way that nurses can effect change is to become educated in foundational safety science.” Nurses who aren’t trained in safety science can obtain training, and many student nurses receive the training as part of the curriculum. “Nurses are perfectly positioned to be able to identify risks and hazards in their work environments that may be mitigated before harm occurs, and this daily commitment to mindfulness about preventing harm before it happens is vital.”
As nurses, ongoing education, and maintaining and obtaining appropriate certifications help nurses provide the optimal care when they are with patients. Consistency in providing care and following a standard of care plan help patient outcomes as well.
“Nurse-sensitive indicators that reflect structure, process, and outcome are of great importance to nurses.” she says. “As a profession, we want to ensure that we have appropriate numbers of skilled nursing professionals who are able to meet the unique needs of patients and families. Process measures are focused on ensuring that we deliver the right care in a consistent and reliable manner.”
Patient harm can result when there is a lack of guidance or an absent standard to follow, says McGaffigan. For instance, harm can result when patients aren’t regularly repositioned or when oral care in ventilated patients is neglected. Other areas of particular importance include medication errors, falls, hospital-acquired infections, or complications, and other injury.
To provide the best care, nurses must also be able to care for themselves. If they are overly fatigued, do not feel supported or able to thrive in their organizations or if they are working in an organization where a culture of safety is not emphasized, patients cannot receive optimal care and nurses themselves might be at greater risk.
“Nurses are increasingly and very appropriately focused on their own physical and emotional safety, as well as cultures of safety,” she says.
The interactions that build relationships between nurses and patients are key to keeping patients safe. “Nurses are often the profession that has the most interaction with patients and families,” says McGaffigan. “We can consistently strive to identify the needs and preferences of patients and families, and also ask patients and family members what matters to them, and what they might be worried about.” McGaffigan knows this first hand. “As a former pediatric critical care nurse, one of my greatest ‘early warning systems’ was when a parent might tell me that ‘something just doesn’t feel right about my child,’” she says.
When errors do happen, a transparent process to understand what went wrong, assess the cause, and prevent future harm is essential. “Punitive cultures exacerbate reluctance to report near-misses and errors,” says McGaffigan. “Nurses can become more familiar with Surveys of Patient Safety Culture, identify areas where unit and organizational performance is stronger or weaker, and play a key role as leaders and participants in initiatives to improve scores on their survey domains.”
Patient safety continues to evolve as new medical technologies are introduced and as patient care continues to become more complex and more challenging.
“Nurses, as well as our other colleagues in healthcare, have chosen our profession because we have a core value of ensuring that our care is not only technically sound and appropriate, but is safe,” says McGaffigan. “As nursing professionals, we come to work every day to ensure nothing less than safe care. Whether we are in traditional roles at the bedside or as nursing leaders, educating our next generation of nurses, sitting on boards of directors of health care organizations, serving in formal patient safety positions, contributing to progress in the medical device and pharmaceutical industries, or more, we individually and collectively embody safety as our core value.”
Those who enter the profession do so knowing they are often a patient’s greatest advocate and a crucial partner in receiving the best care. “We are committed to creating a world where patients are free from harm,” she says, “and we advocate and anchor our healthcare system to not simply regard safety as ‘one more thing that we do,’ but understand that ‘it is the one thing that must permeate and provide the foundation for all that we do.’”
If you ever need a reason to feel proud of the lifesaving treatment and the compassionate caregiving, you offer every day in your nursing career, the launch of Nursing Now on February 27 is a big one.
In an effort to raise the profile of nursing as a career and as a worldwide factor in improving health, the International Council of Nurses and the World Health Organization are launching Nursing Now across the globe.
Nursing Now is organized by the Burdett Trust for Nursing, a UK-based charitable trust. As nurses’ status increases, their influence will be felt in policy, reputation, and the status of the professional nurse. Nurses themselves can begin to tackle some of the biggest challenges that are facing humanity in the next century.
No matter what location nurses practice, they face similar challenges. They want the best opportunity and training to offer their patients top-notch care so they can lead better and healthier lives on their own and within their communities. Nursing Now will push for those changes, but nurses will see them happen slowly in their own communities and then on a broader national level before becoming a worldwide trend.
The launch is the first step in an initiative that runs through 2020. Nursing Now will support other programs around the world and hep nurses become more able to influence the ways in which they work and effect change with patient and community health.
The initiative has five stated goals:
1. Greater investment in improving education, professional development, standards, regulation and employment conditions for nurses.
2. Increased and improved dissemination of effective and innovative practice in nursing.
3. Greater influence for nurses and midwives on global and national health policy, as part of broader efforts to ensure health workforces are more involved in decision-making.
4. More nurses in leadership positions and more opportunities for development at all levels.
5. More evidence for policy and decision makers about: where nursing can have the greatest impact, what is stopping nurses from reaching their full potential and how to address these obstacles.
Nursing Now recognizes that global change begins as people work together in each and every community. As nurses band together for change, the momentum will grow and impact greater people and reach into higher changes.
The University of North Carolina Chapel Hill School of Nursing will host with United States launch event, and nurses will be able to check the main website throughout the day to learn about other events worldwide.
On February 27, check out Nursing Now and envision and even stronger and more influential nursing future.
The celebration of IV Nurse Day every January 25 recognizes the work infusion nurses do with and for their patients. Infusion nurses are an essential part of the care team, acting to properly care for infusion needs and collaborating with other members of the health care team.
“Challenges in our ever-changing healthcare system combined with new, developing technologies and complex infusion therapies, afford the opportunity for the infusion nurse to use his/her expertise in infusion therapy to provide holistic patient care,” says Marlene Steinheiser, MSN, RN, CRNI®, director of nursing education of the Infusion Nurses Society (INS), Infusion Nurses Certification Corporation.
Of the primary responsibilities of an IV nurse, acting with the patient’s health and welfare in mind is primary. Celebrated since 1980, IV Nurse Day focuses attention on this essential care. “The infusion nurse acts as an advocate for patients receiving infusion therapy, ensuring that safe, quality infusion care is delivered,” says Steinheiser. “Patient assessment, with particular attention to the patient’s vasculature and prescribed therapy, is important so that the appropriate vascular access device (VAD) is selected to accommodate the treatment plan.”
Steinheiser also says that many infusion nurses also take on leadership roles where they provide education and guidance to other nurses while also continually monitoring for complications and setting in motion effective interventions when needed.
Student nurses interested in the career will find infusion nurses are not limited to specific settings. “Infusion nurses’ roles may vary depending upon the practice setting,” Steinheiser says. “Infusion nurses work in many settings, agencies, and organizations including, but not limited to, hospitals, nursing homes, ambulatory infusion clinicals, physician offices, and patient homes.”
According to Steinheiser, expert infusion nurses can help reduce complications by sharing their knowledge and educating patients, family members, and other healthcare team members and always assessing the patient. “Skilled VAD insertion, prevention of complications and early identification coupled with implementation of interventions, minimizes further damage that can result from infusion-related complications,” she says.
Like any nursing career, this branch of nursing requires continual education to stay current with best evidence-based practices that help prevent, reduce, and treat any complications or challenges. “Due to the invasive nature of infusion therapy, infusion nurses can encounter possible adverse events with any infusion, such as extravasation, catheter malposition, nerve damage, or infection,” Steinheiser says. “The infusion nurse is prepared with advanced knowledge and continuing education to promptly address these situations.”
The INS is an excellent resource for current and future infusion nurses. The organization offers free educational podcasts (available to members and nonmembers) where nurses can learn about and refresh their skills for safe infusion practices. And the learning center provides both virtual education and recorded educational sessions from prior conferences and webinars, and what Steinheiser calls a key resource for infusion nurses, the Infusion Therapy Standards of Practice.
As with other nursing practices, nurses with the desire to specialize in infusion therapy may study and take the certification exam offered twice a year, says Steinheiser. “To assist the nurse in preparing for this exam, INS has study material which covers the eight core components of infusion nursing,” she says. “Once nurses pass this exam, they are considered infusion nurse specialists and can begin using the credential CRNI®. The CRNI® is capable of an expanded role in directing evidence-based clinical practice, research, and quality improvement activities.”
Infusion nurses care for all patients, providing care that helps many other healthcare processes go more smoothly. “Infusion nurses provide for all patient populations, from the neonate to the elderly patient, and follow them along the continuum of care,” says Steinheiser. “Infusion nurses use their critical thinking skills, perform advanced procedures using state-of-the-art technology, and ensure safe infusion care.”
Certified Registered Nurse Anesthetists (CRNA) Week runs this week from January 21 to 27 and is an excellent opportunity for student nurses to find out more about this path in a nursing career.
With more than 52,000 nurse anesthetists and student nurse anesthetists, the career is thriving and attractive for several reasons. Many nurse anesthetists say the patient interaction they have is unsurpassed. They are with patients before, during, and after surgery, so there’s a necessary trust that is quickly established with the skill and care of the nurse.
Nursing students who are considering this as a career have many resources they can reference and various organizations that will help them succeed on this career path. The American Association of Nurse Anesthetists (AANA) is especially aware of promoting health and wellness among the student nurses who seek a career in this branch of nursing. The AANA’s 2017 report Wellness and Thriving in a Student Registered Nurse Anesthetist Population explored the significance of the relationship between student wellness and how well students do in their academic program.
To celebrate CRNA Week, Minority Nurse recently posed some questions to Michael Neft, DNP, MHA, CRNA, FNAP, FAAN, and assistant director of the Nurse Anesthesia Program University of Pittsburgh School of Nursing and nursing student Sara Wilkinson, BSN, RN, CCRN SRNA at University of Tennessee Health Sciences Center. The following are their answers.
Why is the AANA particularly aware of the health and wellness among student nurses looking to enter or actively studying in this field?
Student nurses are the future of the profession, and it is important to cultivate and prepare for a long and healthy career. Students who aspire to enter into nurse anesthesia programs must be healthy mentally and physically. They must have healthy outlets for stress relief, and healthy lifestyle habits that will support them throughout our educational programs.
Nurse anesthesia education programs are required by their accreditation standards to provide education content on wellness and substance use disorder. The AANA actively encourages members, students, as well as educational programs to engage whenever possible in healthy behaviors, whether that includes physical activity or simply reducing stress by encouraging individuals to take time for their loved ones or to engage in an activity they love.
The AANA is committed to providing resources and information about ways to become involved in establishing a healthy lifestyle and even offers fun runs, wellness tutorials and a massage therapy area at many of their conferences.
How does establishing good health and wellness practices now help a student nurse become better? And how will taking care of oneself now carry over once they graduate and are several years into a CRNA career?
Nursing has unique stressors like dealing with patient care situations that require critical thinking, fast decision making, and autonomy is tough. If the student nurse does not have the ability to cope with these situations autonomously, it is very difficult to care for patients. Maintaining both mental and physical health and wellness are at the foundation of successful practice.
Developing healthy lifestyle habits early, helps students handle stress more effectively, set clear goals, and develop a clear plan to achieve them. They also assist students with discipline, good study habits, prepare for clinical experiences properly, and self-evaluate objectively. It also helps to establish diet and exercise plans that can be adjusted as one transitions to practice, to avoid elimination of healthy habits out of inconvenience.
Maintaining a school-life balance is also important to develop a support system and find time for small, pleasant breaks to gives a fresh perspective and recharge. Establishing healthy behaviors and habits early is vital to long-term health, wellness, and maintenance of a successful career.
Do you have any advice for student nurses about considering this field and being aware of any challenges unique to this branch of nursing?
For student nurses considering the field of nurse anesthesia, awareness about the depth and breadth of study is valuable, but is important to be well, so that an individual will have the endurance to graduate. A strong support system and personal discipline are necessary to allow for healthy stress relief and appropriate professional conduct. Anesthesia remains the field with the highest incidence of drug abuse and unhealthy coping behaviors, due to high stress and access.
Think about what you do when stressed. Review your lifestyle habits: exercise, eating, alcohol use, and other substance use. Some prospective students may want to employ a lifestyle coach who can look at a person individually and help one to develop positive lifestyle habits that will set one up for success in graduate school and a stressful career. Good study habits, a healthy respect for one’s self and career, use of study resources, and strong, supportive relationships will be required to succeed and thrive in this field.
This week, the American Association of Nurse Practitioners is highlighting all the work nurse practitioners (NPs) do with National Nurse Practitioner Week.
The week kicks off today and runs through November 18 and honors the work NPs do both on the job and as ambassadors for the nursing profession.
Minority Nurse caught up with Dr. Scharmaine L. Baker, FNP, FAANP, FAAN, CEO at Advanced Clinical Consultants, to talk about the role of a nurse practitioner. After Hurricane Katrina, Baker’s New Orleans patient caseload swelled from 100 to 500 in three months. With a critical shortage of health care facilities and providers, Baker’s skills as an NP not only saved her patients, but also clearly showed how invaluable her thorough NP training is.
National Nurse Practitioner Week, says Baker, is a way to give nurse practitioners the recognition they often don’t receive. “National Nurse Practitioner Week gives us the positive spotlight that we deserve,” she says.
This kind of national attention to the nurse practitioner’s work shows the devotion nurses have to caring for a patient, and also helps clear up any misunderstandings about the role and how an NP works within a health care team. “Nurse practitioners don’t just prescribe a medicine and send you out of the door,” says Baker. “We take the time to listen to the patient stories about their children, spouses, pets, and job promotions. These stories often solve the complicated puzzle of making an accurate diagnosis. It’s called holistic care of the total man.”
When prospective nursing students are deciding on a career path, Baker urges them to consider a few things. Top in their minds should be the honest assessment of their commitment to making this career decision. Taking the time to complete the challenging NP studies isn’t easy, she says. “Once they have decided that this is indeed the right time to pursue an Advanced Practice Nursing degree,” she adds, “then the necessary preparations as far as letting family and friends know that they will be somewhat unavailable for the next three to four years because the schooling demands all of your time for successful completion.”
But when the degree completion and training are done, the potential for a lifelong career that challenges you, uses all your skills, and lets you connect with and help people is gratifying on many levels. As a nurse practitioner, you’ll be diagnosing, assessing, and treating medical conditions. You’ll also look at the whole patient. NPs take into account the interplay between a patient’s physical and emotional well-being as well as the environment they live in. By doing so, they can help treat every part of a patient’s condition.
“I get to hear the stories that make my patients happy or sad,” says Baker. “Then, I get to connect those stories to their physical state. They are always related. I enjoy providing health care on this advanced level. I get to take care of the whole patient.”
Baker also points out that while NPs continue to earn recognition and some states are allowing them to practice on their own, there is still work to be done. “The most challenging and frustrating part of advanced practice nursing is the many restrictive laws that prevent us from practicing to the full extent of our scope,” she says. “It’s downright ridiculous! I long for the day when all states will actively have full practice authority.”
Currently, nearly two dozen states allow nurses to have full practice authority where they practice without physician oversight. Baker continues to advocate for full practice authority among all nurse practitioners. She also urges NPs and the nursing profession to continue to honor the nurses who worked so hard to get all nurses where they are today.
“Many have fought for us to be where we are,” says Baker. “Every time we show up and provide stellar care, we make our founding nurses beam with joy. We must never forget their sacrifices.”
Celebrate National Nurse Practitioner Week this week and spread the word about these highly skilled professionals. Use #NPWeek to share photos and tags on your social media posts to help others see just what satisfaction a career as an NP can bring.
According to the HIMSS 2017 Nursing Informatics Workforce Survey, nursing informaticists are in a growing field that offers a rewarding career move and one that also helps to advance the field of nursing. Nursing informaticists use their nursing backgrounds, cutting-edge technology, and all the data, communication, and information that is produced in the field to make a healthier world.
According to the American Medical Informatics Association, nurse informaticists are challenged with a wide set of responsibilities, most of which focus on the systems and technologies in which patient information, healthcare results, and research findings are used, stored, and connected. Survey respondents classified their jobs into three main categories: systems implementation, utilization and optimization, and systems development.
Some informaticists tasks include building regional and nationally connected data and communication systems, determining the best ways to ensure that research findings are accessible through practice, promoting information presentation and retrieval in a manner that supports safe patient care, and even defining healthcare policies.
According to the survey, nearly half of the respondents reported great career satisfaction earning salaries of more than $100,000. Because the field is progressing so rapidly, given the technological developments, nursing informaticists receive both on-the-job training and additional training. Forty-one percent of the respondents said they are participating in some kind of degree program to get additional training—including a formal degree program or a non-degree degree program or coursework.
Many nursing informaticists are registered nurses and then go on to earn a bachelor’s or master’s in nursing to gain expertise in the field. Some nursing informaticists might earn an advanced degree in an information technology area like computer science. For those looking to earn an advanced degree, scholarships are available through the American Nursing Informatics Association.
If you are interested in nurse informatics, certification from the American Nurses Credentialing Center is also available and the survey results showed that about 51 percent of respondents indicated they would be pursuing some kind of certification and that they thought this additional education would have a positive impact on their careers.
If you’re a nurse who enjoys technology, check out this branch of nursing.