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Welcome back, everyone.
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According to Maslow's hierarchy of needs,
everyone has fundamental
physiological needs
such as food, water, sleep, and shelter.
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Now once those needs are met,
we move to the topic
of today's video: Safety.
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Patient safety is defined
by the Institute of Medicine
as the prevention of harm to patients.
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The prevention of harm can be defined
as freedom from accidental
or preventable injuries
produced by medical care.
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Now, there are four system levels
involved with patient safety.
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The first is the individual clinician
or the nurse, the physician,
someone who is working
by themselves.
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Second, we think about microsystems
or the unit where you may work.
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Third, the entire organization.
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And, finally, we're talking
about the global environment
of policy, payment,
regulation, accreditation,
and all other factors external
to the actual care of the patient.
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Now working conditions
have an impact on safety.
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Nursing personnel actually represent
the largest component
of the health care workforce.
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Registered nurses provide
health care to individuals
in virtually all locations
in which health care is delivered.
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Nurses though are in short supply
and competition for them is strong.
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So the work environment of nurses
definitely has an impact on patient safety.
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But there are areas for improvement.
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First, we need to work
on the extended work hours
and fatigue experienced by nurses.
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We need to address mandatory overtime.
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Also, regulation of nurse staffing levels.
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Now protecting
patient safety in organizations
has many aspects.
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First, governing boards
that focus on safety,
leadership and evidence-based
management structures and processes,
effective nursing leadership,
adequate staffing,
organizational support for ongoing learning
and decision support,
mechanisms that promote
interdisciplinary collaboration,
work design that promotes safety.
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And, finally, organizational culture
that continuously strengthens
patient safety.
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Now let's go into each one of those
right now.
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Governing boards.
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These are knowledgeable
about the link
between management practices
and patient safety
Their emphasis is on patient safety
to the same degree as financial
and productivity goals.
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When you think of executive
or overall leadership,
they provide ongoing vigilance
in balancing efficiency
and patient safety.
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They demonstrate and promote trust in
and by nursing staff.
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And they actively manage
the process of change.
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Additionally, they engage nursing staff
in nonhierarchical decision-making
and work design.
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They establish the organization
as a learning organization.
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When you move to nursing leadership,
they participate
in executive decision-making.
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They represent nursing staff
to management.
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They achieve effective communication
between nurses
and all other clinical leadership.
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Additionally, they facilitate input
from direct care nursing staff
into decision-making.
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They also command
organizational resources
for nursing knowledge, acquisition,
and clinical decision making.
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When we think
about adequate staffing,
it's established by sound methodologies
as determined by the nursing staff.
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And it provides mechanisms
to accommodate unplanned variations
in patient care workload.
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It enables nursing staff
to regulate nursing unit workflow.
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And it's consistent
with best available evidence
on safe staffing thresholds.
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Moving to learning and decision support,
this uses preceptors
for novice nurses.
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It also provides
ongoing educational support
and resources to nursing staff.
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It provides training in new technology.
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It provides decision support
at the point of care.
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Moving to interdisciplinary collaboration,
use interdisciplinary
practice mechanisms,
such as interdisciplinary
patient care rounds.
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Provide formal education and training
in interdisciplinary collaboration
for all healthcare providers,
so that everyone knows how to work
together from different disciplines.
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Moving to work design,
that defends against fatigue and unsafe
and inefficient work design.
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It tackles medication administration,
handwashing, documentation,
and other high-priority practices.
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The culture of safety,
an organization regularly reviews
organizational success
in achieving formally
specified safety objectives.
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And it fosters a fair
and just error-reporting,
analysis, and feedback system.
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And, finally, the organization
trains and rewards workers for safety.
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Remember, nurses are in a key position
to improve patient safety.
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So, in thinking about
what we've covered today,
I'd like you to consider this question.
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What are the eight principles
which help protect patient safety
within organizations?
Governing boards that focus on safety,
leadership and evidence-based management
structures and processes,
effective nurse leadership,
adequate staffing,
organizational support for ongoing learning
and decision support,
mechanisms that promote
interdisciplinary collaboration,
a work design that promotes safety.
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And, finally, organizational culture
that continuously
strengthens patient safety.
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I hope you've enjoyed today's video
on patient safety in nursing.
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Thanks so much for watching.