Decision Making on Practice Modification

Decision Making on Practice Modification

Elimination of Punitive Error-Reporting Culture

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Working in an acute care setting is taunting to most of the nurses. Besides the working experience, the setting requires resilience and commitment to patient safety. The increased demands and attention in these environments exacerbate the burnouts. Reith (2018) argues that burnouts among nurses increase the likelihood of near misses. It burdens the institutions and patients to lose lives because of avoidable human errors. The stakeholders record these mistakes and invest appropriately in bridging the gap. In case the hospital perceives that burnout is the primary cause of the errors, it invests in deploying more nurses in the facility for optimum delegation and teamwork. However, it is virtually impossible to understand the root cause of the problem if some instances go unreported. The discussion will elaborate on how my organization delves into eliminating punitive culture to encourage more reporting.

The Decision-Making Process

Firstly, the organization identified the need for change. The organization received overwhelming complaints from the patients about the incidences. Most of these errors were not reported. As the rule of thumb, the institution could make some changes to implement a safe patient environment after identifying the mistakes. The changes included more investment in advanced resources and equipment that help in the provision of error-free services. Minimal reporting means that the facility will fail to respond appropriately to address the issue. Traditionally, when the nurse made an error, they fill the errors sheet stating the cause of the mistake and signing to take responsibility and accountability. Errors caused by negligence in service automatically led to the termination of the contract. However, the culture did not make the work flawless, but they looked for ways to cover the mistakes. Continued covering the errors resulted in low patient satisfaction as the leadership had no standpoint of making change. Secondly, the organization gathered the relevant data to ascertain the extent of the problem.

The auditing team reported a mismatch of errors reported compared to the patients’ complaints from the findings. Surprisingly, the report concluded that nurses reported only 30% of errors. Besides, the self-evaluation surveys evaluating error-reporting rates suggested a similar disparity. The organization invested in using the evidence from research to identify the possible alternatives that could offset the trend. Thirdly, the auditing team harmonized the possible alternatives. The leadership involved all employees in gathering information on the suitable option. Notably, the board of governance involved all the nurses through a comprehensive meeting to deliberate on the cause of action. The possible change meant that the organization needed to transform to non-punitive mistakes reporting culture. The traditional accountable method limited the nurse’s expression. The meeting also reported that nurses were likely to report errors that did not harm the patients.

Subsequently, the leadership chose anonymous error reporting as the culture that encourages freedom. The choice of these alternatives could risk accountability and responsibility. Traditionally, the board held the nurses responsible for their errors. The move meant that nurses can now be comfortable in reporting all the instances. When the facility captures all mistakes, it could invest appropriately in preventing future occurrences. The auditing team monitored the efficiency of change monthly and adjusted accordingly. On reviewing the decision after one month of implementation, the team noted improved error tracking where nurses reported four in five incidences. Also, 84% of the reported incidences matched the patients’ complaints. With a suitable investment, patient satisfaction increased significantly by the third month. The improvement matches Pozdnyakova et al. (2018) indicator of improved error-reporting through assessing patient satisfaction.

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