NURS90086 | Healthcare | An Essay on Quality and Safety in Healthcare

Critically examine the literature relating to a specific patient safety problem, identify key criteria that define best practice and critique relevant strategies for improving the quality of care and minimizing the patient safety problem.

Answer:

Introduction

Healthcare safety is one of the most important aspects of the delivery of the nursing services to the infants in the hospital. The need to focus on security and quality of the services provided to the sick children in any health care facility is the core activity of all hospital in Australia. Pediatrics departments are one of the important units in any healthcare facility that ensure infants get treatment and nursing services in a safe manner.  For instance, the case of the dermatological problems such as psoriasis in children, the need to have accuracy and exact science of using machines in the healthcare facility is imperative in the provision of the health care services (Harrop?Griffiths & Hartle, 2014). Overcoming the problem of errors and wrong use of drugs in the treatment of the dermatological problems among infants can be reduced by proper management and use of the evidence-based practices in the delivery of care and treatment of the children in any healthcare facility. Therefore, this essay focuses on the quality and safety of healthcare in the provision of the nursing services to infants with dermatological problems such as psoriasis.

Search Strategy

This essay relies highly on the Australian National Public Hospitals Establishments database to provide proper and precise data on the current issues relating to dermatological ailments and conditions in Australia. In addition to this, The National Health Data Dictionary has been of great assistance in the understanding of the core terms and definition of the particular ailments that are being covered within the essay.  The research is therefore focused more on persons under the age of five who may be faced with issues relating to ailments of the skin. This age group, in particular, can be considered the most vulnerable due to the seeming lack of proper healthcare that would be vital for the said study group. Some of the MeSH terms used include Age Distribution, Cross-Sectional Studies, Dermatitis, Diaper Rash, Extremities, Facial Dermatoses among others.

Magnitude of the problem

For many years many healthcare facilities have faced the problem of managing dermatological problems due to the delicate nature of the infant’s skin (Foley, Zuo, Plunkett, Merlin, & Marks, 2003). A similar issue is the transfer of the secondary infections from one child to another in the sane unit due to poor methods of nursing services. The introduction of the hand washing in hospital after attending to the patients has reduced the spread of the secondary infection in the healthcare facility (Robinson, Vu, Unglik, Varigos, & Scardamaglia, 2016). The need to have also policies that ensure the hand washing is adhered to by nurses at al times is critical. In the United States, for example, the case of the infant dermatological problems is reported to be about 4% of the of all cases of skin infections (World Health Organization, 2016). In Australia, the issue stands at 5% of the Australian population in which all the infants below the age of five years are reported to develop psoriasis problem.  

The cost and financial implication of the disease are about 0.8% of the Australian income. Time is consumed in the care of the psoriasis patients also has some income impacts that are not favorable in the development of the economy (Lee, Smith, Hong, Garnett, & Fischer, 2016). The frequency of the occurrence of the disease among children is reported to be about one in every 200 children (Gardner et al., 2014). Subsequently, most of the psoriasis problem are long term and thus cost a lot of the household resources such time, funds, and loss of income for forgone time in taking care of the sick (Gardner et al., 2014). The mortality rate is very low arising from the disease, and thus Australian healthcare system is work very hard to overcome the problem and reduce death associated with dermatological problems. The patient’s safety is greatly impacted by the occurrences of the disease by reducing the disease in Australia.

The safety and quality of the services delivered to the patients always depend on the financial implication of the psoriasis problems. For instance, washing hands before and after attending of the psoriasis infants particularly in the advanced stages and most complicated nature can be tedious and time-consuming such that nurses may decide simply to change personal protective helped only (Christophers, 2001). In such event transfer of the disease and pathogens from one patient to another can be a problem which can lead to more complication. Psoriasis infection affects skin such that other bacteria or viral agents can encounter the exposed tissues and cells of the body and after become complicated (Bronckers, Paller, van Geel, Van de Kerkhof, & Seyger, 2015). The problem affects nurses in intensive care units caring for the infants with advance and chronic condition of the disease.

Defining best practice

Overcoming the problem of psoriasis requires best practice and evidence-based treatment. The safety of the patients depends on the best use of the machines and tools in a healthcare facility by the medical officers I charge. For instance, the nurses should be required to wash their hands when attending to the dermatological patients is one way of reducing the spread of infection and ensuring the patient is safe. Another approach is to ensure all the medicine and drugs are administered on time as per the guideline of the patient’s requirement. This can be done by ensuring all the nurses in health care facility adhere to the hospital rules. The said practices can be designed such that it follows certain processes and ensure specific outcomes.

Hand washing is the best approach to ensuring patients are safe and quality of the service delivered is the best. The process involves installation of the hand washing facilities in strategic locations such that the doctors or nurses can wash their hands while attending to the patients. The outcome of the process ensures subsequent secondary infection and transfer of the pathogens from one patient to another is controlled. The advantage of the method of the method it is very cheap and applies across all the condition in the healthcare (Greaves et al., 2013). The impact of the process or reducing subsequent infections ensures the patients gets out of the hospital earlier. However the method has its repercussion, it is tiresome and time consuming for nurses attending the patients with same condition and diagnosis in one room. In the case of the infant patients who require regular attendance and the number of nurses be limited, hand washing by the health workers gives can lead to negative impacts on the patients. Subsequently spread of other diseases from one patient to another will occur.

Another criterion to ensure safety is States administration of drugs and medicine in time. For the case of the dermatological problem administering drugs at the right time ensures the disease pediatrics well and faster. Such drugs include creams and disinfectants to the wounds. It can be seen as simple by nurses and failure to administer the medicine on time and subsequently lead to resistance to the infection (Healy, 2016). The Psoriasis problem requires careful, and real-time monitoring of the condition by qualified nurses to reduces pain and administers the right medicine to the patients. The advantage of the approach is that patient will be able to treat well and at the right time. However, in the event of the caregiver who is less experienced or resident, administration of the wrong drug can be done such the health and the safety of the patient the.

Strategies for improving the quality of care

The improvement in patient safety in any healthcare facility requires the use of both policies and internal approaches within each and every hospital. In Australia, the government has come up with many strategies that ensure that all the healthcare facilities comply with quality and delivery of the quality services to the patients. The case of the dermatological diseases such as psoriasis and other chronic conditions such as cancer and tumors requires the intervention of the government and help from another organisation such world health organisation (WHO) (Ekor, 2014). The government has provided resources for treatment and policies for the doctor to comply with safety requirements of the patients. The need to have sound and applicable policy in healthcare sector ensure all the doctors meet requirements of the health services in the care and treatment of the dermatological patients in all Australian hospitals (Braithwaite et al., 2014). The Council of Australian Governments endorsed the National Health Care Agreement that ensures quality services are delivered to the patients at all time in all healthcare system both public and private sector. Subsequently, the government came up with multiple approaches that will help solve the problem of dermatological problem and application of evidenced-based practices in the management of the pediatrics psoriasis disease (Lee, Smith, Hong, Garnett, & Fischer, 2016).

Another study done in Australia reveals that use of the multiple approaches in healthcare help reduces the spread of secondary infection among the infants in primary care and intensive care units. The need to adopt major tested approaches such as the use of hand washing techniques in the healthcare facilities and proper administration of the drugs is mandatory in the provision of the quality healthcare. For instance, use of specific and acceptable disinfectant by the medical officers before and after attending to the patient is crucial in the delivery of the quality and healthcare for the infants in all hospital. Psoriasis if not treated well can advance or reoccurred at a later age when the child has grown (Salman et al., 2014). In such event, the doctors and nurses find it difficult to control the problem since it will be chronic and advance. To avoid such problems from occurring the need to adapt the appropriate medicine in the market that is most current and applicable to the disease is the first step in ensuring quality and safety of the patients. Other studies reveal that compliance well-taken doctor and proper dispensation of the medicine to the right patients at the right time takes places if the policies and laws are enacted to govern them. Subsequently, the doctors will need to follow laws concerning drugs and medicine in a healthcare facility.

Many other types of research have revealed that policies enacted by the government have helped improve the quality of services delivered to the patients and eventually reduces risk associated with caring of infants. For instance, in the United States, John Hopkins department of pediatrics, infants are well-taken care and only registered nurses can deliver services. The doctors have master how to care for the psoriasis patients (Boyce et al., 2014). The use of the technology such as latest machines in care for the patients and communication by doctors has been used entirely. This has led to the reduction of the cases of poor safety and quality. Healthcare services in the United States have been improved due to various combinations of policies and best practices in the health system. On the other hand, Australian health system struggle in the delivery of the quality healthcare to pedantries psoriasis. The case of the dermatological problems such as psoriasis has become a huge problem in the primary care.

Conclusion

Conclusively, the introduction of the hand washing in hospital after attending to the patients has reduced the spread of the secondary infection in the healthcare facility. For instance, the case of the dermatological problems such as psoriasis in infants, the need to have accuracy and exact science of using machines in the healthcare facility is imperative in the provision of the health services. Another approach is to ensure all the necessary medication is administered on time as per the guideline of the patient’s need. This can be done by ensuring all the nurses in health care facility adhere to the hospital rules. To avoid such problems from occurring the need to adapt the appropriate medicine in the market that is most current and applicable to the disease is the first step in ensuring quality and safety of the patients.

References

Boyce, M. B., Browne, J. P., & Greenhalgh, J. (2014). The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research. BMJ quality & safety, bmjqs-2013.

Braithwaite, J., Marks, D., & Taylor, N. (2014). Harnessing implementation science to improve care quality and patient safety: a systematic review of targeted literature. International Journal for Quality in Health Care, 26(3), 321-329.

Bronckers, I., Paller, A., van Geel, M., Van de Kerkhof, P., & Seyger, M. (2015). Psoriasis in Children and Adolescents: Diagnosis, Management, and Comorbidities. Paediatric Drugs, 373-384.

Christophers, E. (2001). Psoriasis—epidemiology and clinical spectrum. Clin Exp Dermatol, 314-320.

Ekor, M. (2014). The growing use of herbal medicines: issues relating to adverse reactions and challenges in monitoring safety. Frontiers in pharmacology, 4, 177.

Foley, P., Zuo, Y., Plunkett, A., Merlin, K., & Marks, R. (2003). The frequency of common skin conditions in preschool-aged children in Australia: seborrheic dermatitis and pityriasis capitis. Arch Dermatol., 318-322.

Gardner, G., Gardner, A., & O'connell, J. (2014). Using the Donabedian framework to examine the quality and safety of nursing service innovation. Journal of clinical nursing, 23(1-2), 145-155.

Greaves, F., Ramirez-Cano, D., Millett, C., Darzi, A., & Donaldson, L. (2013). Harnessing the cloud of patient experience: using social media to detect poor quality healthcare. BMJ quality & safety, bmjqs-2012.

Harrop?Griffiths, W., & Hartle, A. (2014). Quality and safety in healthcare revisited: a challenge accepted. Anaesthesia, 69(6), 537-539.

Healy, J. (2016). Improving health care safety and quality: reluctant regulators. Routledge.

Lee, A., Smith, S., Hong, E., Garnett, S., & Fischer, G. (2016). Paediatric psoriasis is associated with increased waist to height ratio in the absence of obesity: A multi-centre Australian study. Australian Journal of Dermatology.

Robinson, A. J., Vu, M., Unglik, G., Varigos, G., & Scardamaglia, L. (2016). Low-dose Rituximab and concurrent adjuvant therapy for pemphigus: Protocol and single-centre long-term review of twelve patients. Australian Journal of Dermatology, 3-85.

Salman, R. A. S., Beller, E., Kagan, J., Hemminki, E., Phillips, R. S., Savulescu, J., ... & Chalmers, I. (2014). Increasing value and reducing waste in biomedical research regulation and management. The Lancet, 383(9912), 176-185.

World Health Organization. (2016). Global Report on Psoriasis. Geneva: WHO.