Quality and Safety and the role of the NP

The Role of the NP in Improving Quality and Safety
Conduct a literature search to locate at least one article that addresses the role of the nurse
practitioner in improving patient safety and quality of care delivered. Once you have done this,
prepare a posting in which you:
 Describe the role of the NP in promoting quality and safety in the U.S. health care
system.
 Propose a minimum of three methods for the NP to ensure continuous improvement in
the quality and safety of healthcare systems.
Include a reference list for this section right here before starting section B (4 references)
SECTION B (1.5 pages minimum)
National Patient Safety and the Role of the NP
Review the QSEN Competency KSAS (Graduate) (attached)
After reviewing, please address the following in your discussion:
Describe methods the NP will use to identify and prevent verbal, physical and psychological
harm to patients and staff.
Next, search and review the AHRQ Patient Safety Network online
After reviewing, please address the following in this section:

How can the methods you described above be integrated into the role of the NP? Propose new
methods you feel can make an impact on national patient safety resources, initiatives and
regulations. How can these add to the continuous improvement in the quality and safety of
healthcare systems?
Include a reference list at the end of this section ( 4 references minimum)

Quality and Safety and the role of the NP

Section A

Nursing Practitioners are registered nurses whose contribution to healthcare facilities goes
beyond the scope of a traditional nurse. This is because nurses have been known to act as
subordinates to doctors when it comes to their positions in healthcare centers. This is made
possible by the fact that their training and practical exposure is more advanced than that done by
registered nurses. The position of Nursing Practitioner is necessary in the USA’s healthcare
system because they play a major role in the promotion of quality and safety in the delivery of
healthcare services. This is achieved through several roles that they carry out in their day to day
operations (Haig et al, 2006).
Overseeing the management of chronic and acute illnesses through diagnosing, evaluating and
managing their treatment. While general practitioners and registered nurses have the capacity to
handle these ailments, it is important to note that the authority of registered nurses is limited
while the skills of the general practitioner allow for superficial management. Nursing
practitioners therefore bridge this gap (Montalvo, 2007).
Another role of nursing practitioners is the accessing and analysis of the historical records of
patients as well as the conducting of physical examination to investigate the impact of acute
ailments and the progress of their management (Cronenwett et al, 2007).
Nursing practitioners also order and perform diagnostic studies when these are needed. These
diagnostics include MRI scans and X rays.

Nursing practitioners also take part in the prescription of medication for patients who have
chronic or acute sicknesses. It is however important to note that there is a variance in the
authority they have in doing this depending on the state they practice in (Hughes and Mitchell,
2007).
Nursing practitioners also provide healthcare advice to patients on how they can improve and
maintain their health.
Methods Nursing Practitioners can implement to ensure continued improvement of healthcare
The first thing that nursing practitioners can do to improve the quality of healthcare is to
document their work experiences so that others can learn from them.
Secondly, nursing practitioners can also formulate best practices which can be used in the
management of chronic conditions so as to further alleviate the pain and suffering that these
patients undergo.
The third thing that nursing practitioners can to in their effort to improve the quality of
healthcare in the country is to lobby for legislative changes that will guarantee them more power
to prescribe medication since they have the greatest deal of contact hours with these individuals.

References
Cronenwett, L., Sherwood, G., Barnsteiner, J., Disch, J., Johnson, J., Mitchell, P., … & Warren,
J. (2007). Quality and safety education for nurses. Nursing outlook, 55(3), 122-131.

Edmunds & Scudder (2009). Malpractice Litigation Continues to Be of Concern to Nurse
Practitioners
Haig, K. M., Sutton, S., & Whittington, J. (2006). SBAR: a shared mental model for improving
communication between clinicians. Joint Commission Journal on Quality and Patient Safety,
32(3), 167-175.
Hughes, R. G., & Mitchell, P. H. (2008). Defining Patient Safety and Quality Care.
Montalvo, I. (2007). The National Database of Nursing Quality IndicatorsTM (NDNQI®). OJIN:
The Online Journal of Issues in Nursing, 12(3).

Section B

There are three things that a Nursing Practitioner can do to ensure that the prevention and
identification of psychological, verbal and physical harm to the patients and staff. The first of
this is to work on the work environment. This environment needs to be defined through high
levels of trust and respect. In such an environment an individual who has been harmed will
confidently confide in someone on a position to help without any fear of his or her information
being leaked. This trust can be achieved through teamwork training which will bolster trust not
just for work but also for the social interactions between individual healthcare workers (Moote et
al, 2011).
Secondly the Nursing Practitioner can achieve the prevention and identification of the different
forms of harm through the development of a culture that does not foster or tolerate hostility in
the work place. The main cause of hostility in the workplace is the aggressor feeling threatened
unnecessarily. This tension can be reduced by making the working environment at the healthcare
center relaxed with emphasis on the importance of bonding with one’s workmates. The ARHQ
recommends the establishment of safety measures at different levels of the healthcare center’s
management so as to create an organization-wide culture of commitment to safety (Nettina et al,
2013).
Last but not least, Nursing Practitioners can also employ the use of best practices such guidelines
on how to avoid sexual harassment in the office. These best practices can be coupled with legal
approaches which will help in ensuring that those who are found to have been harmful to others
in the workplace face the law for their actions. It is important for the information about the
different forms of harm to be placed in the contract document that employees sign as they start

their employment. Their signing of these contracts binds them to the rules and regulations set by
the employer or since it indicates their agreement to abide by the terms of employment. .
According to the ARHQ, disruptiveness and unprofessionalism pose a grave danger to the
patients. Physicians are therefore encouraged to behave in an ethical manner to ensure the safety
of their patients (Frazee and Grozel, 2009; Haig et al, 2006).
Proposals
To improve safety and quality standards in healthcare, American nursing practitioners need to be
going on ‘exchange programs’ to clinics and facilities in different jurisdictions and possibly
other countries so as to expose them to different approaches to safety and quality.
Appraisals for nursing practitioners and other individuals working in healthcare also needs to be
conducted on the basis of adherence to safety standards.

References
Frazee & Grozel (2009). -Advance for NPs and PAs – Defensive Medicine: Right or Wrong?
Haig, K. M., Sutton, S., & Whittington, J. (2006). SBAR: a shared mental model for improving
communication between clinicians. Joint Commission Journal on Quality and Patient Safety,
32(3), 167-175.
Moote, M., Krsek, C., Kleinpell, R., & Todd, B. (2011). Physician assistant and nurse
practitioner utilization in academic medical centers. American Journal of Medical Quality, 26(6),
452-460.
Nettina, S. M., Msn, A. B., & Nettina, S. M. (2013). Lippincott manual of nursing practice.
Lippincott Williams & Wilkins.

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