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Introduction to Patient Safety and Care

Patient safety is a concept that emphasizes health care safety by preventing, minimizing, recording, and evaluating medical errors which often lead to negative effects. The most frequent root cause of medical errors was found to be a lack of care and ineffective communication. Misinterpretations may arise as information is exchanged between provider and patient or between the multitudes of institutions that make up a modern health system (Higbea&Luboff, 2019). The case scenario has been addressed in this essay where patient safety has been compromised resulting in unmet expectations of nursing safety.

Case Scenario

The case scenario described here involves the death of a 75 year old patient due to sepsis occurring from the contamination of pressure sores. She had associated co-morbidities- type 2 diabetes mellitus and congestive heart failure with a history of a fractured hip, because of which she preferred sitting in a chair all day due to her fear of falls. She has had a 3 week admission to the hospital for her pressure sores and leg ulcers where her condition had improved considerably. She had urinary and fecal incontinence as well and she was advised to stay in a residential care post discharge from the hospital which she and her family denied. She was given a pressure area care cushion for her back which she did not use. A major issue of non-compliance and non-adherence of treatment by the patient should have been noted and corresponding action taken. Home-care assistance visits were arranged for her involving wound dressing and showering.

There were insufficient supplies and insufficient budget for home care service which led to a decrease in the level of her care and improper documentation as well. Improper examination and careless approach to care identified as a major negligence here. Two months before her death, she was visited by a local GP for urinary tract infection where she was not examined properly and later at the local ED as well, her sacral wounds were not examined. Despite concerns being raised for her safety with her family and manager, she continued to sit in the chair for prolonged hours. The issue of non-compliance continued with the patient in this case. Later, after admission to the ED, she was diagnosed with sepsis from her pressure sores and acute kidney failure which could not be managed with treatment. Negligent care at home and the refusal of the patient to adhere to treatment plan and non-compliance led to her death, as noted. The case is an obvious case of negligence in the safety and care of the patient.

Safety Standards

In the current case study, the patient suffered because of her own non-compliance or adherence to treatment along with certain failures by the nursing staff as well. The nursing staff fell short of providing the necessary intervention and care in terms of handling the non-compliant behaviour of the patient especially in the home-care setting where it is more difficult to operate in terms of quality standards and lack of continuous contact between the clinician and the nurse and also, influence of the informal carers (Kulkarni et al., 2019). Another issue arsing includes the financial inability of the patient to handle home care, in which case she could have been moved to a residential care facility funded by the government. Another failure observed on the part of the nurse-in-charge was the lack of proper documentation of the patient’s condition to convey to the doctor-in-charge.

No specific plans for the provision of comprehensive care were where a multidisciplinary team involving a social worker as well was organised in her case. Comprehensive care is the organized provision of the overall medical services a patient requires or asks for. The Australian Health Care Safety and Quality Commission are responsible for leading and overseeing changes in health care protection and efficiency for all Australians. According to the NSHQS nursing standards, the comprehensive care standard focuses on ensuring people experience quality clinical treatment that addresses their requirements and recognizes the effect of their health problems on their lives and well-being (AHCSQC, 2017). The Comprehensive Care standard incorporates care delivery procedures to improve clinical preference. It covers falls, pressure injuries, diet, mental wellbeing, neurological damage, and end-of-life care activities (Salmond&Echevarria, 2017). This standard was not met effectively for the patient and led to the quality and safety failing in this case.

Recommendations on Patient Safety and Care

Non-compliant patients and patients refusing to adhere to the treatment plan should be handled with care from a variety of different perspectives (Noble, 2020). Best practices in the field include trying to establish the reasons for the said behaviour by the patient by counselling or talking to the patient in line with the first standard of NSQHS standards that talks about ensuring patients receive quality health care and safety. Nurses play an effective role in establishing communication with the patient, conveying the pros and cons of the treatment, health education and counselling of the patient and the family as well (Seo& Lee., 2019). Also, a multidisciplinary approach can be employed in managing the patient in terms of a social worker counselling the patient about her concerns , like in this case- her fear of falls could have been addressed and probably made her change her mind and increase her compliance. More assertive and structured techniques and ways of communication by the nurses are also useful methods of dealing with a patient like this which will help in conveying the gravity of the situation to both the clinician and the concerned patient and her family as well. This will be done in accordance with the standard two of the NSQHS talking about health literacy and including the patient in the plan of treatment along with maintaining the autonomy of the patient as well. Provision of comprehensive care for the patient in need should also have been done to improve the clinical outcome (Woo et al., 2018).

Conclusion on Patient Safety and Care

Medical errors and lack of care often lead to negative effects compromising on patient safety. Elderly patients go through a phase of intercurrent illness during treatment periods. They are also prone to non-adherence to treatment due to issues that could be mitigated by patient and family education as well as help from the social worker. A multidisciplinary team approach would also be helpful in avoiding a negligence of this kind. The Comprehensive care standard focuses on ensuring people experience quality clinical treatment that addresses their requirements.

References for Patient Safety and Care

AHCSQC. (2017). The NSQHS Standards. Retrieved from https://www.safetyandquality.gov.au/standards/nsqhs-standards

Higbea, R. J., &Luboff, A. (2019). Care for the root cause of medical errors. International Journal of Applied Philosophy, 1-3.

Kulkarni, M., Tyagi, A., &Raut, R. (2019).Assessment of quality and safety aspects of home healthcare services provided by tertiary care hospital. Indian Journal of Public Health Research & Development10(11).

Noble, L. M. (2020).The concept of adherence to treatment. Adherance to Treatment in Medical Conditions. Netherlands : Overseas Publishers.

Salmond, S. W., &Echevarria, M. (2017).Healthcare transformation and changing roles for nursing. Orthopedic Nursing36(1), 12.

Seo, Y. J., & Lee, M. K. (2019).Performance and impediments to patient and family education among home health care nurses. Journal of Korean Academic Society of Home Health Care Nursing26(3), 329-340.

Woo, K., Conceição, V. L., &Alam, T. (2018). Optimising quality of life for people with non-healing wounds. Wounds International9(3), 6-14.

Remember, at the center of any academic work, lies clarity and evidence. Should you need further assistance, do look up to our Nursing Assignment Help

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