National Patient Safety and Quality Standards

Development of National Patient Safety and Quality StandardAuthor: Ms. Jacklyn T. SantosMonash University Student IQN 2018Author NoteIt took me sometime to finish this essay, there were sleepless nights to think over about this paper, I hope that this essay maybe helpful to me and to the readers. The author would like thank her husband, friends who gave their unending support and to her IQN coordinator who continuously guide her batch in every step of the way.Table of ContentsAuthors Note……………………………………………………….2Table of Contents……………………………………………………3Abstract………….………………………………………………….4Introduction, Body and Conclusion…………………………………5-10Reference……..………………………………………………………11AbstractThis paper will discuss the National Patient Safety and Quality Standards that we have in Australia. These standards started last 2006 and was implemented allover Australia, This paper specifically explains five out of eight of the standards logical basis. The goal of this is to safeguard the public health from any form of potential harm or injury, improve the quality of health and to deliver it to the public in a form of high standard. The basis of this paper was extracted from the latest edition of the patient and safety quality and few from online library.Keywords: Standards, Public Health, harm, quality, health, safetyThe National Safety and Quality Health Service Standards were developed by the Australian Government to safeguard the public from any harm or injury by providing a dynamic and improved health services. These standards ensure that relevant and connected systems meet the quality and safety guidelines that are being set as a requirement. (ACSQHC, 2017)There are eight NSQHS Standards that are needed to be met by each hospital and other medical facilities these are the following: clinical governance, partnering with consumers, preventing and controlling healthcare-associated infection, medication safety, comprehensive care, communicating for safety, blood management, and recognizing and responding to acute deterioration. (ACSQHC,2017)The development of the NSQHS underwent a vigorous process and credible professionals were consulted by the Australian Commission on safety and Quality health care (the Commission). The medical facilities will go through voluntary accreditation. Once the facility is NSQHS approved the areas for improvement will be addressed accordingly. (ACSQHC, 2013)The topic of this report is about the NSQHS with the purpose of discussing and explaining their relevance to the delivery of optimal patient care. It will also mention the logical basis why they were developed. Examples will be stipulated by the author as she details each standard in a clear and systematic manner.The Clinical Governance StandardIt is the responsibility of the leaders of health care services to dynamically improve the provision of their services in terms of quality and safety. This quality framework structures the necessary guidelines that are being provided by the hospitals to their employees, consumers, along with their relatives and the whole community that is being affected. It also maintains the framework that is necessary to promote a consistent, safe and high-quality standard of health services. This standard strives to promote quality and efficient health care services by encouraging hospitals and other medical facilities to adhere to their scientific structure of value. In effect, the increase in the quality of the services being provided boosts a far much better patient outcome and satisfaction. It also decreases the unnecessary hospital expenses over a long period of time. In doing so, organizational leaders lay out and utilize clinical structures in governance to improve the safety and quality of patient care. They set certain priorities that strategically direct the course of the organization to meet the standard. Effective communication is ensured and maintained to avoid delays and conflicts both in the workforce and in the community. An example of this is the clear and proper delegation of roles and responsibilities for the administration, clinicians and the rest of the labor force. The National Safety Standard on Partnering with Consumers With the same goal from the first standard this was made to protect the public from any ravage during their hospital stay and on their way to recovery. This standard also requires partnership that needs everyone’s participation. The standard involves mainly the patient, family, friends, personal carer, other support (which are considered as the consumer), clinicians (who is also important in this standard), and the hospital management (they will be responsible in producing the systems and its limit) in processing, delivering, and evaluating care that is easily accessible to the consumers. A strong foundation of this specific standard can lead to the following outcome: mortality rate will be less, readmission will be reduced, acquired health infections will diminish, and shortened hospital stay. (NSQHS STANDARDS 2017). Some examples that the author want to cite for the the application of this standard in Australia is through an end-of- life tool kit that is used to gauge the hospitalization experience of the patient, the response will be given by the family and the health practitioner. Then, the hospital management will evaluate. Once this is accomplished the management will decide which area needs any improvement. Moreover, a continuous health literacy is given by the clinicians to the consumer for them to be aware what is exactly happening to their health and how to apply the health information, this can be implemented through brochures or signage’s that is clearly written and easy to understand by the consumer. Another way is by providing regular enhancement seminar or training to the staff. In this way health service is improved. For instance, In Riverland general Hospital they provided a Virtual Clinical Care (VCC) it is a home monitoring service for chronic diseases which the allows the patient to self monitor their condition guided by the nurse. This gave a positive feedback for the clinician and patient. The program displayed a slight reduction in re-admission and the length of admissions.The Medication Safety Standard Since medicine is commonly used in the health care setting, medicine can relieve pain, cure a disease or extend someone else’s life. But, medication can be harmful if not properly prescribed or administered. The harm that the medication error may bring is costly. On the other hand, it is avoidable. This standard will be applied in connection with the two Standards that the author previously mentioned, This standard was developed to ensure that the clinician prescribes, dispense and administer the correct medicine that the patient needs, the patient has to be informed through proper communication about the medicine that they are about to receive. To support this standard, the committee decided to set up the tools like: Tallman lettering, Medication Safety alerts, electronic medical records, use of bar coding, medication reconciliation, Proper labelling of injectable medicine, Intravenous fluids and lines. These are needed to improve the health care and avoid such incidence. The example that was found is about the tools that were noticeably effective when The Centre for Health Systems and Safety Research in NSW 2001 used the eMAR system there were able to detect dose omission in particular and it gave a surprising result of 26% pre-eMAR and 4.4% post eMAR, medication transcription wise from the same study it was reduced to 80%. Overall, if the Medication safety is strictly implemented in every facility a striking improvement in medication error will decrease, Patient-centred approach is the key to this standard in coordination with the two previous standards that the author previously tackled.The Blood Management StandardBlood transfusion can save lives that is why it requires a thorough assessment not just the recipient, the prescriber but also the donor. This standard would like to specify the possible risks of blood transfusion, handling, screening, donation, storage, highlight any notifiable adverse reaction, and proper disposal. This standard wants to ensure that the patient will receive the blood that is clean, safe, and necessary, it also engage the patient and family in the decision of blood transfusion. For this to be possible there are criteria’s that has to be met, the standard also encapsulates Patient Blood Management (PBM) it is known as the step which use the patient’s own blood during their medical and surgical crisis. (NSQHS 2017). The Australia’s National Blood Authority (NBA) is the institution responsible for the blood supply across Australia, they have set some clinical indication for Blood transfusion these are the following: Critical bleeding massive transfusion, Perioperative, Medical, Critical care, Obstetrics and Maternity, Neonatal and Pediatrics. As evidence from a study in Western Australia last 2008 they implemented the PBM program that gave a 41% decrease in admission which allowed the facility to save AU$18,507,092 meaning it can give a huge impact on the patient improvement and maximizing the blood products. All in all, blood management can be improved if the product that the patient will receive is safe, on time and appropriate and adequate blood usage is observed if the Patient Blood Management is considered.Recognizing and Responding to Acute Deterioration StandardThis was the last standard stated in the revised edition of NSQHS last 2017, It was clearly explained that it was designed for the health care workers. The little changes that is occurring to a patient is vital. This maybe a change in their physiological state, mental state or even cognition as it requires special care that is on time to avoid deterioration or worst sudden death. As a health worker we should be sensitive enough to see what are their needs, this can avoid further management and save their lives. This standard requires the health practitioner to be more focus when it comes to understanding deterioration and forming a system how to respond to deterioration. The health practitioner can be equipped through continuous study provided by the facility like competency skills assessment, peer review, simulation review. Another way, is by giving a development plan like frequency monitoring of the core vital signs, formulating clinical pathways for a specific disease, proper escalation is also appropriate for this scenario to address what is urgent to be settled during the time of deterioration (NSQHS 2017). ReferencesHttps://www.safetyandquality.gov.auhttps://www.nationalstandards.safetyandquality.gov.au/1.-clinical-governancehttps://www.nationalstandards.safetyandquality.gov.au/1.-clinical-governance/governance-leadership-and-culture/governance-leadership-and-culturehttps://www.safetyandquality.gov.au/wp-content/uploads/2012/01/NSQHS-Standards-Fact-Sheet-Standard-4.pdf https://www.nps.org.au/australian-prescriber/articles/reducing-medication-errors-at-transitions-of-care-is-everyone-s-businesshttp://aihi.mq.edu.au/sites/default/files/aihi/resources/eMAR_draft_final.pdfhttps://www.safetyandquality.gov.au/wp-content/uploads/2012/01/NSQHS-Standards-Fact-Sheet-Standard-7.pdfhttps://www.anzsbt.org.au/data/ANZSBT_Guidelines_Administration_Blood_Products_3rdEd_Jan_2018.pdfhttps://onlinelibrary.wiley.com/doi/full/10.1111/trf.14006National Safety and Quality Health Service Standards (NSQHS) 2017 Second edition page 4-66National Safety and Quality of Health Care 2013 edition page Smeltzer &Bare’s Volume 1 fourth edition page 9-10