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Running head: ACCOUNTABILITY OF NURSING PROFESSIONALS Accountability of Nursing Professionals Accountability of Nursing Professionals Errors pervade in our lives whether it is our home, in our workplace, or in our society. The effects of healthcare errors have impacted all our lives either directly or indirectly. Patient safety and quality care are at the core of healthcare system which strongly depends upon nurses. “To achieve goals in patient safety and quality, thereby improve healthcare, nurses must assume the leadership role.
Nurses need to ensure that they and other healthcare providers center healthcare on patients and their families. Even though the quality and safety of healthcare is heavily influenced by the complex nature of healthcare and multiple other factors, nurses have been held accountable for harm to patients, even when other clinicians and other healthcare providers and characteristics of the care system in which they work often have- almost without exceptions- greater roles and in some respects have ensured that an error would happen” (Patient Safety and Quality, 2008, p. ). “Evidence based practice is the combination of individual, clinical or professional expertise with the best available external evidence to produce practices that is most likely to lead to positive outcomes for a patient ” (Integration Of Evidence, 2011, p. 1). The evidence should be used in clinical decision making whenever possible in order to improve quality of care. Findings from research continue to provide information about how some patients are not receiving the quality of care and how errors continue to adversely impact patient outcomes.
Sources for evidence based practice are not limited to research findings. Sources can include clinical experience, quality improvement data, logical reasoning, client satisfaction and situation. If a patient is not assessed accurately, the wrong intervention will be selected which can harm the patient. Medication errors such as wrong patient, wrong drug, wrong dose, can threaten the safety of patients. As a nursing professional, we are accountable for these errors.
A physician could make mistakes in prescribing, the pharmacy could send the wrong medication, but who actually gave it to the patient is accountable for the consequences. For this reason, it’s our responsibility to implement change in our practice based on the evidence in order to ensure safe patient care. From investigation in health practices, ventilator associated pneumonia caught my attention. “Ventilator Associated Pneumonia (VAP) is a leading cause of morbidity and mortality in intensive care units.
Most episodes of VAP are thought to develop from the aspiration of oropharyngeal secretions containing potentially pathogenic organisms. Aspiration of gastric secretions may also contribute, though likely a lesser degree. Tracheal intubation interrupts the body’s anatomic and physiologic defenses against aspiration, making mechanical ventilation a major risk for Ventilator Associated Pneumonia. Semi-recumbent positioning of mechanically ventilated patients may help reduce the incidence of gastroesophageal reflux and lead to a decreased incidence of VAP.
The one randomized trial to date of semi- recumbent positioning shows it to be an effective method of reducing VAP. Immobility in critically ill patients leads to atelectasis and decreased clearance of bronchopulmonary secretions. The accumulation of contaminated oropharyngeal secretions above the endotracheal tube cuff may contribute to the risk of aspiration. Removing these pooled secretions through suctioning of the subglottic region, termed continuos aspiration of subglottic secretions may reduce the risk of developing ventilator associated pneumonia” (Making Health Care, 2001. , 185). From this information that I have received, I will implement some changes in my practice, taking care of patients on ventilators. Since aspiration of subglottic secretion is an uncommon practice, suctioning patients more frequently can help reduce ventilator associated pneumonia. So I will suction patients more frequently. I will also share this information with my co-workers. Most of the time we run to patients when the ventilator is alarming, and what they need is suction. From now on I won’t wait for the alarm.
Another change I will enforce with patients on ventilators is making sure the head of the bed is elevated at least forty-five degrees at all times to prevent aspiration. I always keep the head of the bed elevated before I leave bedside. But, most of the time what happens is, other healthcare workers such as x-ray technicians, taking a chest x-ray or a nursing assistant turning the patient forgets to put the head back up. I guess they don’t realize the damage they are doing to these patients.
Now I can share this information with other healthcare workers to keep my patients safe. Since as a nurse, I am accountable for the consequences, I have to assume the leadership role and make sure that my patient’s well being is not being challenged by any other healthcare workers. Patient safety and quality care are at the core of health care system. As nurses, it is our responsibility to acknowledge evidence based practice and implement changes in practice to provide the best care for our patients. References Hughes, Ronda. (2008).
Patient Safety and Quality: An Evidence-Based Handbook of Nurses. Maryland: AHRQ Publication. Scott. (n. d. ) Integration Of Evidence-Based Practice Into Professional Nursing Practice. Retrieved on February 17, 2011, from http://www. oppapers. com/essays/Integration-Of-Evidence-Based-Practice-Into-Professional/565941 University of California at San Francisco. (2001). Making Health Care Safer: A Critical Analysis of Patient Safety Practices [Electronic version]. Retrieved February 17, 2011, from http://archive. ahrq. gov/clinic/ptsafety/pdf/ptsafety. pdf