Discussion onNational Safety and Quality Health Service Standards for Nurses
Question
Task: Students are required to refer to the National Safety and Quality Health Service Standards and choose one standard as the foundation of the assignment. The assignment will provide an overview of the standard, inclusive of its intent and desired outcomes, strategies used for achieving the standard and evaluation criteria in relation to their own workplace environment.
Answer
Introduction
National Safety and Quality Health Service has different standards for registered nurses to involve in their practices to secure the best quality patient care and safety of the patients in the workforce. Among the eight standards first standard conveys critical thinking and analyzing nursing practices for the registered nurses where the second standard depicts the engagement of the nurses in therapeutic along with the professional relationship. The third standard of National Safety and Quality Health Service helps nurses to maintain the capability for their practice followed by comprehensively conducts an assessment by the 4th standard. Standard 5 assists nurses to plan for nursing practices to provide safe, responsive, appropriate, quality nursing practice as it is detected by Standard 6. Standard 7 helps the nurses to evaluate outcomes to inform the practices and Standard 8 most critically deals with the aspect of recognizing and responding to clinical deterioration. All the standards are set to address the best care and quality in the health sector by the assistance of a registered nurse.
The paper will convey its concern for the 8th standard where it will depict an in-depth description of the standard followed by intention and desired outcomes. The implementation strategy will even be evolved followed by the criteria for the standard. Further, the paper will offer its concern for Royal Perth Hospital to convey the designing procedure of the organization for the referred standard. In the discussion, it will even offer a comparison between two health care organizations followed by the relationship between the standard and WACHS and clinical governance framework.
Analysis
Description of the standard
Recognizing and responding to the deterioration standard of National Safety and Quality Health Service signifies processes and systems for responding effectively to patients' cognitive, mental, or physiological deterioration. The standard basically tries to ensure acute deterioration of a patient can be recognized promptly followed by effective action. Acute deterioration involves physiological challenges along with acute changes in mental and cognition state. Thereby, the entire aspect can be divided into three aspects - physiological deterioration, cognitive impairment, and mental health.
Physiological deterioration- receiving timely appropriate care is the key aspect of quality and safety challenges. The commission basically introduced this range of systems to control recognition and respond to acute physiological deterioration. Different tools and resources are there to achieve the target like the National Consensus Statement, end-of-life care in acute hospitals, implementation guide, observation and response chart, tips from the real world, the survey of recognition and response systems, audit tools, along with quality measures for recognition and response system, evaluating recognition and response system (Ritchie et al, 2020). The tools basically help to deal with physiological deterioration for a patient.
Cognitive impairment - the concern in hospitals can often be associated with negative outcomes like falls. Patients with cognitive impairment can face different types of issues in staying hospital with negative experience as the staff of the hospital cannot be able to provide proper care without having proper training and education to deal with the issue. Thereby, it is important that patients with cognitive impairment they are staying at the hospital needs to be safe, and those different steps need to be taken to reduce adverse effects. Problem-solving, thinking, memory, attention, and effective communication are must deal with the issue. It is important to understand the patient properly, as a misunderstanding between patients and caregivers can lead to a negative outcome. Understanding further needs to be equipped with effective communication through which the caregiver would offer the right care. The most common conditions of cognitive impairment are dementia, delirium, etc (Banks, 2016). Mostly brain injury, stroke, or intellectual disability can be the reason for such cognitive impairment. The commission even shares its concern for people with mental health issues by promoting, supporting, and encouraging quality and safe environment. Elevated risks like functional loss, behavior loss, distress can be major and common issues for mental issues.
Intention and desired outcome
Leaders of the health sector establish and maintain procedures to recognize and respond to deterioration by different systems. The standard basically objectifies the recognition and responding of the patient in his or her acute deterioration. Providing the best quality and safe service is the ultimate target of the health sector and the standard helps the sector to achieve its target. Without addressing recognition and responding system to acute deterioration the sector cannot be able to offer quality and safe services to its patient (Ritchie et al, 2018). Different types of deterioration can occur for a patient however the standard ensures that whatever the circumstances are, nurses need to be prepared with proper tools and systems to recognize the deteriorationpromptly followed by effective care treatment to deal with the issue. Basically, acute deterioration is identified and recognizedto initiate a care system for the sector. Major adverse events like cardiac arrest, unexpected death can be observed due to clinical and physiological abnormalities. Other important events like aggregation and suicide can even be the result of behavioral change of a patient which immediately deteriorates the mental state of the patient. The desired outcome of the standard basically expects early identification of such deterioration or behavioral changes through which outcome can be improved by stabilizing the patient through effective communication and support of the caregivers. The warning signs for clinical deterioration often misidentified or enacted inappropriately (Pazokian, &Borhani, 2017). However, the standard objectifies proper evaluation of such concerns followed by effective handling of the concerns. Different commissions are there to handle such issues. However, the aim of the expected outcome from the standard points out to the same concern which is the best effective, safe, and quality environment for the patients with acute deterioration. For the registered nurses the most important duty is to provide the best care to their patients. Offering the best care cannot be objectified without identifying or recognizing the problem of the patient and eventually removing the problem for him. The standard deals with the referred concern where the expected outcome is best, possible, prompt response of nurses for patients by effectively handling acute deterioration.
Implementation strategies
In order to attain the standard in the workforce, registered nurses need to plan an implementation strategy through which the concern can best fit in the organizational structure. Effective training is most important for proper implementation of the standard (Barnett et al, 2019. Acute deterioration cannot be understood appropriately without checking all the details of the patient thereby the implementation strategy of the standard need to follow certain steps:
Collecting additional information- it is an important aspect for a registered nurse to collect as many details of the patient as possible (Castillo, 2016). The details of the patients regarding physiological aspects, behavioral changes, cognitive impairment, or mental issues can be helpful to identify the problem area for the patient which can better be addressed by a proper response system.
Positioning the patient- after collecting the information it is an important aspect for evaluating well with those aspects for recognizing and responding clinical deterioration as effective evaluation of the collected data the registered nurse can understand the problem area for the patient and he or she can be referred to the proper department to attend better healthcare from both the nurses and doctors (Mather, & Cummings, 2019).
Getting help- evaluation of the collected data even helps the registered nurse to understand the critical aspect of the patient and considering the degree of the complexity for the patient then the nurse needs to take effective help from a concerned person along with technological advancements to respond to the deteriorating patient (Straube et al, 2016). Taking help is an important aspect for the implementation strategy as can be followed by negative outcome thereby obtaining help needs to be supported with proper problem-solving skill, and decision making skill in the part of the nurse. Experience even can be a great factor in this regard (Cho et al, 2016).
Tracking the record- as the deterioration can be of three different types thereby tracking records for the patients in the part of the nurse is important; where he or she needs to track record regularly for blood pressure, oxygen saturation, and heart rate. The record can help to understand changes in the patient. Recording vital signs- as per the record, this can be understood and vital signs for the patient can be identified or evaluated. Further background checking helps to evaluate the concern properly and recording those vital signs is important for the registered nurse for further evaluation to escalate care for the patient (Hinchcliff et al, 2017).
Criteria
Criteria of the standard facilitate aspects like clinical governance, integration of clinical governance, application of quality improvement system, and partnering with consumers.
Clinical governance along with quality improvement basically helps the system of recognition and response for acute deterioration. The systems get used organization-wide to support along with promoting recognition and detection for acute deterioration. It will help to record the response of the patients who are suffering from acute deterioration (Havers, Hall, Page, & Wilson, 2016). Different systems are involved with the entire concerns like delirium, clinical care standard, essential elements for safe and high quality pediatric end-of-life-care, National Consensus Statement, Essential elements for recognizing and responding to deterioration in a person's mental state, Essential elements for recognizing and responding to acute physiological deterioration. All the systems basically objectify three aspects of the acute deterioration considering physiological, cognitive, and mental state (Christensen, Janssens, & Beckmann, 2017).
Integrating clinical governance- clinical governance can be implemented under certain circumstances when policies and procedures need to be accompanied for recognition and response to acute deterioration, identification of training requirements for the concern, and managing risk, which are associated with the entire procedure (Flockhart et al, 2016).
Applying quality improvement system- as per clinical governance, standard quality improvement system can be implemented for the standard when monitoring of the recognition and response system is needed, reporting for effectiveness and outcomes of the system needs to be evaluated, and improvement by the implementation strategy needs to be identified (Travaglia et al, 2017). Collaboration with consumers- best patient care cannot be attained without an effective collaboration with the consumers. In order to treat the patient best possible way, it is important to make them aware of the entire treatment procedure along with all the details as the strategy helps to build cooperation from the end of the patients which is most important for providing the best care (Halton et al, 2016). However, according to clinical governance, collaboration with consumers needs to be taken special care when the involvement of the active patients is required for their own care, decision making needs to be supported with their concern, and the information needs of the patients get increased.
Strategies of workplace
Source: (Halcomb et al, 2017)
Royal Perth Hospital becomes the best healthcare provider by evolving itself in research and education. Promoting and protecting the health of the community, specifically for metropolitans, indigenous, rural, disadvantaged populations, and the remote population is the basic target for the hospital. The strategic plan establishes a vision along with direction for the organization which gets all the guidance from Waste Australian Government Health System as per the report of Reid and gets implemented by the Health Reform Implementation Task Force. A successful partnership is a key strategy for achieving the best Health Care in the organizational culture (Brand et al, 2020). Providing high quality efficient timely service is their key objective to address the standard of recognition and response to acute deterioration. The workforce of the organization ensures that every patient can receive efficient and effective assessment, diagnosis, admission, treatment procedure, and discharge along with preventive care for achieving the best possible result from every individual (Skyes et al, 2018). Their strategy for minimum waiting time for all the clinical departments helps them to identify and respond with the issue promptly and ensure customers to make the service accessible and available. For identifying and responding acute deterioration or clinical deterioration it is important to evaluate all the background details of the patient and the organization has implemented the strategy in a way which takes care of the fact that care planning by the registered nurses has been done as per the best available evidence to sustain the best result (Mousa, 2017). In order to identify and response for the deterioration, it is important to have a better collaboration or partnership with the patient and the organization has implemented the strategy as it exercises collaboration with not only patients but all the healthcare providers to offer integrated service by meeting the healthcare needs of the patients. Active participation has been offered by the entire workforce for planning and implementing the best individual care structure for the patient to address their respective issues. In order to offer the best service organization obtains evaluation process for individuals where, by being approached with the problem they immediately referred the patient to the specialist one along with an experience trained nurse for identifying and responding to the deterioration immediately. Individual assessment along with treatment procedure gets followed by the evaluation process.
Effectiveness
Effectiveness of the strategy of Royal Perth Hospital depends on different aspects through which it successfully attainsidentification and respondsto the deterioration for the patients. Strategic excellence helps the organizationto secure the best care for the patient initiating organizational value. Thestrategies of systems that Royal Perth Hospital has sustained in a structure are high performing. Furthereffectiveness of the trained nurse even recommendable for the infrastructure as training and experience help them to identify and respond to the acute deterioration easily (McCaffrey et al, 2018). It has sustained individual patient care for every individual patient and in this concern, they do not make the background a barrier for the entire treatment procedure as the strategies obtained by Royal Perth Hospital is supportive of cultural diversity. It is already stated that the best care cannot be given without understanding the specific need of individual patients. In this concern, the strategy of a consumer-centered approach in the part of the hospital helps it to be effective in identifying and responding to any deterioration successfully and effectively (Hay, 2018). Further, the customer-centered approach even helps them to initiate the best possible care plan which indirectly justifies its effectiveness in the healthcare sector. It has already stated that critical thinking and problem-solving skills are important for registered nurses to identify and respond to the acute deterioration and in this concern, intellectual curiosity has been practiced by the organization as research is the most important aspect of the organization through which the entire workforce always get them involved with better planning.The strategy even proves its effectiveness for the organization as it initiates patient care continuously from the part of the organization developing its workforce to a better extend. Theorganizationis quite advanced in its thinking process as with valuing patients it even offers proper and justified value to its workforce by providing them necessary types of equipment and training.Further, they are even allowed to exercise innovation for identifying and responding deterioration to make the entire process successful for which flexibility is needed for maintaining the standard in the work culture. Most importantly placing the right thing at the right place conveys the best effectiveness of the organization as individual patients after evaluation gets referred to the specialist one for best care whichjustifies the main criteria of the standard by showing all the quickness to address the standard (Bender et al, 2016).
Comparison
Strategies and effectiveness of Royal Perth Hospital convey the fact that they are obtained the best facilities for utmost patient-centered care where rights of the patients get fulfilled and objectified to the better extend. Along with the concern, the hospital is the best example of cultural diversity, as they provide their service to everyone with special consideration for aboriginal, disadvantageous rural people. The trained nurses are most valuable for the entire workforce as through their effective training and experience they can provide the best care plan for individuals with their entireneeds. Tracking record and further improvement for the care plan has been done by the nurses effectively to satisfy all the patients by removing their issues. Along with the best service,the organization even has an advanced IT department that takes care of everything to make the service more efficient for the patient (Schuldt, 2019). The organization contains a vending machine along with it takes care of the fact for patient entertainment as identifying and responding to the acute deterioration can be of three different types. Among the three types, mental state and cognitive impairment make the patient reluctant to stay in the hospital, and in this concern entertaining them effectively along with the treatment helps the organization to have the best care in the organizational culture (Coggins, 2020). Pastoral care services are even recommendable factors for the organization and the Research team is the most recommendable aspect of the organization as it consists of continuous improvement for the organizational culture. In order to understand the efficiency of the Royal Perth Hospital, it is important to judge the services in the context of any other hospital. South Perth Hospital is even a renowned hospital of Perth where the Board of Management consumes the local community in it.It is a nonprofit health service where improvement regarding service for consumers is most important. It provides different types of medical services to people with dedicated staff and a positive environment. However,neither the technological advancement not a great mission nor vision is there for South Perth Hospital comparing to Royal Perth Hospital. In addition, it can even be said that,though patient care is the most important aspect for South PerthHospitalstill strategies it obtained to address that is not much advantageous like Royal Perth Hospital (Hincks, Jones, Reynolds, & Robertson, 2019).
Relation ofNational Safety and Quality Health Service with Western Australian Clinical Governance Framework Western Australian Clinical Governance Framework basically objectifies high-quality safe care. In order to accomplish the concern two-way communications between patients and caregivers, family along with other consumers need to be obtained. WACHS makes the commitment to develop a respectful, accountable, open environment for the healthcare sector. The clinical governance framework objectifies a consistent approach for safety and quality and patient care is of utmost concern for the framework (Mousa, 2017). Develop an understanding for National Safety and Quality Health Service helps to understand that the standard of NSQHS even objectifies the same. Thereby it is the most common factor that the target of both the concerns is the same. Further standards of NSQHS are basically providing guidance to WACHS for designing their clinical governance system for improving safety and quality concerns in healthcare for patients. The system even includes information provided through consulting and listening to patients, consumers along with other staff of the workforce. The relationship between registered nurse standard practices and clinical governance framework is the same as the relationship between NSQHS and AWCHS (Lock, 2019). The clinical governance framework basically provides clinical governance standards by exercising partnering with consumers maintaining the standard. Five components are there in the clinical governance framework are governance, leadership, and culture; partnering with consumers; Patient safety and quality; improvement safe environment for delivering care; clinical performance and effectiveness (Lock, 2018). Standard of registered nurse practices consumes 8 different standards where thinking critically,analyzing nursing practices, engaging in therapeutic along with professional relationships, maintaining the capability for practice, comprehensive conduct assessment, developing plan for nursing practice, providing safe appropriate responsive quality nursing practices evaluating outcome to inform nursing practices, and recognizing and responding clinical deterioration are important (Leggat, & Balding, 2019). Considering the characteristics of both the concern it is quite clear that both clinical governance and registered nurse standard practices objectify best patient care with quality and safety.
Conclusion
The paper has offered its concern for NSQHS specifically for the standard of recognizing and responding to acute deterioration. It has offered a standard description where it has stated that it basically tries to ensure acute deterioration of a patient can be recognized promptly followed by effective action. Acute deterioration involves physiological challenges along with acute changes in mental and cognition state. Thereby, the entire aspect can be divided into three aspects - physiological deterioration, cognitive impairment, and mental health. Further, the paper offers intention and desired outcome for the standard where it has conveyed that the desired outcome of the standard basically expects early identification of such deterioration or behavioral changes through which outcome can be improved by stabilizing the patient through effective communication and support of the caregivers. The paper even offers implementation strategy and criteria for the patient where it has been seen that certain criteria are there for implementing the standard in the health sector whereas implementation strategy for the standard is collecting additional information, positioning the patient, getting help, tracking the record, and recording vital signs. Criteria of the standard have depicted that clinical governance and quality improvement are the main aspects of the referred standard. Further, the standard gets evaluated in the context of Royal Perth Hospital. Providing high quality efficient timely service is their key objective to address the standard of recognition and response to acute deterioration. The workforce of the organization ensures that every patient can receive efficient and effective assessment, diagnosis, admission, treatment procedure, and discharge along with preventive care for achieving the best possible result from every individual. Strategic excellence helps the organization to secure the best care for the patient initiating organizational value. The strategies of systems that Royal Perth Hospital has sustained in a structure are high performing. Further effectiveness of the trained nurse even recommendable for the infrastructure as training and experience help them to identify and respond to the acute deterioration easily by exercising cultural diversity in the organizational culture. Comparison with South Perth Hospital proves that the infrastructure of Royal Perth Hospital is much advantageous in its design of infrastructure. The relationship between NSQHS and WACHS is even established by the paper where it has explored that NSQHS guides WACHS for implementing clinical governance in its structure.
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