Patient Safety and Quality Improvement Act of 2005.

In: Social Issues

Submitted By TBrowdy
Words 3619
Pages 15
In Social Learning Theory, human behaviour is explained in terms of a three-way, dynamic, reciprocal theory in which personal factors, environmental influences, and behavior continually interact. A basic premise of Social Learning Theory is that people learn not only through their own experiences, but also by observing the actions of others and the results of those actions. In the 1970s, Albert Bandura published a comprehensive framework for understanding human behaviour, based on a cognitive formulation which he named the Social Cognitive Theory. That framework is currently the dominant version used in health behaviour and health promotion; however, it is still often referred to as Social Learning Theory.

The impetus for this special issue on HIV came from a discussion a few years ago during which we established a shared interest in a revival of the sort of scholarly innovation that characterized the early years of the HIV epidemic. As far back as the early 1980s, social theorists, cultural, critics, artists and others created a vibrant body of work on HIV/AIDS. Working from various theoretical and disciplinary sites they steadfastly emphasized the ‘social’ for understanding the significance of AIDS and opened up new avenues for critiquing and re-imagining scientific, cultural and social responses to infectious disease. At its best, this work served also as an impetus for queer theory, various feminist critiques and a range of research under the rubric of science, medicine and technology studies.
The contributions made by this early work and its effects on public discourse on HIV/AIDS were multiple. Among the more groundbreaking contributions worth underscoring here were analyses that destabilized the neutrality of scientific knowledge and practice, emphasizing the malleability and culture-bound nature of its disease definitions (Martin, 1994) as well as…...

Similar Documents

Nursing Overtime and Patient Safety

...outcomes for patients, including early readmission, medication errors, falls and nosocomial infections. More regulation may be necessary to reduce the hours worked by nurses. Advanced practice registered nurses are in a position to advocate for stricter policies in their facilities, and to implement strategies that would reduce overtime hours worked in their facilities, for example by increasing staffing. Nurse managers can ensure that their nurses doing overtime take the recommended breaks and do not exceed the recommended number of hours worked per week. Nursing Overtime and Adverse Effects Mandatory overtime is defined as employer-imposed work time in excess of one’s assigned schedule. Voluntary overtime is time worked at the employee’s discretion over and above that specified for a full-time employee. Both of these are utilized frequently by the health care sector, primarily in light of the nursing shortage. A study by Berney, Needleman and Kovner (2005) demonstrated that an average of 4.5% of total paid hours worked by registered nurses (RNs) was paid overtime. Furthermore, paid overtime increased from 1995 to 2002, from an average of 3.9% to 5.9% of total hours, and mean overtime rose from 0.23 to 0.39 hours per patient day. The economic recession has forced many nurses to pick up extra shifts pay their bills, often to make up for the loss of income from recently laid off family members. The nursing shortage has resulted in fewer hospital workers to care for......

Words: 3346 - Pages: 14

Quality Improvement

...Collaborative Communication: Integrating SBAR to Improve Quality/Patient Safety Outcomes Cynthia D. Beckett, Gayle Kipnis Purpose/Evidence-Based Practice Question Collaborative communication and teamwork are essential elements for quality care and patient safety. Adverse patient occurrences are an extremely common outcome of communication failures (Leonard, Graham, & Bonacum, 2004). In 2004, the Joint Commission (formerly the Joint Commission on Accreditation of Healthcare Organizations) analyzed 2,455 sentinel events from hospitals across the United States and reported through root cause analysis over 70% of the events were due to communication failures, and approximately 75% of the patients involved died (Leonard et al., 2004). Although improving communication has been included as a Joint Commission’s National Patient Safety Goal for hospitals since 2003, in 2006, handoff communications were included as a specific communication subset. NPSG 02.05.01 states ‘‘The organization implements a standardized approach to handoff communications, including an opportunity to ask and respond to questions’’ (Joint Commission, 2006). Michael Leonard, MD, from Kaiser Permanente- Denver introduced a collaborative communication tool to support patient safety and outcomes. The structured communication tool is Situation, Background, Assessment, and Recommendation (SBAR) (Haig, Sutton, & Whittington, 2006). The SBAR tool provides a framework for organizing......

Words: 5750 - Pages: 23

Ensuring Patient Safety

...Today’s healthcare institutions and providers strive to be safe places for patients to receive care, but past data indicates it has not always been so. The Institute of Medicine determined in the late 1990’s that 44,000 to 98,000 patients die from medical mistakes each year (Wachter, 2008). This tremendous number of deaths places medical care mishaps between the fifth and eighth leading causes of deaths in the United States (Kizer, 2001). In 2002, The Joint Commission established National Patient Safety Goals (NPSG) to help accredited organizations with patient safety in specific areas. An advisory group comprised of nurses, physicians, pharmacists, risk managers, clinical engineers, and others with appropriate experience advises The Joint Commission on how to address emerging patient safety issues. This group also periodically develops and updates the goals. The goals are grouped into broad categories and for 2011-2012, cover such categories as patient identification, health care-associated infections, improving communication, medication safety, reducing falls, and risk assessment. A discussion of selected elements underlying the current NPSG such as hand washing techniques, training, and lack of communication between healthcare personnel that can lead to medication errors, to falls, and even death, plus other related factors such as staffing shortages, problems with using outdated equipment, considerations in using the electronic medical records, and compliance with......

Words: 5259 - Pages: 22

Patient Safety Risks

...Patient Safety Risks Medication safety continues to be one of the most significant issues in patient safety. The increase incidence of adverse drug events makes medication safety an urgent goal and should remain high on the organization’s agenda (World Health Organization, 2008). The process of medication reconciliation identifies the most accurate and comprehensive medications list, which contains all prescription medications, herbal supplements, vaccines, vitamins, and over-the-counter medications (Barnsteiner, 2008). This is a very important part of the care transition process, in which healthcare providers come together to improve upon medication safety, as the patient goes to and from different levels of care (www.uthscsa, 2010). Medication reconciliation became a frontline matter, when the Joint Commission (JC) defined its national goals to improve a patient’s safety. The JC changed its requirements to medication reconciliation under the NPSG 03.06.01 Act, which became effective on July 1, 2011 (Steeb & Webster, 2012). Even the revised version consists only of five elements of performance instead of seventeen from the previous version. The implementation process continues to be a difficult one. Every health care provider can have a role that differs from others in the process. A general goal of medication reconciliation directed towards a patient’s safety and outcomes improvement is obtaining and maintaining the accuracy and complicity of medication information and......

Words: 1421 - Pages: 6

Improving Healthcare and Patient Safety

...Running head: IMPROVING HEALTHCARE QUALITY AND PATIENT SAFETY !1 ! ! ! ! Quality Improvement Techniques: Improving Healthcare and Patient Safety ! HMGT 320 ! February 9, 2014 ! ! ! ! ! ! ! Quality Improvement Techniques in a Healthcare Setting !2 ! There is a great need to improve on the quality of healthcare we are providing to patients and it is a necessity to improve on patents safety also. Quality health care is defined as the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge (Chassin, 2006). According to the Institute of Medicine, To Err Is Human, the majority of medical errors result from defective systems and procedures, not individuals. Processes that are ineffective and flexible, changing case mix of patients, health insurance, differences in provider education and experience, and numerous other factors contribute to the difficulty of health care. With this in mind, today’s health care industry functions at a lower level than it can and should, and it put forth the following six aims of health care: effective, safe, patient-centered, timely, efficient, and equitable (Ferlie, 2005). The aims of effectiveness and safety are targeted through various processes that will measure whether providers of health care perform processes that have been demonstrated to achieve the desired aims and avoid those processes that are given toward......

Words: 901 - Pages: 4

Course Project Quality Improvement in Healthcare

...Table of Contents Introduction Page 3 Risk Scenario Related to Patient Care and Safety Page 5 Risk Scenario Related to the Physical Plant Page 9 Risk Scenario Related to Staffing Page 13 Best Practices in 4 Hospitals Page 15 Tenet Healthcare Page 16 Cleveland Clinic Stroke Improvement Plan Page 17 Conclusion Page 18 References Page 19 Introduction The issue of risk scenario carries immense importance for most of the hospitals that are part of the healthcare setting. However, there is not only one scenario that can affect the hospitals but there are several scenarios that can create an impact on the functions of the hospital. There are three scenarios that would be highlighted in the current topic. These three scenarios have a tendency to put a hospital at risk for financial stability. The first scenario that can produce a negative impact on the hospital risk is related to patient care and safety. The second scenario is related to the physical plant. The third and last scenario is related to staffing. The role of HIM practitioner in this regard would be very important. They would serve as a clinical quality assessment resource and as a team member to perform their tasks related to healthcare work. Therefore, all the issues related to three scenarios will be discussed in detail. The impetus for quality improvement has been driven in recent years by three main factors: 1. The amount of money that the US spends on healthcare per capita and......

Words: 4236 - Pages: 17

Patient Safety

...Abstract Patient safety and Medical errors are one of the major concerns of healthcare industry. Our group decided to throw more light on the present situation of this issue. In this paper we have given a clear picture about the types of errors, how these errors occur and towards the end we have discussed on how to prevent these errors. The implementation of the actions to prevent errors discussed in our paper will help in improving and reducing them. In doing so, we can be leaders in an effort to provide the best care possible to all Americans. We have also discussed about the importance of patient safety. Reducing errors and improving how we respond to error is but a subset of the all-important issue of quality of care.   TABLE OF CONTENTS Introduction ……………………………………………………………………………... 5 Regulatory Authority……………………………………………………………………. 5 Patient safety ……………………………………………………………………………. 6 Medical Errors ………………………………………………………………………….. 7 Why medical errors occur? .............................................................................................. 8 When errors are not reported ………………………………………………………….. 8 Types of Medical Errors ………………………………………………………………… 9 Sentinel Events ……………………………………………………………………….. 9 Diagnosis or evaluation ………………………………………………………………. 9 Medical decision-making …………………………………………………………… 10 Treatment and medication …………………………………….…………………..… 10 Dispensing ……………………………………………………………………………11 Procedural......

Words: 3792 - Pages: 16

Patient Safety Workshop

...Patient Safety Workshop Learning From Error PATIENT SAFETY WORKSHOP LEARNING FROM ERROR WHO Library Cataloguing-in-Publication Data Patient safety workshop: learning from error. Includes CD-ROM 1.Patient care - standards. 2.Medical errors - standards. 3.Patient rights. 4.Health facilities - standards. 5.Health Management and Planning. I.World Health Organization. ISBN 978 92 4 159902 3 (NLM Classification: WX 167) This publication is a reprint of material originally distributed as WHO/IER/PSP/2008.09. © World Health Organization 2010 All rights reserved. Publications of the World Health Organization can be obtained from WHO Press, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland (tel.: +41 22 791 3264; fax: +41 22 791 4857; e-mail: Requests for permission to reproduce or translate WHO publications – whether for sale or for noncommercial distribution – should be addressed to WHO Press, at the above address (fax: +41 22 791 4806; e-mail: The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. Dotted lines on maps represent approximate border lines for which there may not yet be full agreement. The mention of specific......

Words: 9127 - Pages: 37

Patient Safety

...Patient Safety in a Home Care setting 1 Kimberly Casimier Chamberlain College of Nursing Instructor: Pamela Morgan September 27,2014 Patient Safety in a Home Care setting 2 Introduction Thousands of deaths are caused and could have been prevented if patient safety measures would have been taken. It is very important improve patient safety compliance to prevent things like surgeries being done on the wrong site, medication errors, health care acquired infections, falls, and diagnostic errors. Patient safety not only takes place in the hospital, doctors office, and rehab/nursing home facilities, but it also takes place in the home care setting. The Speak Up home care brochure is geared to inform that patient on what to speak up about in the home care setting and if the patient speaks up and the nurse of healthcare worker complies, more errors can be prevented. The home care brochure really gives that patient many options of questions to ask the nurse or healthcare working during their home care. It empowers that patient and hopefully helps them know what they are entitled to as a patient as far as home care, questions they should ask if they are concerned and for information purposes, and I hopefully helps the patient to not......

Words: 1293 - Pages: 6

Patient Safety

...Patient Safety Project Week Six Dawn Frizell NURS/588 Linda Horton University of Phoenix Patient Safety Project Week Six Executive Summary One out of five falls results in major injuries such as fractures and head trauma. Medical cost for such falls are $34 billion yearly, and hospital cost account for two-thirds of the total of falls (CDC, 2013). Along with this information, hospital losses from falls occurring as inpatients have lost millions of dollars in revenue. Many of these fall can be avoided, and can also decrease extended inpatient care along with decrease profit loss. A process must be developed here at Davis Healthcare System (DHS), in response to patient falls, injuries and profit loss. In the Mission and Vision statement at the DHS, it states several key words: high-quality care, safety, innovation, patient-centered care, and that is the reasons that we must initiate the quality improvement plan immediately. Safety deals with lack of harm to the patient and Quality is an effective, efficient and focused direction that to get to safety. Our team of experts in quality improvement will use our mission, tools, communication along with collaborating with the patients to get to the root and cause of this problem. There are several ways to accomplish this goal, 1). Purchasing an item called Radio Frequency......

Words: 3184 - Pages: 13

The Culture of Patient Safety, suicides, restraint-related injuries or death, falls, burns, pressure ulcers, and mistaken patient identities. High error rates with serious consequences are most likely to occur in intensive care units, operating rooms, and emergency departments. Beyond their cost in human lives, preventable medical errors exact other significant tolls. They have been estimated to result in total costs (in­ cluding the expense of additional care necessitated by the errors, lost income and household productivity, and disability) of between $17 billion and $29 billion per year in hospitals nationwide. Errors also are costly in terms of loss of trust in the health care system by patients and diminished satisfaction by both patients and health professionals. Patients who experience a long hospi­ tal stay or disability as a result of errors pay with physical and psychological discomfort. Health professionals pay with loss of morale and frustration at not being able to provide the best care possible. Society bears the cost of er­ rors as well, in terms of lost worker productivity, reduced school attendance by children, and lower levels of population health status. A variety of factors have contributed to the nation’s epidemic of medi­ cal errors. One oft-cited problem arises from the decentralized and frag­ mented nature of the health care delivery system--or “nonsystem,” to some observers. When patients see multiple providers in different settings, none of whom has access to complete......

Words: 3171 - Pages: 13

Radiology Technologists Role in Quality Patient Care and Safety

...Technologists Role in Quality Patient Care and Safety Keiser University Abstract I never really sat down and realized how important patient care really was going to be to my job. I always just thought of it as just taking pictures of the bones. Come to find out there really is a whole lot more to it than what I thought. Quality patient care is very important from the way that we communicate with the patient all the way to the time they go home and or are released from the hospital or care. There are several protocols and procedures that we are required to follow and abide by. These are just done to ensure that neither the patient nor we get hurt; and that everything is done in a safe manner. The patient’s life kind of still lies in your hands sometimes. Radiology Technologists Role in Quality Patient Care and Safety How would you feel if the Radiology Technologists that was taking care of you didn’t know what they were doing? I know that I wouldn’t feel comfortable and would probably ask to have someone else take care of me. Which as a patient we have that right; but there are roles and guidelines that the Radiology Technologists have the duty to follow as well. The American Society of Radiologic Technologists has made a Code of Ethics that should be followed. These Code of Ethics are put into place to make sure that the patient receives quality care,......

Words: 1839 - Pages: 8

Quality Improvement

...Assessment for Quality Improvement Quality improvement should be a major focus in any organization and requires four basic steps: “…specify the requirements, design the product, create the product, and examine the product.” (Burrill and Ledolter, 1999, p. 142). Each process must be completed in order as each is important. Once requirements and specifications have been determined, resources and standards can be evaluated to create and test the product. The means of creation will be different in various organizations but the process remains the same. During every part of each process, flow charts can be analyzed to make proper decisions; strategic plans must be considered; impact on all stakeholders must be evaluated; and appropriate quality management tools must be determined. Each member of the team involved in writing this paper completed a simulation exercise on “Quality Management and Productivity” to determine the ability to analyze data. Information on the above considerations, perceptions of the simulation and suitable quality management tools to improve processes in a health facility are furnished in this paper. Description of the Create Process “Create is the process of actually producing the required product. Whether the product is a house, a gourmet meal, a term paper, or a clean office, this stage involves the creation of a product according to the product requirements.” (Burrill and Ledolter, 1999, p. 148). The creator is simply creating something different,......

Words: 2138 - Pages: 9

Quality Improvement Part Ii

...Running head: QUALITY IMPROVEMENT PLAN PART II Quality Improvement Plan Part II Cheryl Wright University of Phoenix HCS 588 Cynthia Hughes July 16, 2012 Quality Improvement Plan Part II Quality improvement is a hospitals process to advance the quality of care and outcomes for patients using an explicit set of philosophies and procedures (Walker, 2012). This paper attempts to describe some of the areas of potential advances for quality improvement at Washington County Regional Medical Center (WCRMC) nursing unit. One principle of quality improvement is measurement, which is the collection of data to improve patient care. Using these measurements and tools can help leaders understand the direction of quality in the organization. Areas of Potential Improvement for the Organization. The areas of consideration for improvement at WCRMC are emergency room wait times and discharge instructions. Both of these improvement areas have financial and influence for the health care organization. Emergency room wait times can reduce the market share and financial stability of the health care organization. Discharge instruction if given appropriately by the nursing staff can reduce the readmission rate for WCRMC, along with financial gain and improve the satisfaction of the patient experience. These are just of couple of measures WCRMC can use to align the mission of the organization and the commitment of improving performance. There are several models and......

Words: 1382 - Pages: 6

Use of Information Technology to Improve Patient Safety and Quality of Nursing Care

...Use of Information Technology to Improve Patient Safety and Quality of Nursing Care Introduction We are in a great evolution in the way we are gathering data, gaining information, and increasing our knowledge to provide our patients’ with safe quality care. Without information technology (IT) in today’s healthcare industry, it would be impossible to delivery high quality care. The purpose of this paper is to explore data accuracy & safety, data integrity, and the contributions of IT. Data Accuracy and Safety One of the biggest obstacles to interoperability among information systems is the vast amount of medical terms used to describe the same concept. One strategy that is being implemented in IT to increase data accuracy and safety is to ensure that all electronic health records (EHRs) in all hospitals share common standards for data, classifications, coding systems (Qamar, R., Kola, J.S., & Rector, A.L., 2007). The aim is to standardize medical vocabulary to reduce differing interpretation of information and errors resulting from the traditional paper records. This is an accomplishment that groups have been working on for the last decade. The health IT Standards committee has endorsed a single set of vocabulary standards and a single guide for putting them in place for each area of quality reporting measures (Mosquera, 2011). Two work groups, The Systemized Nomenclature of Medicine-Clinical Terms (SNOMED-CT) and The Logical Observation Identifiers Names and......

Words: 1098 - Pages: 5

What Strange Mystery Unites the Turkish Nations India Catholicism and Mexico A Concise but Detailed History of Things Divine and Earthly Gene D Matlock pdf | Sam Parsonson | Öl, Pflege- & Schmiermittel