The use of EBP promotes more of a collaborative approach to care. Care variation is reduced when all providers base their care on the latest evidence. Additionally, provider communication within the organization ensures quality care and improved patient safety. The development of evidence-based interventions is critical for St. Anthony Medical Center to address the worrying patient safety scores and incidences related to staff and patient safety. It is vital to determine whether cases of poor patient safety scores and incidences related to the staff and does patient safety Incident reporting (IR) or liaising with pharmacists improve patient and practitioner safety in three months.
The clinical problem presented for investigation includes persistent poor patient safety scores and incidences related to staff and patient safety. According to the Chief Nursing Officer (CNO), using patient incidence reports is a crucial intervention in improving a patient’s health. Research by Jani (2018) to explore the reliability of using incident reports posted on national reporting and learning system in improving the safety of antimicrobials in patients with penicillin allergy agree with the Chief Nursing Officer’s recommendation. The research found that thematic analysis of incidents may provide a valuable source of learning and improvement by gaining a better understanding of the healthcare system and individual factors that cause or contribute to inappropriate or unsafe prescribing of antimicrobials in patients with penicillin allergies.
Implementation Of a Search Strategy for The Best Evidence
The search strategy for the best evidence entailed gathering crucial information from different sources, including the internet and the library. The next step entailed brainstorming terms, indexes, or authors that might be significant for describing the topic of interest. Standard terms and keywords include patient safety, employee safety, employee workplace safety, drug error, adverse drug events, or patient safety incident. The next step in the process was a search on Google Scholar using terms and keywords I had previously brained stormed while connecting it to Rushlibrary.
The next step of the search strategy involves taking the terms and critical words previously brainstormed and searching for controlled vocabulary within the databases like PubMed for MeSH terms. The strategy follows a search within the Rush library’s databases using controlled vocabulary, test terms, and combinations. The next step in such an approach was using the controlled vocabulary to search the Rushlibrary databases for resources related to the clinical problem. It was crucial to keep a record of citations and resources using appropriate citation managers like RefWorks or develop an account within the library database such as PubMed.
The rationale for concluding to have made the best choice of research that offers the best evidence is based on the use of reliable databases like PubMed and google scholar. These databases offer peer-reviewed studies, which are also quantitative, as required in the guidelines. I have found the best evidence regarding whether using incident reports within the national reporting and learning system can enhance patient safety, particularly for those with penicillin allergy. The St. Anthony Medical Center reports that in 2018 and 2019, medical errors resulting from medical errors causing patient allergic reactions were 2 and 4, respectively. This situation refers to a worrying trend that the evidence provided by Jani (2018) offers to solve.
The study by Jani (2018) sought to find out if we Improve the Safety of Antimicrobials in Patients with Penicillin Allergy by Using an Incident Reported to the National Reporting and Learning System. The quantitative study involved reporting the numbers and characteristics of incidents. This includes those by the reported degree of harm, a proportion that involved anti-infectives, and the proportion where the patient was known to be allergic to the medicine before the actions leading to the incident. It also includes the stage of medicines use at which the incident was reported. The qualitative component involved a thematic review of incidents that were reported to lead to some degree of harm and to develop an assessment of the quality of the reported incidents.
The study’s results comprised a preliminary search that yielded a total of 21754 incidents, approximately half (10958) were related to anti-infectives. In nearly 60% (6536/10958) of the incidents involving anti-infectives, the patient was known to be allergic to the medicine involved before the actions leading to the incident being reported, with nearly equal numbers at prescribing (5339/10958) and administration (4370/10958) stages. The research concluded that the quality of reports to the National Reporting and Learning System limits the use of the data for quantifying the scale of the problem. However, thematic analysis of incidents may provide a valuable source of learning and improvement by gaining a better understanding of the healthcare system. Additionally, the analysis offers individual factors that cause or contribute to inappropriate or unsafe prescribing of antimicrobials in patients with penicillin allergies.
Evaluation Of the Qualitative and Quantitative Research Studies
Some of the strengths of the qualitative research recommended by the CNO is that trustworthiness was obtained by repeated discussions among the authors during the analysis process. Additionally, trust was built by describing the different steps in the analysis. Regarding dependability, it was considered a strength that the author who performed the individual interviews and moderated the focus groups (AG) is herself a physician and has also served as an incidence reports coordinator. The interviews and focus group discussions took place with an air of confidence and security, and it seems that the informants did not hesitate to express their thoughts. This situation enhances the reliability of the study in this field.
Some of the strengths of the study by Jani (2018) include using both the quantitative and engaging in a qualitative approach to study. This phenomenon provides more vital evidence and more confidence in the study findings. The study uses thematic analysis of incidents which offers a reliable venue for analyzing the practices within the healthcare systems and individual factors that lead to the unsafe prescription of antimicrobials.
One of the study’s weaknesses is that qualitative research alone is often insufficient to make population-level summaries (Carlfjord et al., 2018). The research is not designed for this purpose, as the aim is not to generate summaries generalizable to the broader population. The research findings might not be generalizable to other healthcare settings as they might contain small sample numbers, possible answer bias, self-selection bias, and perhaps inadequate research questions. The major weaknesses of the study by Jani (2018) are that as quantized qualitative data is highly susceptible to collinearity, there may be statistical measurement constraints when using such data. This method undermines the statistical significance of an independent variable, undermining our understanding of the magnitude of the effect of incidence reporting on patient safety.
Evidence And Its Implications to the Health Care Challenge
Incident reporting provides insight into the problem areas; in this case, for example, medication issues, patient falls, poor patient safety scores, and incidences related to the staff and patient safety. The findings by Carlfjord et al. (2018) reveal that adopting an electronic IR system is of great Value. The system contributed to making patient safety work visible to staff. Information produced by electronic records will be more accurate and timelier. The real-time and consistent recording makes current information easily accessible. Reporting promotes a safe workplace culture and raises everyone’s level of safety awareness. Practitioners can remain vigilant and aware of potential concerns due to incidents and observations. The IR system can warn before a significant catastrophe or disaster while offering a considerably less expensive reporting option.
The creation and usage of incidence reporting systems result in changes that can improve team-based treatment, alter clinic workflow, and increase staff engagement. Due to obstacles, including underreporting and fear of criticism from practitioners, incidence reporting consistently fails to provide results. The main issue with incident reporting is not that learning is not produced but rather that learning does not result in practice that is improved visibly. The fact that risk management divisions, not the clinical settings where the occurrences take place, own and run incident reporting systems are one potential explanation for this predicament. Risk managers might focus more on collecting data at the organizational or national level, while departmental-level input might not receive enough attention.
The quantitative study I found while researching the clinical problem provides the best evidence for my PICO(T) question for various reasons. For instance, the study sought to address the efficacy of incidence reporting in improving the safety of antimicrobial prescribing in patients with penicillin allergies. The results of this study are critical in providing evidence to back the recommendations made by the CNO for reducing cases of medical errors that cause patient allergic reactions. The study thereby provides evidence of the reliability of incidence reporting in improving patient safety. The study recommended by the CNO also provides significant evidence for the research question. The study findings elaborate on the importance of developing a local electronic IR system to ensure patient safety. Evidence obtained from the study reveals that an IR system within the hospital is significant in ensuring patient.
The process of implementing incidence reporting involves the development of a local incidence reporting system within the facility. When implementing the strategy, it is essential to update the current EHR to ensure that the staff is alerted about any red flags or other information relating to patient safety. According to a study by Odes et al. (2022) in California, incidence reporting on workplace violence was crucial in identifying significant interventions for violence prevention that may be generalizable to other healthcare settings. Additionally, research by Fukami et al. (2020) links incidence reporting among medical practitioners as a crucial strategy for ensuring patient safety and improving the quality of care. Healthcare professionals in different areas can utilize the findings of this study to develop a culture that ensures that they are free to enter data within the EHR system. This data could pertain to physical injuries, medical errors, equipment failure, administration, patient care, and generally anything that endangers a patient’s or staff’s safety.
At St. Anthony Medical Center, we can improve our practice based on the interpretation of the implications of these studies. This effort can be achieved by improving our knowledge of where, when, and how to report and fostering a positive attitude towards incidence reporting. There is a need for collective action among healthcare professionals in the hospitals to ensure that incidences are accurately reported within the EHR. Everyone needs to understand and be free from fears of disciplinary action for incidences entered into the system. Through this practice, St. Anthony Medical Center will stand a better chance to improve patient safety scores and incidents related to staff and patient safety.
References
Carlfjord, S., Öhrn, A., & Gunnarsson, A. (2018). Experiences from ten years of incident reporting in Health Care: A qualitative study among department managers and coordinators. BMC Health Services Research, 18(1). Web.
Fukami, T., Uemura, M., & Nagao, Y. (2020). Significance of incident reports by medical doctors for organizational transparency and driving forces for patient safety. Patient Safety in Surgery, 14(1). Web.
Jani, Y. (2018). ISQUA18-2497can we improve the safety of antimicrobials in patients with penicillin allergy by using incident reported to the National Reporting and Learning System?International Journal for Quality in Health Care, 30(suppl_2), 34–35. Web.
Odes, R., Chapman, S., Ackerman, S., Harrison, R., & Hong, O. S. (2022). Differences in hospitals’ workplace violence incident reporting practices: A mixed methods study. Policy, Politics, & Nursing Practice, 23(2), 98–108. Web.