NSQHS Standards: Falls, Infections, and Nursing Practice

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This essay examines the National Safety and Quality Health Service (NSQHS) standards, specifically focusing on the prevention of falls and harm from falls, as well as infection prevention and control systems. It highlights the critical role of registered nurses (RNs) in implementing these standards to ensure patient safety and improve healthcare quality. The essay discusses the importance of assessing patients for fall risk, implementing preventative strategies, and the nurses' responsibilities in monitoring, educating, and reporting incidents related to both falls and infections. It also covers the significance of hand hygiene, aseptic techniques, and the use of personal protective equipment (PPE) in preventing hospital-acquired infections. The conclusion emphasizes the RN's pivotal role in upholding these standards through various practices, ultimately contributing to better patient outcomes and a safer healthcare environment.
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Running Head: NS 0
NSQHS STANDARDS
ESSAY
MARCH 30, 2020
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NS 1
NSQHS standards
Nurses are the core members of health care in a health care setting. they perform
different activities during their shift and spend most of their time wot diseased persons
compared to other health care providers. They generally assess the patients, administer
medication, and make discharge plans (Joel, 2017). NSQHS standards are developed to
protect the individuals from harm and enhance the quality of patient care proposed by the
Australian Commission on the safety and superiority of health care in the discussion and
collaboration with the jurisdictions, different technical specialists, and stakeholders. Each
standard has the conditions that specify the demonstration of the standard. These standards
are applied to a broad range of health services (ACSQHC, 2017). These standards deal with
the areas in which a huge number of diseased persons are involved, identified gaps between
the present conditions and finest practice results, present improvement strategies. Each of the
standards outlines the intended action and approaches to be obtained, a statement on the
context in the specific standard must be applied, and a list of important criteria (Hamilton,
2019). This particular essay will discuss two particular standards: stopping falls and harm that
happen from falls and deterrence of infection and control systems. The significance of these
standards to the RN role will also be mentioned in the essay.
The main intention of this specific standard is to prevent the incidence of falls in the
patient and reduce associate harms. The clinical manager or frontrunners of a health care
setting implement different system effective to prevent falls and reduce the harms occur from
falls. The health care settings have different governance structures and frameworks that are
used to stop such incidences. They assess and screen patients for risk of fall during the
admission in the health care organization (Moyle, 2016). They use prevention strategies for
these individuals and communicate with them to inform them about the risk of falls. Falls are
a usual and devastating problem of hospital care, chiefly in aging patients. Epidemiologic
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NS 2
investigations have identified that falls happen at a degree of 3–5 every 1000 bed-days, and
the Agency for the Healthcare Investigation and Quality evaluates that particularly in the
United States, 700,000 to one million individuals admitted to the healthcare setting fall
annually. According to a report published by Australia institute of health and welfare (2018),
In 2015–16, there were greater than 34,000 separations in which a diseased person was
treated by health care providers for injuries occurs from a fall in a healthcare setting—a rate
of 3.2 every 1,000 separations. This degree may be undervalued, as a place of incidence was
not detailed for 18 per cent of separations including falls, however, some falls that happened
in health care settings except a hospital are similarly comprised because of the means the
information is coded. The frequency of falls augmented by 0.8 every 1,000 separations
between the year of 2009–10 and 2015–16. This alteration may reflect altering patient
profiles and/or a growing focus on the protection and quality of healthcare settings and
favorable reporting of pertinent data throughout this period. It can help the healthcare
organization to prevent falls and associated injuries and increase hospitalization Australia
institute of health and welfare (2018). This standard required healthcare organizations to
implement and maintain systems to avoid falls by including screening or assessing
individuals with falls risk and use multifactorial falls deterrence strategies. It requires an
organization to develop policies that enable health care providers to report and record fall
cases and focus more on elderly people as they have a high risk of falls. Implementation of
this standard can lead to improved standardized processes and a chance for knowledge
sharing within the health services (McKechnie, Pryor & Fisher, 2017).
Nurses can play a key role in the deterrence of falls and associated injuries and
implement systems. They are equipped with different skills such as treatment, prevention,
education, promotion, advocacy for the admitted individual and their families. They also have
skills like effective communication skills, empathy, having knowledge of different cultures,
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NS 3
and developing a therapeutic relationship. the NSQHS standards require nurses to be
involved in the implementation process of systems necessary to falls and reduce fall injuries
(Chu, 2017). The role of nurses in fall prevention includes completing and documenting
patients with a high risk of falls and their screening and assessment. They must also
document patient-specific fall deterrence practices, and monitor the medical condition of the
patient for any alterations. They must report every fall incident to the doctor, and obtain
medical orders from the clinician as required. They also supervise the nursing aids, educate
the diseased person and their family on fall deterrence and obtain that supplies required to
stop patient falls. The NSQHS standards also require nurses to evaluate the environment of
the patient for safety throughout the patient care tasks, perform car plans practices and report
to the higher authority when the task is completed (Quang-Tri, Tran-Thi & Tran, 2020). They
must also identify the risk factors associated with the patient fall such as old age, earlier fall
history, gait unpredictability, urinary incontinence, medicine, patient care equipment,
changed mental status, and high-risk assessment through ABCS injury risk assessment.
Nurses must develop a therapeutic relationship with the patient and educate them about fall
prevention practices. The patients who are not able to perform daily life activities must be
supported by the nurses. The cleanliness of the floor can be a key aspect in preventing
patients fall in the hospital. nurses must keep the hospital environment clean and making
sure bright lighting. providing a padded fall mat to the patient reduces the risk of injury if the
patient rolls or falls from the bed. the nurse must also assess the patient for any injury once he
or she on the floor, before moving them. if the patient is unable to stand, the mechanical lift
must be used by nurses and must ask for help if necessary (AIHW, 2018).
Infection stoppage and control systems This particular standard is intended to reduce
the infection linked with preventable healthcare practices. It requires the healthcare provider
to efficiently manage contaminations if they happen, and control the growth of antimicrobial
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NS 4
resistance by the prudent application of the antimicrobial as the aspect of antimicrobial
stewardship. Patients admitted to the hospital often affected by hospital-acquired infections
(ACSQHC, 2017). Healthcare-acquired infections (HAIs), also recognized as nosocomial
contaminations, are infections that diseased persons get while getting treatment for medicinal
or surgical situations. HAIs happen in all healthcare settings, counting hospitals, medical
centers, ambulatory hospitals, and long-standing care facilities, for example, nursing homes
and different rehabilitation facilities. According to (Mitchell et al., 2017) around 83,096 cases
of hospital-acquired infection occurs annually in Australia, and around 5 per cent to 10 per
cent of patient acquire an infection during their hospital stay. These contaminations cause
significant harm, increase the usage of health care services, and place higher demands on the
medical workforce. the infection prevention and control system standard require the health
care provider must use evidence-based systems to prevent and regulate healthcare-related
contaminations. Some of the aspects associated with this standard include standard and
transmission- founded precaution, improving hand hygiene, the aseptic practice, clean
atmosphere, and workforce vaccination (Russo et al., 2018).
Standard precautions are rudimentary contagion deterrence and control approaches
that apply to everybody, irrespective of their apparent or confirmed communicable status.
Approaches including hand hygiene, individual defensive equipment, different cleaning
practices, and suitable management and removal of sharp devices. These are recognized as a
first-line method to infection deterrence and regulation in health facility organizations and are
regularly applied as an important approach for reducing the spread of contaminations
(ACSQHC, 2017). Standard protections reduce the risk of the spread of transmittable agents
to different people and places, even in the situations of high-risk, and reduce and maintain
substances and zones as free as likely from transmittable agents. The transmission- grounded
safety measures are precise interventions to interject the method of spread of communicable
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NS 5
agents. They are medically used to reduce contamination risk with the hospitalized person
who is assumed or assured to be diseased with agents conveyed by touch, droplet or airborne
ways (Mitchell et al., 2017). Hand hygiene is an important infection deterrence and control
approach. The present National Hand Hygiene program states that hand hygiene should be
achieved according to My five Moments essential for Hand Hygiene of the World Health
Organizations. Aseptic practise, usage of invasive medical equipment, workforce vaccination
and cleaning are comprised in this standard as they are part of contamination deterrence and
control framework (Fernando et al., 2017).
Nurses are the core member of the healthcare team in a hospital. They spend most of
their time with the patients compared to other healthcare providers. Nurses can play a key
role in the application of this standard and its aspects (Padigos, Lim & Ritchie, 2017). Nurses
play a straight role in the spread of Multidrug- resilient organisms because of movement
between communicable and non-infectious patients, therefore they require to follow policies
about hand hygiene, use of PPE, isolation of diseased patients, effective cleaning while also
screen the efficiency of these approaches. They equipped with skills essential to apply the
aseptic technique. They can classify the actions where the aseptic technique put on, assess the
patient’s hygiene, and provide training to other healthcare provides like assistant nurses
(Ward, 2016). Nurses also develop a healthy relationship with the clients and educate them
about effective hygiene techniques. Nurses must also use different methods to uphold a clean
and harmless condition that can also be applied. This involves the use of proper waste
management of devices like catheters, intravenous needles, and wound dressings. Other
responsibilities of nurses may comprise isolating the infected patient from the outpatient
department, utilizing suitable PPE when communicating with the infected individuals and
their instant environment; and warning a contamination control group or a nurse. The data
collected about the contamination must be comprised of handling the patient by using a care
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NS 6
strategy and included in their remark charts as the further safety protection for other different
health care providers (Dekker et al., 2019).
In conclusion, Nurses are an significant part of a healthcare team as they perform
multiple tasks during their shift. To provide effective and appropriate care to the patients, the
nurse must also follow the NSQHS standards that are essential for safe and effective
practices. NSQHS standard prevention of falls and fall-related injures specifies the guidelines
to stop the incidence of patient falls. It assists the healthcare organization to use preventable
frameworks or systems to assess and screen patients with increased risk of falls. Another
major issue is hospital-acquired infections that affect patients admitted to hospitals. It has
been reported that nearly 83,096 cases of HAIs happen every year in Australia. To avoid
these issues Infection prevention and control systems standard is proposed. This specific
standard is proposed to reduce the infection in healthcare settings and apply preventable
healthcare practices. Nurses can play a key role in the implementation of both the standards
and reduce the patient fall and hospital-associated infection. To reduce patient, fall nurses can
educate the patients about fall prevention practice, help them with daily activities, and
develop a therapeutic association with the diseased person. They can also reduce infection in
healthcare settings by the implementation of some aspects like hand hygiene, environment
cleaning, and the use of PPEs.
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NS 7
References
Australian Commission on Safety and Quality in Health Care (2017). National Safety and
Quality Health Service Standards: Second edition. Retrieved from:
https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-
Quality-Health-Service-Standards-second-edition.pdf
Australian Institute of Healrth and Welfare (2018). Australia's health 2018. Retrieved from:
https://www.aihw.gov.au/reports/australias-health/australias-health-2018/contents/
indicators-of-australias-health/falls-resulting-in-patient-harm-in-hospitals
Chu, R. Z. (2017). Preventing in-patient falls: The nurse's pivotal role. Nursing2019, 47(3),
24-30.
Commonwealth of Australia (2012). Standard 10: Preventing Falls and Harm from Falls.
Retrieved from:
https://www.safetyandquality.gov.au/sites/default/files/migrated/Standard10_Oct_201
2_WEB.pdf
Dekker, M., Jongerden, I. P., van Mansfeld, R., Ket, J. C., van der Werff, S. D.,
Vandenbroucke-Grauls, C. M., & de Bruijne, M. C. (2019). Infection control link
nurses in acute care hospitals: a scoping review. Antimicrobial Resistance & Infection
Control, 8(1), 20.
Fernando, S. A., Gray, T. J., & Gottlieb, T. (2017). Healthcareacquired infections:
prevention strategies. Internal medicine journal, 47(12), 1341-1351.
Hamilton, S. (2019). The new NSQHS standards: One day surgery unit's accreditation
experience. Day Surgery Australia, 18(2), 16.
Joel, L. A. (2017). Advanced practice nursing: Essentials for role development. FA Davis.
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NS 8
McKechnie, D., Pryor, J., & Fisher, M. (2017). Clinical commentary: Predicting falls in the
inpatient setting. Journal of the Australasian Rehabilitation Nurses Association, 20(3),
14.
Mitchell, B. G., MacBeth, D., Halton, K., Gardner, A., & Hall, L. (2017). Resourcing hospital
infection prevention and control units in Australia: A discussion paper. Infection,
Disease & Health, 22(2), 83-88.
Mitchell, B. G., Shaban, R. Z., MacBeth, D., Wood, C. J., & Russo, P. L. (2017). The burden
of healthcare-associated infection in Australian hospitals: a systematic review of the
literature. Infection, Disease & Health, 22(3), 117-128.
Moyle, S. (2016). Falls Prevention. Australian Nursing and Midwifery Journal, 24(1), 32.
National Health and Medical Research Council (2017). Australian guidelines for the
prevention and control of infection in healthcare. Retrieved from:
https://www.safetyandquality.gov.au/standards/nsqhs-standards/preventing-and-
controlling-healthcare-associated-infection-standard/infection-prevention-and-control-
systems
Padigos, J. A., Lim, A. G., & Ritchie, S. R. (2017). Exploring the Role of Nurses as
Antimicrobial Stewards.
Quang-Tri, L. E., Tran-Thi, H. G., & Tran, M. K. (2020). An Assessment of the Nurses’
Knowledge and Practices of Inpatient Fall Prevention. International Archives of
Medicine, 13.
Russo, P. L., Cheng, A. C., Mitchell, B. G., & Hall, L. (2018). Healthcare-associated
infections in Australia: tackling the ‘known unknowns’. Australian Health
Review, 42(2), 178-180.
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Slade, S. C., Carey, D. L., Hill, A. M., & Morris, M. E. (2017). Effects of falls prevention
interventions on fall outcomes for hospitalized adults: protocol for a systematic
review with meta-analysis. BMJ Open, 7(11), e017864.
Ward, D. (2016). Role of the infection prevention and control link nurse. Primary Health
Care, 26(5).
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