Quality and Safety in Practice – Week 4 Solution

This article covers a sample assignment solution about Quality and Safety in Practice.

Instructions

Assignment Content

This assignment is designed to highlight the role you play in quality, safe patient care on a daily basis.

Identify a patient care case from your own practice experience that involves quality and safety.

Note: If you are not practicing or have nor practice, use a case that has received media attention or one from the textbook.

Summarize the situation.

Describe your (or the nurse\’s) role in the patient care situation.

Explain the role the patient played in their own quality- or safety-related situation.

Evaluate the relationship between the patient\’s care and the outcome.

Identify how the care environment affected the situation, including the nurse or provider, the patient, and the outcome.

Determine whether a quality model was employed. If yes, identify and explain it. If not, identify one that could have improved the situation.

Explain what actions you might take to improve the outcome or prevent an adverse outcome in the future.

Format your assignment as one of the following

  1. 875 word paper

Solution

Quality and Safety in Practice

Patient safety is a critical aspect of high-quality nursing care. However, clinical system faults make the healthcare system vulnerable to various errors, which can jeopardize patient safety. This essay evaluates and discusses clinical issues involving delayed diagnosis and treatment as a patient care quality and safety issue. 

The Situation

Delayed diagnosis and treatment are all too common in healthcare, and they’re usually related to the patient, clinician, and socioeconomic issues.  When healthcare providers delay diagnosis, patients are put at a significant disadvantage, increasing their risk of complications and, in some circumstances, death (Holmes et al., 2020). When a medical provider misreads tests or x-rays, loses test findings, or performs incorrect tests, delayed diagnosis occurs. This is a regular occurrence in medical illnesses such as cancer, tuberculosis, aortic dissection, and pulmonary embolism. Unfortunately, physicians are not the only ones who make mistakes. Nurse practitioners are not as well trained as physicians, and they are just as likely to make mistakes when diagnosing a disease. 

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Role of Nurse in Prompt Diagnosis and Treatment.

Establishing a nursing diagnosis based on a patient’s condition and health is a complicated process that necessitates a wide range of skills. Nurses spend much time directly caring for patients, which puts them in a great position to track their symptoms and markers for serious medical problems to ensure prompt diagnosis (Gleason et al., 2017). Consequently, nurses ensure good communication of test outcomes to practitioners and patients and engage patients and their caregivers in the diagnosis and treatment interventions.  To accomplish these roles, nurses examine and monitor the patient and record any pertinent information to assist in treatment decision-making (Gleason et al., 2017). 

Nursing diagnosis can improve patient safety and quality and raise nurses’ awareness of and reinforce nursing role in diagnosis and treatment. Nurses’ involvement in diagnosis helps them see the patient in a more holistic context, easing the decision on specific nursing actions (Thomas, D. B., & Newman-Toker, 2016).  Therefore, nurses can successfully direct disease screening and referral schemes crucial for prompt diagnosis and treatment.

Role of Patient in Delayed Diagnosis and Treatment

The role of patients and their families in the diagnosis process is critical. This is because an accurate and prompt diagnosis necessitates collaboration between health care providers and patients. Patients are involved in providing health-related information and communicate their needs and healthcare beliefs to the physician or nurses (Balogh et al., 20).  Since patients understand the effect of their condition, they have critical information that guides diagnosis.  Such information includes their symptoms, health history, exacerbating factors, current medications, previous medical appointments. The patient information constitutes subjective and objective data crucial for initial diagnosis and treatment intervention.

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Quality and Safety in Practice
Quality and Safety in Practice

Relationship between the Patient’s Care and the Outcome

In reality, the pathway of care is determined by the assessment of patient symptoms, communication, care coordination, and transitions. Identification of symptoms and quick presentation for diagnosis are required for patient diagnosis and treatment (Muhrer, 2021). Through an appropriate establishment of patients’ needs, nurses can see a patient in a more holistic light, making it easier to choose specific nursing actions. In addition, appropriate maintenance of healthcare contributes to reduced morbidity and death.  As a result, patients achieve their healthcare needs and associated quality of life.

The low number of qualified physicians and lack of knowledge of presenting conditions increases the time taken for diagnosis and treatment (Gleason et al., 2017). Equally, lack of treatment resources, including laboratory or testing equipment and medicine, also reduces diagnosis and treatment delay. The high number of patients and the low staffing ratio, including the limited supply of medical equipment, contributed to the delay in response to individual patient cases, thus, redisposing the theme to adverse health outcomes. As a result, patients have a poor survival rate or more advanced stage of their conditions.

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Care Quality Model

Inflexible care models contribute to delay in diagnosis and treatment. Most healthcare facilities depend on physicians as the leading personnel in delivering primary diagnosis and treatment interventions. Physician assistants and nurse practitioners, on the other hand, can provide much of the same primary care at a cheaper cost and with the same high quality. Using a Coordination of care planning model would be critical in improving timely diagnosis and treatment actions (Williams et al., 2019). Coordinated care plans enable patients to share treatment interventions to relieve the need for appointments with physicians.

Coordinated care plans include the needed resources for specific conditions, treatment goals, and continuum for care. In addition, the plans help patients and their caregivers to understand complex clinical recommendations and treatment procedures.  Lastly, coordinated care plans provide care professionals with continuous and real-time information on patient’s physiological data to speed up diagnosis and treatment, lowering the risk of complications and fatalities caused by delays.

Actions to Improve Effects of Delayed Diagnosis and Treatment

The most appropriate actions against delays in diagnosis include increasing the physician-patient ratio, resources, and medical supplies (Car et al., 2016). The top issues causing delays in diagnosis and treatment in hospitals are the low number of qualified physicians and inadequate clinical knowledge, medical equipment, and medicines. Equally, enhancing collaboration among healthcare personnel could help mitigate poor communication leading to the mismatch between patient needs and medical intervention.  Having a functional communication channel such as telephone lines to general practitioners could help patients reach medical personnel immediately (Car et al., 2016). As a result, investigation on patient symptoms can commence early, and so is the treatment.

References

Williams, M. D., Asiedu, G. B., Finnie, D., Neely, C., Egginton, J., Rutten, L. J. F., & Jacobson, R. M. (2019). Sustainable care coordination: a qualitative study of primary care provider, administrator, and insurer perspectives. BMC health services research, 19(1), 1-10. 10.1186/s12913-019-3916-5

Car, L. T., Papachristou, N., Bull, A., Majeed, A., Gallagher, J., El-Khatib, M., … & Vincent, C. (2016). Clinician-identified problems and solutions for delayed diagnosis in primary care: a PRIORITIZE study. BMC family practice17(1), 1-9. 10.1186/s12875-016-0530-z

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Gleason, K. T., Davidson, P. M., Tanner, E. K., Baptiste, D., Rushton, C., Day, J., … & Newman-Toker, D. E. (2017). Defining the critical role of nurses in diagnostic error prevention: a conceptual framework and a call to action. Diagnosis4(4), 201-210. https://doi.org/10.1515/dx-2017-0015

Holmes, S. M., Hansen, H., Jenks, A., Stonington, S. D., Morse, M., Greene, J. A., … & Farmer, P. E. (2020). Misdiagnosis, Mistreatment, and Harm-When Medical Care Ignores Social Forces. The New England journal of medicine382(12), 1083-1086. 10.1056/NEJMp1916269

Thomas, D. B., & Newman-Toker, D. E. (2016). Diagnosis is a team sport–partnering with allied health professionals to reduce diagnostic errors. Diagnosis3(2), 49-59. https://doi.org/10.1515/dx-2016-0009

Balogh, E. P., Miller, B. T., Ball, J. R., & National Academies of Sciences, Engineering, and Medicine. (2015). Diagnostic Team Members and Tasks: Improving Patient Engagement and Health Care Professional Education and Training in Diagnosis. In Improving Diagnosis in Health Care. National Academies Press (US). https://www.ncbi.nlm.nih.gov/books/NBK338597/

 Muhrer, J. C. (2021). Risk of misdiagnosis and delayed diagnosis with COVID-19: A Syndemic Approach. The Nurse Practitioner46(2), 44. 10.1097/01.NPR.0000731572.91985.98

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All the Best, 

Cathy, CS

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