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Let’s talk about a Culture of Safety


By: Cynthia Sylvia, D NURS, MSc, MA, RN, CWCN

Dear Caregiver,

I’d like to briefly introduce myself – My name is Cindy and I’m a nurse consultant working alongside HoverTech. My background is in wound care with a certification from the Wound Ostomy Continence Certification Board, and I am a long-standing member of the WOCN Society.  I have practiced in a variety of roles, so it gives me great pleasure to be able to share and connect with you using this platform.

If you are a nurse at the bedside, you have probably heard a lot about Safe patient Handling and Mobility (SPHM) and much about Pressure Injury Prevention (PIP).  You might be wondering how they relate and what they mean for you as a caregiver.  Perhaps you’re questioning how your practice is impacted by both of those initiatives, and if there’s any overlap between them in relation to the nursing actions that you perform daily.  You might’ve heard the term “high reliability organization.”  What do you think “reliability” really means? I’d like to take the next several blogs in this series to explore these questions. I hope you find some value in this discussion.

Let’s begin with defining each of these terms. SPHM is defined by the American Nurses Association (ANA) as a set of initiatives that prevent unnecessary injury and keep both patients and nurses safe.  Through programs and advocacy, ANA is working toward establishing a safe environment with the goal of complete elimination of manual patient handling. The use of technology is critical to the success of these programs.

https://www.nursingworld.org/practice-policy/work-environment/health-safety/handle-with-care/

PIP is defined by the National Pressure Ulcer Advisory Panel (NPUAP) as improved patient outcomes in the prevention of pressure injuries (PIs) through public policy, education and research.  PIP consists of five points that include risk assessment, skin care, nutrition, repositioning, mobilization and education.  To see the specific recommended nursing practices under each point, you can find them in a downloadable format on the website of the NPUAP at:

 http://www.npuap.org/wp-content/uploads/2016/04/Pressure-Injury-Prevention-Points-2016.pdf

The ANA brings it all together as Culture of Safety, so it’s an inclusive approach, safety and prevention for both patients and caregivers. The zone of practice that is part of your daily experience is being recognized as a space where both patients and caregivers can feel safe without threat of injury. 

The journey to SPHM and PIP is interdisciplinary and interprofessional and involves the commitment and dedication of organizations from the top down and the bottom up.  You might be asking yourself, commitment to what?  Commitment to reliability that considers both quality and patient safety.  Being proactive and having the insight to identify problems before they happen, engaging in a systems approach that negates the blame, and being willing to delve deep to identify the root cause within a system; these are some of the qualities that enable a high reliability organization and the individuals who come together as one.   

The next blog in this series will examine how SPHM, PIP and high reliability contribute to a culture of safety.  I’ll go over the collaborative professional actions that are involved, how they are linked to one another and what you can do to drive this culture within your own organization.  In the meantime, I’d like you to ask yourself: What can you do to facilitate reliability within your organization? 

Warm Regards,

Cindy Sylvia

 

 

Oster, C.A., Braaten, J.A., 2016. High Reliability

Organizations. Indianapolis, IN.

http://www.npuap.org/

https://www.nursingworld.org/ana-enterprise/

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