NR361 | Workarounds and Their Implications for Patient Safety
Questions:
1.What is a workaround? Identify a workaround (specific to technology used in a hospital setting) that you have used or perhaps seen someone else use, and analyze why you feel this risk-taking behavior was chosen over behavior that conforms to a safety culture. What are the risks? Are there benefits? Why or why not?2. Discuss the current patient safety characteristics used by your current workplace or clinical site. Identify at least three aspects of your workplace or clinical environment that need to be changed with regard to patient safety (including confidentiality), and then suggest strategies for change.
Answer:
Workaround refers to a bypass of some identified limitation or problem in a system. In other words, workarounds are commonly known as temporary fixes that illustrate the need of genuine solutions to some existing problems (Debono & Braithwaite, 2015).
One problem that was encountered at my workplace was associated with lack of technical competency among the nursing professionals in operating eMARs. The hospital formed a collaboration with a technical school that enrolled nurses in a diploma course in technical skills. Technical skills are one of the core competencies that all nursing professionals should have for attending their clients and delivering optimal health outcomes. One major risk was related to the fact that spending time in learning the skill might have reduced the patient time. However, the major benefit was related to standardizing documents, preventing medication errors and promoting concise patient charting (Cifuentes et al., 2015).
The patient safety characteristics of the workplace include empowering everyone and making the patients aware of the risks and benefits of the interventions that the hospital promotes. However, three aspects that should be changed are related to human errors, lack of patient confidentiality, and lack of alarms for adverse events that directly violate patient safety (Weaver et al., 2013).
Human errors can be analyzed by performing failure modes and effects analysis (FMEA) that would promote the identification of the possible failures in the workplace. Development of comprehensive confidentiality policies, ensuring the storing of patient information in secure systems and implementing IT security policies would help to maintain patient privacy. Furthermore, appropriate installation of medical alarms and feeding their data into reporting databases would encourage healthcare staff to monitor all patients and enhance their health.
References
Cifuentes, M., Davis, M., Fernald, D., Gunn, R., Dickinson, P., & Cohen, D. J. (2015). Electronic health record challenges, workarounds, and solutions observed in practices integrating behavioral health and primary care. The Journal of the American Board of Family Medicine, 28(Supplement 1), S63-S72.
Debono, D. S., & Braithwaite, J. (2015). Workarounds in nursing practice in acute care: a case of a health care arms race?. Resilient Health Care (Vol 2): The Resilience of Everyday Clinical Work.
Weaver, S. J., Lubomksi, L. H., Wilson, R. F., Pfoh, E. R., Martinez, K. A., & Dy, S. M. (2013). Promoting a culture of safety as a patient safety strategy: a systematic review. Annals of internal medicine, 158(5_Part_2), 369-374.
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