2020 National Patient Safety Goal #1 for Nurses

A Culture of Safety

Patient safety is a crucial and fundamental element of quality nursing care. It denotes the nonexistence of avoidable harm to patients in the course of obtaining health care and prevention of risks of needless harm linked to medical attention to a tolerable minimum. Nevertheless, the health care system is susceptible to mistakes, which may be detrimental to safe patient care because of basic systems imperfections. Different stakeholders such as nurses and nursing teachers have the responsibility of making sure that patient care is provided safely through the prevention of any likely harm.

This paper focuses on goal 1 of the 2020 National Patient Safety Goals under the Nursing Care Center, “improve the accuracy of patient and resident identification,” and discusses how information technology in the form of electronic health records, has assisted in the minimization of risks and improvement of safety (The joint commission, 2019). There is a need to establish a culture of safety in the health care system to prevent identification errors that may arise at any phase of diagnosis or treatment and have a negative impact on patient outcomes and well-being.

Informatics Technologies for Patient Safety

The purpose of goal 1 selected for this paper is to assist in dependably recognizing patients and matching the required care to each individual. Suitable identifiers might encompass the patient’s name, allocated identification number, phone number, or any individual-specific indicator. In the facilitation of informatics technologies for patient safety, electronic health records have been extensively used in care delivery.

Such systems comprise electronic patient charts and characteristically encompass practicality for mechanized access referred to as computerized provider order entry, image and lab reporting, and health tool interfaces (Leite, Andrews, & Thomas, 2016). Preferably, the system generates a seamless, readable, extensive, and enduring record of patients’ details for easy identification, clinical treatment, and history.

Computerized provider order entry in electronic health records enables medical professionals to key in instructions such as required medications, lab tests, and other treatment processes in a data processor instead of writing down on paper. The computerization process eradicates possibly detrimental medical flaws attributable to poor handwriting of the care provider, misplacement, or difficulty in the retrieval of the record when needed.

It also creates an efficient ordering progression since nursing and pharmacy professionals do not require further clarification or search for missing details from unreadable or unfinished orders. Identification problems can be lessened by around 85% when electronic health records are used, and alerts are generated anchored in physician orders (Papoutsi et al., 2015). This enhances not just the safety of care but also its effectiveness and efficiency.

Attributable to medical details being available automatically to care providers, electronic records improve the sharing of vital data through health information exchange. Easing the process of sharing crucial patients’ information between different care providers using technology facilitates the protection of their well-being and safety. Apart from improving patient identification and safety, health information exchange decreases the costs of expensive tests, which are redone because a caregiver does not have access to medical data kept in another physician’s register.

Patients characteristically have information kept in different locations where they go to receive medical care (Jawhari, Ludwick, Keenan, Zakus, & Hayward, 2016). This may encompass their primary care provider’s office, in addition to registers of other specialists and departments. Health information exchange allows the sharing of all such data through electronic records, which may lead to increased cost-effectiveness and quality of care.

Advantages and Disadvantages to the Patient Safety Technology

Advantages

Electronic health record systems have changed the approach of health care provision from a mainly paper-anchored one to the application of computerized information to help caregivers in easy delivery of care to patients. Some of the fundamental advantages linked to this patient safety technology include access to required records without problems, easy identification, and eradication of the predicaments of a mistaken understanding of poor writing (Leite et al., 2016).

Electronic health record systems provide numerous potential capacities with three functionalities holding assurance in the improvement of care and reduction of costs. The three include health information exchange, computerized physician order entry, and clinical decision support tools. The three, alongside other capabilities of the patient safety technology, facilitate identification and treatment for a positive outcome of care.

Electronic health record systems have been associated with the gain of preventing wastage of resources encompassing writing materials, equipment, energy, and funds. An instance through which wastage occurs if electronic records are not used is in unnecessary diagnostic testing. Paying for redundant tests might become extremely expensive for patients and their family members (Jawhari et al., 2016). Moreover, such tests may result in false-positive results that might then translate to even higher costs of care and worsening of the patient’s condition at a later time, for example, in the treatment of cancer that advances in stages when not tackled early enough.

Attributable to their application of clinical decision support tools, electronic health record systems have been highly associated with increased adherence to evidence-based medical practices and improved quality of care. Regardless of the best intention of health professionals, different aspects might lead to patient experiences that do not conform to best practice directives if safety technology is not used. The rationales behind such nonconformity include care providers being unaware of some directives, health professionals not recognizing that a guideline is applicable to a patient, and inadequate time (Papoutsi et al., 2015).

Electronic health record systems surmount such problems hence enabling caregivers to focus on preventive practices encompassing the administration of vaccines and assess how patient safety technology may improve the quality of care and outcome of treatment. From a public health point of view, adherence to the set medical guidelines, which is facilitated by the use of electronic health records, keeps people healthy and reduces risks of epidemics in communities.

Disadvantages

Despite the advantages of electronic health record systems, the transition to patient safety technology has created chances for mistakes and other unexpected outcomes that may increase associated risks. Though clinical decision support tools are beneficial in numerous circumstances, many health conditions lack scientifically anchored directives that caregivers can follow hence decreasing the value and success of patient safety technology in some medical situations (Jawhari et al., 2016). Other disadvantages of electronic health record systems encompass monetary issues, alteration in the workflow, short-term loss of efficiency linked to the adoption of patient safety technology, lack of confidentiality, security risks, and unplanned consequences.

Monetary issues, encompassing preparation and implementation expenses, continued maintenance outlays, lost revenue linked to a short-term negative effect on efficiency, and reduced profitability, may create deterrence for health institutions and caregivers to adopt and implement patient safety technology. Costs associated with the use of electronic health records encompass procurement and installation of gadgets and software, change of paper records to computerized ones, and thorough training of all users (Papoutsi et al., 2015).

Maintenance expenditures of patient safety technology might also be high because hardware requires replacement and software needs upgrading over time. Moreover, the implementation of electronic health record systems necessitates continuing training for caregivers and support for other users.

Expenditure on the application and regular maintenance of patient safety technology is complicated by the reality that most monetary gains do not benefit hospitals or health professionals, who incur expenses on upfront investment, but patients in terms of easy identification, prevention of errors, and enhanced efficiency, which lead to decreased payments. Such disarray of incentives for medical institutions, in conjunction with huge upfront expenses, generates a hindrance to the implementation of electronic health record systems, particularly for minor illnesses (Leite et al., 2016). The technology also has the demerit of disrupting workflows for health professionals, which leads to short-term loss of productivity.

This causes lessening of revenue as health providers take some time to learn the new system while they could otherwise have been treating patients. Moreover, there are reduced costs to patients after implementation attributable to lesser errors and shorter durations of hospitalization. Though superfluous, most of the costs incurred by patients when technology is not in use, for instance, longer periods of hospitalization and increased errors, generate revenue for health institutions and caregivers.

Electronic health record systems have the disadvantage of increasing risks of patient privacy infringements. This is a rising concern because of mounting levels of medical details that are shared electronically. To prevent such risks, stakeholders have embarked on policies that guarantee the safety and confidentiality of patient information. For instance, recent regulations have enforced directives purposely associated with the electronic exchange of medical details.

Though it is difficult for electronic data to be secure, rigorous conditions set and laws enacted make it hard for electronic information to be accessed unsuitably. If not well utilized, electronic health record systems may raise medical errors, negative sentiments, and overreliance on technology. Mistakes arise because of poorly established interfaces or insufficient user training. Furthermore, end-users of patient safety technology might develop negative emotional reactions as they strive to implement new systems and bear with interruptions in the workflow (Jawhari et al., 2016).

To avoid overdependence on technology, organizations should make sure that fundamental health care may still be offered even when systems fail. Despite the numerous disadvantages of electronic health record systems, their advantages outshine associated demerits because they enhance patient safety, which saves lives.

Summary

Stakeholders in the health care system, for example, nurses, have the responsibility of ensuring that patient safety is upheld. A culture of safety assists in the prevention of identification mistakes that might occur at any stage of diagnosis or therapy. In the enhancement of informatics expertise for a positive outcome of care, physicians, nurses, and hospitals have extensively employed electronic health record systems. Patient safety technology has the benefit of minimizing the wastage of resources such as papers, pens, and finances. On the contrary, it has the drawback of raising confidentiality violations since a huge amount of health information is shared electronically. Regardless of the several demerits of electronic health record systems, their benefits surpass linked disadvantages due to the improvement of patient safety.

References

Jawhari, B., Ludwick, D., Keenan, L., Zakus, D., & Hayward, R. (2016). Benefits and challenges of EMR implementations in low resource settings: A state-of-the-art review. BMC Medical Informatics and Decision Making, 16(1), 116-120. Web.

Leite, A., Andrews, N. J., & Thomas, S. L. (2016). Near real‐time vaccine safety surveillance using electronic health records—A systematic review of the application of statistical methods. Pharmacoepidemiology and Drug Safety, 25(3), 225-237. Web.

Papoutsi, C., Reed, J. E., Marston, C., Lewis, R., Majeed, A., & Bell, D. (2015). Patient and public views about the security and privacy of Electronic Health Records (EHRs) in the UK: Results from a mixed methods study. BMC Medical Informatics and Decision Making, 15(1), 86-89. Web.

The joint commission. (2019). Nursing Care Centre: 2020 National Patient Safety Goals. Web.