NUR3605 Report: Improving Patient Care Through Clinical Standards

This report analyzes clinical practices and national safety standards in a healthcare organization, focusing on improving patient care and reducing risks. It examines the case of Mandy Andrews, who experienced a medication error, and discusses the importance of NSQHS standards, communication, and medication safety. The report includes a literature review, root cause analysis, and recommendations for enhancing patient-centered care, quality, and safety. It emphasizes the need for nurses to adhere to clinical guidelines, use effective communication skills, and prioritize patient safety to prevent errors and improve patient outcomes. The PDSA cycle is applied to address the medication error, and the report highlights the importance of clinical governance and continuous improvement in healthcare services. Desklib offers more resources for students.

Report

EXECUTIVE SUMMARY
A clinical practice in nursing is generally referred as the ability of the nurses to
effectively solve the problems as well as provide the quality care to the patients. In this report it
is been covered that the various national safety standards which has been implemented in a
healthcare organization so as to achieve the main objectives that an organization does contains.
This report covers the various advantages or the importance of adapting such standards and the
clinical guidelines that makes an impact over the health of the patients care. As the clinical
practices and the national safety standards are essential because they aims to intercept and also
decreases the chances of risks, errors and the harms which may occurs to the patients during the
provision of healthcare. The report will also cover the different factors which make influence in
patient centred care, their quality as well as safety in terms of communication and medication
safety standards and various others also. The safety in nursing care may impact the patients
outcomes but if they may effectively designed and established then these basic protocols
encourage the healthcare administrators and make them to learn from their past mistakes,
enhance their trustiness among medical staffs and leads to reduce the errors and most
significantly decreases the patient mortality rates.

Table of Contents
EXECUTIVE SUMMARY.............................................................................................................2
INTRODUCTION...........................................................................................................................1
LITERATURE REVIEW................................................................................................................1
DISCUSSION..................................................................................................................................3
CONCLUSION................................................................................................................................5
RECOMMENDATIONS.................................................................................................................6
REFERENCES................................................................................................................................7

INTRODUCTION
Clinical research is quite important in order to find a new treatment for any disease. It is
also a new way to detect as well as diagnose and overcome the chances of developing the new
illness. The purpose of this report is too aware about the various guidelines of the NSQHS which
should be adapted by every healthcare department. This report will cover the various clinical
practices which should be acquired by the nurses so that they can provide a quality care to their
patients. As per this report, it will cover the various problems which was faced by Mandy
Andrews who is suffering from ruptured appendix problem. In addition to this, this report will
also cover the various risk management strategies which should be why are NSQHS standards
developed adapted by the healthcare professionals that significantly makes an impact over the
organization's ability to achieve its objectives as it is quite essential for every healthcare system
to maintain its link (Breytenbach & et. al., 2017).
LITERATURE REVIEW
A literature search utilises the electronic information which includes the clinical
practices that must be adhered by the nurses or caregivers in a particular organization. As it is
necessary to improve the clinical practices among the healthcare professionals in a particular
healthcare system so that they can provide a better quality care to their patients. As per the
national safety and quality health services standards (NSQHSS), these standard areas are made
for people in order to ensure the quality as well as consistency of the products and the services
which are provided for their greater relief of mind. Such standards make benefits to enhance the
health and safety, develops the quality of life also (Duncombe, 2018).
The root cause analysis of the given case study is that Mandy has issue with the
medication where the same medication which include 20 mg of morphine is administered two
time within 45 minute. This mistake is occurring due to Registered nurse Smith who verbally
state that Mandy require morphine and there is no documentation is done over that day which
may cause issue and again enrolled nurse Black also administered 20 mg morphine again to
Mandy. With this all, the factor is initiated with the leading cause of narcosis from the morphine
in Mandy case. As per this, to reduce the increase of narcosis the non-inflammatory drug is
administered with the slow rate can used to put the Mandy from the risk zone. Overall, the root
cause analysis of Mandy case study is overdose of drug due the documented error that result in
the medication error. In this, issue is identified and causes are usually prioritising which is
1

double dose of morphine. With this, the narcosis is happening and it must be reducing by using
the non-steroid anti-inflammatory drug, the inspection of Mandy is taken with proper care.
According to the Ronda G. Hughes, 2020, As per the research the measure of safety as
well as quality can lead the progress of improvement in quality initiatives by using the external
benchmarks. These benchmarks in a healthcare system is basically refers to the collaborative
study of measuring as well as examining the results with the departments action. As these
benchmarks are generally used to examine the safety and the quality performance of patients.
According to the Melissa Beauchemin, 2019, the author has conducted a focused
literature search so that they can simply identify the existing meaning of the clinical practice
guidelines implementations. In this they identified that the implementation is basic term which is
used in the delivery system so as to enhance the quality and the patient safety initiatives.
From the above research analysis, the randomised control trails were in this includes the
effectiveness of the interventions to promote the behavioural change may vary in a healthcare
system, the multi branched approaches are more successful than the single interventions. The
national standards should be adhered in every healthcare organization as it necessary for the
patient hygiene and their safety (Feo & et. al., 2017).
PDSA is defined as the Plan Do Study Act which is term as interactive and four stage problem
solving model which is used for improving the process or used to carrying out the change.
Plan: With the contrast with case study, the team is assigned in order to reduce the overdose or
the cause of medication error.
Do: In this, the strategy is implemented in order to reduce the complication which may arise with
Mandy due the medication error which violate the guideline of standard 4 which provide the
aspect of medication safety. The anti-category of drug (ibuprofen with slow rate with intravenous
route) is used in order to minimise the effect of Narcosis.
Study: The regular monitoring is being take for the Mandy to determine the change that is
positive or not. As per this, it helps to change medication pattern and dose as according to
recovery.
Act: The strategies which is formulated for the Mandy is inspected and with the change the
proper implemented is taken with by following the standard 1 (governance to safety and quality
systems), standard 4 (medication safety), standard 5 (comprehensive care) and standard 6
(communication for safety)
2

The cross section analysis of the given case study includes the lack in clinical standards
about the safety and quality of the patients which is important in every healthcare. It is essential
for the nurses to follow such clinical practices. The national safety standards such as clinical
governance standards, the safety standards about medications, the communication based
standards as these such standards are very general and also important for an organization to
adapt. As these standards are only made in order to protect the public health from any harm as
well as to enhance the health quality service provision.
DISCUSSION
As per the given case study, nurses should adapt the basic and most important clinical
practices in their daily routine so that they did not make any blunder mistakes which in results
patients have to suffer. They should aware about their basic duties so that they can provide full
care to the patients. Among nurses or the caregivers, the safety of their patients should be kept on
top of the priority list. According to the above research, these safeties as well as quality
guidelines must be adhered by the nurses in every healthcare department. It is necessary to
achieve all the skills which helps a nurse or care giver to provide quality care to the patients and
these skills are such as the communication skills, empathy, critical thinking as well as creative
problem solving and teamwork. It is very crucial in an organization to use the effective
communication skills as lacking such skills can directly impact on the patient's life for example
in the above case. The better communication skills can decrease the chances of medical errors or
the patient’s injury (Kristensen & et. al.2020).
It is important for every nurse to treat a patient's physical ailment as well as their
emotional support. Such behaviours from nurses can foster the relationships with their patients
which usually aid in rooting out the causes, symptoms and the explanation which results in a
proper diagnosis and the treatments. It is important for every nurse to checklist their clinical
practices as it may sometimes lead to suffer the patients with heavy doses like in the above case
study. As per the above case study, nurses should check the medications and make ensure that no
medication should by repeated again by mistake without under supervision of the healthcare
professionals. As this may lead to the patients to suffer from such heavy doses. In some cases,
these heavy doses can lead to the death of the patients. The national safety standards are general
which generally includes the safety and quality care of the patients, as these gives the assurance
mechanism which tests whether an organization is in place to verify that the expected standards
3

are met or not. In the clinical practices it is essential to use the clinical based evidences that are
proven scientifically. This include the combination of the best available evidence, the values of
the patient and their condition, the patient management, governance of practices and the decision
making regarding the health policies (Labrague & et. al., 2018).
The standard 4 from the NSQHS is based on the medication safety which is breached due the
misconduct of documentation when drug is administered to Mandy. In this, some of the guideline
is followed in order to reduce the risk of medication error. The major steps of guideline are
divided in some of criteria. This include governance and system for the medication safety which
state that there is some regulatory guideline with drug and their combination effect. Error due to
the combination of drug cause adverse drug reaction and drug-drug interaction which is risky for
patient. This is followed with the respect to patient. In this, the documentation of patient
information which act as main issue with this case study regards with Mandy. With this guideline
every single drug or medication is recorded when it is administered to patient (in case of Mandy).
With this, medication management process which is regulated by pharmacist and other medical
staff who provide medication as per requirement of dose, frequency and taking contrast of
different age group. The second last is continuity of medication management which is managed
by medical staff and patient itself for the recovery from disease. In contrast with Mandy, it is
followed till Mandy become normal with their health aspect. The last criteria are communicating
with patient and carers, in case of Mandy if the last criteria are followed then EN Black must
know that the patient have already take medication morphine 20 mg.
The national safety and quality standards involves the clinical governance standards as in
this the leaders of the health service healthcare systems may have the responsibility to the
following community for the continuous development in the safety as well as quality of the
services and ensuring that they are patient centred, safe and effective. The another standard
includes the medication safety standards which lacks in some of the organizations but it must be
adhered by every healthcare departments as the nurse’s implement and also supervise the
systems to decrease the occurrence of the medication incidents and also enhance the quality as
well as safety of the medicine uses. As the healthcare departments uses these such systems. In
addition to this, the another standard which an organization sometimes lacks includes the
communication as a safety standard. In this, the healthcare professionals of a healthcare
organization build and maintains the systems and the processes in order to empower the effective
4

communications with the ill people, families or the carers and among the clinicians and the
multidisciplinary teams and also across a healthcare service system. As these such care service
system uses such standards to effectively communicate to check the safety standards (Najafi &
et. al., 2018).
In context with the national safety standards, another standard also there such as a
comprehensive care standard which is basically used to ensure that the ill people can receive a
quality care which is generally a coordinated delivery of the total healthcare that is requested or
needed by the ill people. As the higher authority of the service system build and keeps the system
and processes to encourage the care givers to provide the comprehensive care to the patients. The
higher authority also build and keeps an organization to intercept as well as manage the
particular risks which may harm the patients while delivering of the health care. All the
healthcare organizations basically uses this standards to provide the comprehensive care and
manages the following risks. The specific criteria for these basic standards are to improve the
quality to support the comprehensive care, developing the care plans, delivering the care and to
reduce the patient harm. If the basic standards are follow in the healthcare systems, then the
objective of every healthcare organization will be achieved. As it is good for the caregivers and
the patients that they can easily maintain their healthy lifestyle and this can also build a healthy
relationship between the members and patients in a health department (Peralta, 2017).
CONCLUSION
Clinical practices involves the capabilities of the nurses to effectively resolves the
complicated problems and in return provides an appropriate as well as high quality healthcare
facilities. From the above report it is analysed that some of the national safety standards is not
followed by the given healthcare organization in the case study. In return to this the patient has to
suffer from this as he has given the double dose of morphine and it is quite dangerous for him in
a particular situation. For teen ages, nurses should provide some extra care to the patients who
are just come across with the surgery as they should keep the records of their medications which
they give to their patients. In healthcare, skin aid and circumvent patient security incidents.
Physically and psychologically sound the health care givers are less susceptible to make
mistakes, as they are furnishing to the safer care. In the above study, it is also described by the
researched articles that the national safety standards are very essential for an organization and it
must be strictly followed by every organization. These basic and useful standards helps to
5

provide the care or develops the quality care for the patients and also maintains their lifestyle as
healthy as possible.
RECOMMENDATIONS
 It is recommended that the clinical practice guidelines should be strictly adhered by every
healthcare service systems as it is quite necessary for the patients also to provide them
with quality care.
 The basic recommendations here includes that the nurses should maintain a discipline of
the procedures which is provided by the higher authorities (Ryan& et. al., 2018).
 Nurses or care givers must check their patients status and also maintain a proper checklist
of their medications so that they can not repeat over again the medicines which is done in
the given case study of Mandy Andrews. The repetition of his dose can lead to suffer him
from narcosis and according to his age it can be dangerous for him also.
 The another recommendation includes as the important clinical practice guidelines must
be adopted by them also as they helps them to build their knowledge and make them to
serve for their patients. This ultimately can results in the improvement of patients health
status and with this nurses can build a strong relationship between a patient and care giver
(Scott & et. al., 2020).
 It is recommended to apply the evidence based clinical practices which are scientifically
proven. As their intention is to provide the best effective care that is being available
containing the goal for enhancing the patients health improvement. It is because, the
healthcare providers ensures that their clinical practice services must be informed by the
best available evidence.
6

REFERENCES
Books and Journals:
Breytenbach, C & et. al., (2017). An integrative literature review of evidence-based teaching
strategies for nurse educators. Nursing Education Perspectives, 38(4), 193-197.
Duncombe, D. C. (2018). A multi‐institutional study of the perceived barriers and facilitators to
implementing evidence‐based practice. Journal of Clinical Nursing, 27(5-6), 1216-1226.
Feo, R & et. al., (2017). Developing effective and caring nurse-patient relationships. Nursing
Standard (2014+), 31(28), 54.
Kristensen, S & et. al., (2020). Culture as a cure: Assessments of patient safety culture in OECD
countries. OECD Health Working Papers, (119), 0_1-100.
Labrague, L. J & et. al., (2018). Stress and ways of coping among nurse managers: An
integrative review. Journal of Clinical Nursing, 27(7-8), 1346-1359.
Najafi, F & et. al., (2018). Antecedents and consequences of workplace violence against nurses:
A qualitative study. Journal of clinical nursing, 27(1-2), e116-e128.
Peralta, J. V. (2017). Statin Therapy Evidenced-Based Practice for Peripheral Artery Disease
(STEP PAD) Improves Standards of Care (Doctoral dissertation, Brandman University).
Ryan, C & et. al., (2018). Australian final year nursing students′ and registered nurse
supervisors’ perceptions of a gerontology clinical learning experience: A preliminary
appraisal. Nurse education in practice, 31, 182-187.
Scott, G & et. al.,. (2020). GUIDELINES–SIMILARITIES/DISSIMILARITIES. A
SYSTEMATIC REVIEW OF INTERNATIONAL CLINICAL PRACTICE
GUIDELINES FOR PREGNANCY HYPERTENSION. American Journal of Obstetrics
and Gynecology.
Snowdon, D. A & et. al., (2020). The association between effectiveness of clinical supervision of
allied health professionals and improvement in patient function in an inpatient
rehabilitation setting. Disability and rehabilitation, 42(8), 1173-1182.
Spiva, L & et. al., (2017). Effectiveness of an evidence‐based practice nurse mentor training
program. Worldviews on Evidence‐Based Nursing, 14(3), 183-191.
Zamoscik, K., Godbold, R., & Freeman, P. (2017). Intensive care nurses’ experiences and
perceptions of delirium and delirium care. Intensive and Critical Care Nursing, 40, 94-
100.
7

8