Integrating and Implementing Qualitative Evidence

Author

Affiliation

Course

Instructor

Due date

Integrating and Implementing Qualitative Evidence

Patient safety ratings are a current problem for Villa Health's healthcare system. This year's results were "worse than predicted" in both 2018 and 2019, with incidents involving patients who had fallen, had adverse reactions to drugs, or acted violently against the personnel. A series of executive-led focus groups were employed to get insight into worker perceptions of hospital safety. Underreporting of violent occurrences against employees and poor electronic health record (EHR) training were among the themes that emerged, as was a lack of thorough documentation and inadequate identification of at-risk patients in the EHR. Physicians also expressed concerns about the lack of sufficient data to back the idea that evidence-based therapies increase patient safety in a recent presentation to medical staff. 

The medical team's presentation focused on the importance of event reporting in detecting and reducing threats to the company's safety. To elicit the current findings, a research article was utilized to emphasize the critical nature of event reporting and to advocate for extra action. While incident reporting has been critical in improving patient safety, experts think that new techniques for reporting and controlling events, as well as additional activities, are required (Ramos & Abeldano, 2018). Following a comprehensive review of the literature, the researchers found few evidence that event reporting systems improve outcomes or promote cultural change. According to the authors, reportable events should be more precisely defined and integrated into bigger clinical safety programs (Stavropoulou et al., 2015).

---

ALSO READ: Nursing Case Study Writing Help

---

PICOT Question

When it comes to Villa Health's healthcare dilemma, a PICOT question is needed to help lead a literature search. To what extent, over the next 90 days (T), will the adoption of a staff-led safety committee at Villa Health (P) affect (O) patient safety scores (I) compared to the risk manager's monitoring and follow-up of entries in the incident reporting system (C)? As a result of this hypothesis, this question asks whether or not staff-led committee members have a higher level of affective involvement in the organization and thus contribute more to the organization's goals, take more responsibility for their organization's safety culture and thus have a greater impact on patient safety scores.

Search Strategy

For the search phrases of "patient safety," "incident reporting," "safety culture," "evidence-based practice," and "competency," we utilized a variety of databases, including those listed above as well as those in Science Direct and Summon. Large and well-conducted qualitative investigations with systematic assessments of the literature were found to provide the strongest evidence.

Appraisal of the Evidence

We looked at three different research projects. Article "Experiences from ten years: a qualitative study among managers and coordinators of health care departments" (Ramos & Albedano, 2018) was selected to highlight to medical staff the necessity of incident reporting in patient safety. "Building safety cultures at the frontline: An emancipatory practice development approach," used an emancipatory practice development strategy to improve nurse monitoring on an acute ward to illustrate staff-led actions that promote patient safety. The third paper, "The Effects of Organizational Commitment and Structural Empowerment on Patient Safety Culture," was selected because of its focus on employee empowerment and commitment. A set of Rapid Critical Appraisal Questions for Qualitative Evidence was used to assess the three pieces of work (Zellefrow).

Figure A:

As a medical practitioner conducting interviews, the researcher's expertise in event reporting systems and credibility as a researcher were found to be two of the study's strengths. A flaw in this research may be that all participants were from the same area of Sweden, which limits the study's generalizability (Ramos & Albedano, 2018). Rapid evaluation criteria were satisfied by the second trial as well. Emancipatory practice development technique is what made this research stand out. Although the researchers acknowledge the challenges connected with applying this method to more complicated systems, they believe that their results are relevant to other acute care settings (Cardiff et al., 2020). The third article met the rapid appraisal criteria by utilizing validated tools such as the Organizational Commitment Questionnaire and the Conditions of Work Effectiveness Questionnaire-II, as well as conducting the first empirical study to examine how Kanter's structural empowerment theory relates to the perception of patient safety culture. The Organizational Commitment Questionnaire and the Conditions of Work Effectiveness Questionnaire-II were used in the study. However, despite the limited sample size and the absence of a statistically significant influence of emotional commitment and structural empowerment on patient safety culture, subsequent findings from this research may provide valuable information on the issue (Fragkos et al., 2020).

Implications of the Study Results

The research findings have a plethora of consequences. To begin, the creation of more tools and techniques for following up on occurrences is essential (Ramos & Albedano, 2018). Reporting incidents alone is not enough to enhance patient outcomes or foster a patient safety culture, according to a comprehensive evaluation of the literature on the subject. Clinical ownership and integration with broad safety procedures were also supported by these experts (Stavropoulou et al., 2015).

Healthcare employees' opinions of patient safety culture may be influenced by their emotional and institutional commitments (Fragkos et al., 2020). Cooperation was shown to be the most important component in determining nursing competency in patient safety tasks (Cho & Choi, 2018). There is evidence to back up the idea that a staff-led committee overseeing the incident reporting system may improve both the number of incidents reported and the overall quality of patient safety. Another research found that patient safety occurrences were reduced when health professionals collaborated and communicated with each other. This supports the premise that teams that handle patient safety are more engaged and successful (Han et al., 2019).

Implementation Strategies

Patient safety culture is shaped by frontline workers, but they need organizational support and a flattened structure to increase their adaptability. In order to assist nurses transform the meaning of safe practice in their region, the multidisciplinary team and leaders must promote bottom-up innovation (Peet et al., 2021).

Nurses who believe they can make a difference are the driving force for shared governance systems. The quality of treatment and the satisfaction of patients may both be improved by including patients in the decision-making process. Having the ability to work in interdisciplinary teams improves patient outcomes while promoting nurse autonomy and supporting patient-centered care (Hendrian & Tipton, 2020). Villa Health may choose to develop an incident reporting system review, follow-up, and education process for workers by hiring personnel from each practice area to work in teams with their service line leaders and organizational leaders. Teams might be made up of people from all the disciplines engaged in patient safety incidents.

Conclusion

Health care specialists from a number of disciplines may endorse a shared governance model for incident reporting management based on the information uncovered in this search. Finding high-quality literature that makes it through the evaluation process and fulfills the required evidence level for the change necessitates the use of relevant search keywords and databases. On the basis of earlier studies that back up the notion, a trial project targeting PICOT might be undertaken, with specified outcome indicators being monitored. Incorporating and empowering staff members may help improve patient safety, according to a growing body of data. Villa Health should adopt an unified governance structure to address concerns about patient safety.

References

Ramos, F. O., & Abeldaño Zuñiga, R. A. (2018). Underutilization of the reports of adverse events in an Argentine hospital. International Journal of Risk & Safety in Medicine, 29(3-4), 159-162

Cho, S., & Choi, J. (2018). Patient safety culture associated with patient safety competencies among registered nurses. Journal of Nursing Scholarship, 50(5), 549–557. 

Han, Y., Kim, J.-S., & Seo, Y. (2019). Cross-sectional study on patient safety culture, patient safety competency, and adverse events. Western Journal of Nursing Research, 42(1), 32– 40. 

Hendrian, K., & Tipton, E. (2020). Decreasing hospital falls with injury. Nursing Management, 51(12), 10–12. 

Fragkos, K. C., Makrykosta, P., & Frangos, C. C. (2020). Structural empowerment is a strong predictor of organizational commitment in nurses: A systematic review and meta‐analysis. Journal of Advanced Nursing, 76(4), 939-962.

Zellefrow, C. G. Evidence-based Practice in Healthcare: Implications for Nursing Education..

Cardiff, S., Sanders, K., Webster, J., & Manley, K. (2020). Guiding lights for effective workplace cultures that are also good places to work. International Practice Development Journal, 10(2).

Stavropoulou, C., Doherty, C., & Tosey, P. (2015). How effective are incident-reporting systems for improving patient safety? a systematic literature review. The Milbank Quarterly, 93(4), 826–866. https://doi.org/10.1111/1468-0009.12166

Villa Health: The best evidence for a healthcare challenge. (n.d.). Villa Health. Retrieved August 9, 2021, from https://media.capella.edu/CourseMedia/nurs8035element18327/wrapper.asp#