Just Culture Model and its Impact on Patient Safety - Research Paper Example

? Just Culture Model and its Impact on Patient Safety as Part of the Roles of Clinical Nurse Specialist The demand in the healthcare sector is increasing as people need health assistance for survival. The increase in demand shows that improvements must also be done to boost the health support to patients. One of the professions in the healthcare sector that requires improvement is the nursing career. They serve as assistants to the medical doctors as they perform various clinical tasks. As nurses, they take care of the patients unlike medical doctors who are very much concerned with removing the disease and symptoms. For nurses, they may also expand their knowledge by studying further and advance their career into clinical nurse specialists which may give them the chance to work at the management level in the clinical setting. They would have the knowledge on the healthcare systems and find ways on how to improve the efficiency of the healthcare organization through policies and culture that caters the growth and learning of the staff nurses. To improve the competencies of the clinical nurse specialists, just culture model may be used as framework. It gives importance to patient safety and increase in accountability among members of the healthcare organization. Just Culture Model and its Impact on Patient Safety as part of the Roles of Clinical Nurse Specialist Introduction The healthcare sector has been growing as the demands for health assistance is increasing. It is the sector that will never die out as people need the basic services or even the sophisticated care in that area for survival and to prolong life. People need health assistance when they are sick, injured or weakened. The need for healthcare has also been growing due to its primary importance to human survival. Whenever people get sick, they visit the hospital to get solutions for their health problems. Care is also provided in the hospital for patients with aggravated situations and helps them to recover. When people are sick, they are very fragile as their bodies are weakened. They need the support to totally bring back their healthy bodies. In the search for health assistance, various health staffs are prepared to assist the patients with their specific needs. From food intake to drug administration, the healthcare staffs are there to assist them. The professionals that assist the patients usually require long and intense training and license before they can perform their tasks to care for the patients. One of those health professionals is the nurse. Nurses have been important as they assist the doctors in the medical field to provide health assistance to patients in hospitals, at home or in the community. They are entrusted to help in the health restoration of the patients from their current weak condition to a healthy one. Nurses then may work on their own as they specialize on various roles or take part in a group in planning and evaluating the health care performance. They also attend trainings to further enhance their knowledge and skills to better support the health needs of the patients (Smith, 2004, p. 3). They are also updated with the current breakthroughs in their field of career through scholarly journals. Nurses may opt to specialize further through studies and further trainings to become clinical nurse specialists. As clinical nurse specialists (CNS), they must have more than the undergraduate degree in nursing and the education must be provided by accredited CNS institutions (Callara, 2008, p. 57). They are highly specialized to cater the specific needs of the patients that may depend upon the kind of diseases or illnesses the patients have. The CNS may also work on hospitals, houses, communities or specific units of the hospital such as emergency room and operating room. They also assist in surgeries or clinical procedures (Dreher et al., 2011, p. 78). In general, there are five duties each CNS may do like hospital work, management, education and instruction, research and consultancy. The common notion on nurses are involving hospital work such as taking care of the patients and assisting the doctors. Management may also be done by highly-educated CNS as they have the know-how in the routines and responsibilities of nurses (Callara, 2008, p. 93). They may also work under the educational field wherein they teach the basic nursing skills to nursing students. Research is also undertaken by CNS as they look for breakthroughs to improve the quality of health services they provide. Consultancy is also part of the roles of CNS as their advices are needed in hospitals and health safety issues in the community (McGrath et al., 2006, p. 47). Then, their skills surpass the abilities of expert staff nurses as CNS people are expected to be the leaders in their field. They also have a big role in education wherein they teach the staff nurses and may also deal with the instruction on nursing students regarding proper patient care. They also seek to devise various ways to explain the medical conditions to their patients (Callara, 2008, p. 58). They also handle other people besides the nurses as long as they deal with the health needs of the patients. Clinical nurse specialists have the ability to encompass a wide scope of health care roles to better improve the health care of the individuals and of the community as a whole through consistent revision, application and evaluation of the system of health assistance (Dreher et al., 2011, p. 263). In return, the nurses must be able to provide the best services to their clients to ensure them that patient safety is a priority. Once The paper discusses clinical nurse specialists further with a focus on the patient safety through the administration of just culture model. The impacts of the model will also be dealt with as to see whether any improvements may be seen in the health care system and results will be optimized on the patient conditions and health staff learning. Topic Presentation Clinical nurse specialists work in a team or individually in hospitals and other facilities like clinics, health centers and even at home. Since they are highly specialized, it is expected that they can handle any kind of patient situations and give the utmost care to their patients without losing their composure (Callara, 2008, p. 91). CNS may specialize in one or more subareas such as care for mild diseases, care for the elderly, community health assistance, circulatory system health help, home-based care, child health care, school health assistance and many more (Zuzelo, 2010, p. 22). They may choose to master any combinations of those fields to enhance the health support system further and satisfy the health service demands of the patients. Clinical nurse specialists must be able to combine the three factors that are part of the picture in their health care practice namely the system, nurses and patients. Each of the factors is called spheres with its own focus that can be separated from the others. Though they have differences, they are considered to be overlapping (Callara, 2008, p. 265). With those three in consideration, CNS people consider the improvement of the system through the actions of the nurses to cater the needs of the patients as the most important objective. The primary objective may be done through continuous learning catered by the system that favors growth through experience and mentoring. With the experience comes mastery that will later on reduce the unwanted services or below the standards health assistance that patients may have suffered in the past. The diversity in the nursing organization is also considered as each individual is unique (Zuzelo, 2010, p. 299). It may be a reason for the clinical nurse specialists to think about the ways on proper facilitation without losing ethics and provide the best services while the staff nurses are learning too. Being objective prevails among clinical nurse specialists as they target to showcase evidence-based nursing treatments. They also prioritize patient safety as the survival and recovery of patients depend upon the hands of the nurses and other healthcare professionals. Their profession is about service and care for the diseased and weakened people in general. They are largely concerned with the wellness of their patients. In line with the concern for the condition of patients, the discipline and practice of patient safety has been created to cater their needs. The said discipline relies on reports, studies and preventive techniques to ensure that the healthcare practices are not detrimental to the patients. Medical errors must be avoided for healthcare system to be very effective. When it comes to the model, it has been a norm in the academe and professional careers to make use of models to better understand and accurately summarize certain concepts. As such, the clinical nurse specialists may opt to use a nursing model as the framework of their competencies to further enhance and promote the nursing practice. Nursing model is different from medical model though they are both under the health sector. Medical model is mainly concerned with the extinguishment of the disease which means that model desires to remove the diseases and illnesses as the priority. Nursing model differs from medical model as its main concern is to take care of the patients. It is about the support in the health needs of the patients and not focusing on the elimination of symptoms and diseases (Barnum and Kerfoot, 1995, p. 25). In line with the nursing model, the focus will go onto the just culture model on patient safety. Review of Literature The rise in adverse effects on patient safety had been recorded only during the 90s when various nations were able to find evidences on dying patients due to healthcare errors. The errors include human errors, medical complications and errors on systems. Human errors include differences in expertise and trainings, tiredness, no knowledge on serious adverse effects of medical errors, pressures, confusing healthcare setting and negative emotional condition. Medical complications include high technology equipment failures, side-effects of medicines, and long-term stay of patients with the healthcare provider. System failures include lack of communication, lack of line of authority among health staffs, lack of healthcare staffs as the number of patients increases, lapses in coordination among staffs and departments, too much dependence on automatic systems for error prevention, lack of access to information on medical errors and strategies, budget cut, poor hospital layout, and medical equipment malfunction. All of those errors make the patient conditions unfavorable. In line with the errors, two approaches are identified which are the system and person approaches. The person approach points out that the mistakes are committed by the people in the organization and they should be the ones to be blamed. On the other hand, system approach focuses on the circumstances and not directly on the people involved. System approach is about the larger perspective and objectively solves the errors that occur. It prevents any further defense mechanisms that the people in the organization tend to build when they are accused of committing the errors. Organizations become more accountable to the errors as they tend to identify errors as inevitable and room for growth. They still work hard to prevent any errors from happening without forgetting the risks involve (Reason, 2000). Efforts are made to reduce the errors like identifying the mistakes detrimental to the health of patients. Standards have been created across hospitals to make the patient safety a priority. Some points to remember are patient identification, medicine administration, staff communication, disease prevention, risk identification and surgical error prevention. Patient identification is done by using their names and birthdays in labeling the required treatments for them. Also the health staffs must be sure to give the patients the right blood during transfusion. In medicine administration, proper labeling should be done at all times. The proper care must also be done to patients who take drugs for blood thinning. The right information must also be provided to the patients about their medicines and should be compared with the new administered drugs. In terms of staff communication, it should be on-time whenever test results are available. For disease prevention, proper hand washing must be practiced based upon the standard set forth by World Health Organization. Guidelines must also be followed for infection prevention especially during surgery. Risk identification must also commence as to know who among the patients may have disruptive behavior and may commit suicide. Surgical error prevention may be done by having a pause before starting the actual surgery through identification of the right person and right body part to be operated (The Joint Commission Accreditation Hospital, 2012). In healthcare, patient safety is important and it may be promoted further through just culture model wherein the healthcare organization has its own culture or set of values that must be given importance. Safety is part of the culture in healthcare which the staffs must be aware of at all times. It is still a challenge as various parts of the culture are not dealt with accordingly. It is suggested that goal setting may entail a clear vision for the patient safety improvement among healthcare organizations worldwide. They also must cater the social cognitive theory as the basis for learning among the staffs in the organization. It may be used for an easier evaluation and changes that must be done within the culture of the organization (Cooper, 2000). The theory holds true to prevent any blaming happening in the organization and promote responsibility in experiential learning. Discussion Usually the implementation and absence of systematic procedures discourage any improvements in the health care services of organizations. Without proper consciousness, patients may not be able to recover fully or maintain their health conditions. Besides, inconsistencies will sprout and once the regulatory bodies make their inspections, they will see that standards are not well-implemented across the departments (Callara, 2008, p. 154). The coordination in the system is primarily the task of the clinical nurse specialist especially in the growth of the staff nurses and in the education of the patients and their families. Since the perspective traversed more than one discipline, it is necessary for the CNS to cooperate and communicate with both the patients and the family together with the direct health assistance provider such as the staff nurses. It is expected that a clinical nurse specialist is a master of working relationships that he can manage a diverse group with the individuals contributing to the attainment of the objectives and needs of the patients. The CNS then looks at both the healthcare staffs and the patients and families and how both parties may come into terms to reach the peak of the patient recovery (Edwards, 1999). Also the role of other institutions and medical providers are necessary for the improvement of the healthcare system as a whole. The just culture model may show how collaboration may be done among healthcare organizations and within the organization. It increases the accountability of people without hurting them personally. It promotes growth among the members while ensuring a higher level of patient safety (Connor et al., 2007). Conclusion Just culture model is effective to use for improving the patient safety and must be considered by clinical nurse specialist and other medical and health staffs. Their growth is ensured in their career through experiential learning with increased accountability and upholding patient safety. References Barnum, B. and Kerfoot, K. (1995). The nurse as executive. USA: Aspen Publishers. Callara, L. (2008). Nursing education challenges in the 21st Century. USA: Nova Science. Connor, M., Duncombe, D., Barclay, E., Bartel, S., Borden, C., Gross, E., Miller, C. and Ponte, P. (2007). Creating a fair and just culture: One institution’s path toward organizational change. Joint Commission Journal on Quality and Patient Safety, 33 (10). Retrieved from http://www.ingentaconnect.com/content/jcaho/jcjqs/2007/00000033/00000010/art00009 Cooper, D. (2000). Towards a model of safety culture. Safety Science, 36 (2). Retrieved from http://www.sciencedirect.com/science/article/pii/S0925753500000357 Dreher, H., Glasgow, M., and Melnyk, M. (2011). Role development for doctoral advanced nursing practice. USA: Springer. Edwards, D. (1999). The synergy model: Linking patient needs to nurse competencies. Critical Care Nurse, 19 (1). Retrieved from http://www.aacn.org/WD/Certifications/content/ synpract2.pcms?pid=1&&menu=Certification McGrath, P., Anastasi, J., Young, S., Gorman, D., Moxham, L., and Tollefson, J. (2006). Collaborative voices: Ongoing reflections on nursing competencies. Contemporary Nurse, 22. Retrieved from http://eprints.usq.edu.au/2589/2/ McGrath_Anastasi_FoxYoung_Gorman_etal_CN_v22n1_PV.pdf Reason, J. (2000). Human error: models and management. British Medical Journal, 320 (7237). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/pmc1117770/ Smith, A. (2006). Using the synergy model to provide spiritual nursing care in critical care settings. Critical Care Nurse, 26 (4). Retrieved from http://m.aacn.org/WD/Certifications/Docs/synergyjun06.pdf The Joint Commission Accreditation Hospital. (2012). Hospital national patient safety goals. Retrieved from http://www.jointcommission.org/assets/1/6/2012_NPSG_HAP.pdf Zuzelo, P. (2010). The clinical nurse specialist handbook. USA: Jones and Bartlett. Read More