NSB203: Analyzing Safety Checklists for Improved Patient Safety

This report provides a critical analysis of how safety checklists in healthcare improve patient safety, drawing on both qualitative and quantitative research approaches. It compares these research methods, highlighting their respective strengths in understanding the effectiveness of safety checklists. Qualitative studies reveal that checklists reduce malpractice incidents by improving communication and standardizing processes, aiding in patient transfers, boosting healthcare professionals' confidence, and ensuring comprehensive patient information. Quantitative studies emphasize the responsibilities of healthcare providers in ensuring patient safety, noting the importance of nurse involvement in checklist creation, which correlates with reduced patient harm and mortality rates. The report addresses counter-arguments, such as potential hierarchical barriers, increased nurse stress, and time constraints, proposing solutions like improved interprofessional relationships and awareness programs. Ultimately, the analysis supports the conclusion that effective implementation of safety checklists significantly enhances patient safety in healthcare settings.

Running head: INQUIRY INTO CLINICAL PRACTICE (NURSING)
INQUIRY INTO CLINICAL PRACTICE (NURSING)
PART 2: CRITICAL ANALYSIS
SAFETY CHECKLIST IN HEALTHCARE IMPROVE PATIENT SAFETY
Name of the student:
Name of the University:
Author note:

1INQUIRY INTO CLINICAL PRACTICE (NURSING)
Introduction:
One of the main responsibility of the health professional is to ensure the patient safety.
However, lack of safety in the care process has been reported. Thus it is important to utilize
effective measures to reduce the unnecessary harm and improve service quality to enhance
patient safety (who.int, 2018). In this regards the use of safety checklist has been found to be
most effective (Thomassen et al., 2014, p. 5-18). The purpose of the assignment is to provide
critical analysis about the contribution of qualitative and quantitative approaches in the
understanding of effectiveness of safety checklist. The following paper will provide the critical
analysis in brief.
Comparison of qualitative and quantitative approaches:
There are different research approaches that could be used by the researchers in order to
address their research questions. In this regards the qualitative and quantitative research
approaches are most common approaches that are used by majority of the researchers (Brannen,
2017, p. 3-37). Qualitative approach is a type of inductive approach. It relies on the previous
literatures for the theoretical construct. Qualitative method contains 5 different approaches such
as, case study, narrative, ethnography, grounded theory and phenomenology. The most common
types of qualitative approach is case study. Narrative approach is used for inquiry a story and
explore the learning from that story. Ethnography focuses on in-depth study of a focus group.
Grounded theory is used to investigate any process, interaction or action in order to develop a
theory. Phenomenology is a research approach that describes the experience of the participants in
a particular context (Lewis, 2015, p. 473-475).

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On the other hand, quantitative study based on scientific process and utilize deductive
reasoning. In a qualitative method the researchers create a hypothesis, collect data, analyze and
investigate the data and derive conclusion. The quantitative study mainly depend on the
statistical analysis (Brannen, 2017, p. 3-37). There are 4 approaches of a quantitative research,
for example, experimental, quasi-experimental, descriptive and correlational. In an experimental
study an independent variable is manipulated in order to measure the effect on the dependent
variables. In quasi-experimental approach independent variable is not manipulated, however,
independent and dependent variables are measured to identify the effect. Correlational approach
is used to establish relationship between different variables through statistical data and
descriptive method is used to find out the current status of different variable of a study (Henry &
Ramirez-Marquez, 2012, p. 114-122).
Moreover, a qualitative approach is subjective approach whereas the quantitative study is
objective in nature. In a qualitative study, previous literatures are used thus, complication related
to generalization occurs, but in case of quantitative study it is easy to generalize the findings as it
use statistical data and analyses the data in an effective manner. On the other hand it is difficult
to establish theory with quantitative study, however, qualitative study helps to develop theory in
an effective manner (Frels & Onwuegbuzie, 2013, p. 184-194). With such comparison it can be
said that, both the qualitative and quantitative approach is adequate to conduct research and
address the research questions effectively.
Critical analysis:
In this study, the qualitative and quantitative research approaches have helped to gather
adequate information in order to argue that safety checklist in health care improve patient safety.
Qualitative approach has been used in order to gather information from previous studies and

3INQUIRY INTO CLINICAL PRACTICE (NURSING)
understand them to develop knowledge regarding theory related to patient safety and
contribution of safety checklist in ensuring patient safety (Lambert & Lambert, 2012, p. 255-
256). Simultaneously, quantitative approach has been used to understand the effectiveness of the
safety checklist to improve patient safety in health care and understand the level of
generalizability of the findings to make the argument strong with adequate evidence (Henry &
Ramirez-Marquez, 2012, p. 114-122).
The qualitative studies have helped to collect information about the way in which safety
checklist could reduce the risk of harm and ensure patient safety. It has been informed by the
qualitative approach that safety checklist reduces the incident of malpractice due to
miscommunication, lack of information and inconsistent process (Russ et al., 2013, p. 856-871).
It has been found that safety checklist could help to improve the process of transferring of
discharging a patient. In addition, with the improvement in service, safety checklist could help to
develop self-confidence within the health professional regarding their practice. They could
evaluate that the process used to cure the patient is accurate (Thomassen et al., 2014, p. 5-18). It
has been identified from the qualitative study that, making the use of safety checklist compulsory
could help to identify the barriers in the implementation, measure the effectiveness of evidence
based practice and ensure that patients are getting adequate information about their treatment
(Russ et al., 2013, p. 856-871). From the qualitative approach it has been identified that safety
checklist helps to transfer patient information to different health care department and
communicate the care staffs during alternative shift, thus, reduce the risk of miscommunication
during changing shift. It helps to manage diffuse incident by improving relationship between the
patient and health professional, thus, helps to avoid litigations (Thomassen et al., 2014, p.-5-18).

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It helps to manage the surgical interventions and reduce the risk of wrong treatment or surgery
(Russ, et al., 2013, p. 856-871).
On the other hand, the quantitative approach has helped to understand the responsibilities
of health care professionals in order to provide quality service and ensure patient safety. It has
been found that, it is the duty of the health service providers to introduce adequate policies,
measures and practice in order to avoid the risk of unnecessary harm to the patient (Olds et al.,
2017, p. 155-161). One of the most important step is the association of nurses in order to prepare
safety checklist. In this regards the quantitative study has provided survey within the registered
nurse (Borchard et al., 2012, p. 925-933). It has been found that, with proper association of the
health professionals it is possible to reduce the risk of patient harm by 8.1% and risk of mortality
could be reduced by 7.7% (Olds et al., 2017, p. 155-161). Another quantitative study has
indicated the effectiveness and compliance of safety checklist in the health care settings. The
average compliance rate of safety checklist has been found to be 75% (Borchard et al., 2012, p.
925-933). Such information has helped to establish understanding regarding the effectiveness of
safety checklist. Thus, using safety checklist is applicable in health care setting to improve the
patient safety. Such information provided by the different qualitative and quantitative study has
helped to develop the argument in an effective manner.
Impact of alternative argument:
In the debate, the downside of the safety checklist has been represented in the debate. It
has been argued that using safety checklist is one of the crucial part of the interventions for
patient safety. As I argued that safety checklist helps to improve the communication between the
health professionals and with patients as well, the counter argument has mentioned that, in some
cases where, horizontal and vertical hierarchy is exist in the medical team, the safety checklist

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acts as the common ground only and does not play any role in order to improve the relationship
dynamics within the health professionals. Such argument has forced me to think about the
implementation of safety checklist within a complex medical team. I think it is important to
improve the interprofessional relationship in order to reduce the hierarchy within the health care
settings. In this way the restriction could be managed (Pfaff et al., 2014, p. 4-20). Thus, it can be
said that the argument is not negligible, however, the disadvantage is modifiable.
On the other hand it has been argued that the risk of escalation within the nurse could
create stressful work environment, thus could affect the ability of the nurses to perform their duty
in an effective manner. In addition, safety checklist could hamper the quality of care if the nurses
start to focus only on completing the written documents in the list. Such incident could create
false sense regarding the accomplishment of duty. This particular argument has created a
dilemma for me. It is important to include safety checklist in order to prepare a proper care plan,
prioritize the care area and communicate with the other health care staffs during different shift,
however, it is required to provide information to the nurses about the importance of safety
checklist so that they could focus on the necessity not only what is written in the list to avoid the
escalation. In addition, escalation could help to identify the mistakes in the duty, thus, they could
resolve their mistakes and learn to improve their skill (Thomassen et al., 2014, p. 5-18). I think in
this way the issue of escalation and false accomplishment could be resolved.
Furthermore, the lack of time of health professional to use safety checklist has been
represented in the argument. However, according to me this just an excuse, because, it is the duty
of the health professional to prepare proper schedule for their daily work, thus, in the schedule
they could include the use of safety checklist. Individual level awareness and encouragement is
required to successfully implement the use of safety checklist (Olds et al., 2017, p. 155-161).

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Thus, I can say that the opposite argument has neutral impact on my thoughts as the points are
not negligible but such limitations of safety checklist could be resolved with proper
interventions. Hence, it can be said that, with effective implementation of safety checklist it is
possible to improve the patient safety in the health care in an effective manner.

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References:
Borchard, A., Schwappach, D. L., Barbir, A., & Bezzola, P. (2012). A systematic review of the
effectiveness, compliance, and critical factors for implementation of safety checklists in
surgery. Annals of surgery, 256(6), 925-933.
Brannen, J. (2017). Combining qualitative and quantitative approaches: an overview. In Mixing
methods: Qualitative and quantitative research (pp. 3-37). Routledge.
Frels, R. K., & Onwuegbuzie, A. J. (2013). Administering quantitative instruments with
qualitative interviews: A mixed research approach. Journal of Counseling &
Development, 91(2), 184-194.
Henry, D., & Ramirez-Marquez, J. E. (2012). Generic metrics and quantitative approaches for
system resilience as a function of time. Reliability Engineering & System Safety, 99,
114-122.
Lambert, V. A., & Lambert, C. E. (2012). Qualitative descriptive research: An acceptable
design. Pacific Rim International Journal of Nursing Research, 16(4), 255-256.
Lewis, S. (2015). Qualitative inquiry and research design: Choosing among five
approaches. Health promotion practice, 16(4), 473-475.
Olds, D. M., Aiken, L. H., Cimiotti, J. P., & Lake, E. T. (2017). Association of nurse work
environment and safety climate on patient mortality: A cross-sectional
study. International journal of nursing studies, 74, 155-161.

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Pfaff, K., Baxter, P., Jack, S., & Ploeg, J. (2014). An integrative review of the factors influencing
new graduate nurse engagement in interprofessional collaboration. Journal of advanced
nursing, 70(1), 4-20.
Russ, S., Rout, S., Sevdalis, N., Moorthy, K., Darzi, A., & Vincent, C. (2013). Do safety
checklists improve teamwork and communication in the operating room? A systematic
review. Annals of surgery, 258(6), 856-871.
Thomassen, Ø., Storesund, A., Søfteland, E., & Brattebø, G. (2014). The effects of safety
checklists in medicine: a systematic review. Acta Anaesthesiologica Scandinavica, 58(1),
5-18.
who,int. (2018). Patient safety. Retrieved from http://www.who.int/patientsafety/en/