Patient safety is always a top priority. It gives meaning to the essence of healthcare. There is no quality care to talk about if a staff’s carelessness puts a patient in harm's way.
All healthcare workers, nursing assistants included, must always follow protocols that pertain to safety because breaches in these rules have drastic consequences. Overwhelming evidence shows that patient safety issues lead to more hospitalization days, injuries, and even death. It is for this reason that maintaining a culture of safety is vital to achieving quality patient care.
Performing patient care procedures safely is your responsibility, but it is also just as important to be mindful of coworkers who fail to follow the rules. And the first step to this awareness is to know common scenarios of how this usually happens, such as these below:
1. Infection control breaches.
Due to the enormous pile of tasks to complete in a single shift, some CNAs skip seemingly trivial procedures, such as handwashing. This bad practice is particularly alarming during this COVID-19 pandemic, when the coronavirus that causes the disease is especially brutal to the vulnerable patients, such as the older ones and those with chronic conditions.
You might also encounter a colleague who has a cold casually going from room to room without a mask. Other times, you might see another drop the dirty linens on the floor and then pick them up, contaminating their scrubs in the process.
Some CNAs who are responsible for cleaning, disinfection, and sterilization of devices and equipment do not follow procedures to the detail. They may also mishandle already disinfected equipment.
2. Working under the influence of alcohol or illegal drugs.
Providing patient care while drunk or high on drugs is a major breach of safety protocols. It can easily endanger a patient's life. An intoxicated staff member will behave and think differently and dangerously; hence their decisions become unreliable, and their actions can lead to patient harm.
3. Doing procedures that are beyond their scope of practice.
CNAs must always be aware of what their license allows them to do. Doing more and beyond one’s scope of practice is dangerous and illegal and can put one's career on the line.
4. Failure to follow falls prevention protocols.
Did you know that patient falls in healthcare settings happen frequently? Yet this type of accident is easily preventable. According to the Agency for Healthcare Research and Quality, there are 700,000 to 1 million hospitalized patients who fall each year. The same is also true for half of the 1.6 million nursing home residents. As simple as failing to raise the side rails as needed can lead to patient accidents and injuries.
5. Improper use of cleaning materials.
Safety issues can arise even from the incorrect use of cleaning products, such as bleach. As a general rule, bleach should not be mixed with any other products or else it may give off toxic fumes and cause breathing difficulties and skin and eye irritation not only to the CNA who's using it but also to the patient who's in the same room as them.
Have you seen any of the above scenarios happening in your workplace? If you did, what did you do?
When a coworker is breaching a safety protocol, you might be torn between just minding your own business or calling their attention to it. If you are unsure of what to do next time, here are some tips to help you deal with such a situation:
1. Protect the patient first.
If it's between protecting your patient or your coworker, your patient comes first. It's not ratting out or snitching on your colleague. It's doing the right thing.
If, for example, you smell alcohol in a coworker and see them help a patient transfer from the bed to the wheelchair, will you intervene? Yes, you should. If you don't, the patient may fall.
Your colleague who is under the influence is not fit to care for patients. Stop them from providing care and report to the nurse or supervisor immediately.
2. Follow safety rules and agency protocols.
Protocols are in place to prevent accidents and injuries to both patients and staff. It dictates the behavior needed to ensure quality care. If your agency has guidelines on reporting erring coworkers, it would be best for all concerned to follow procedures.
3. Communicate openly and respectfully.
Learn how to give feedback. It takes skill to do so without sounding mean. No shaming whatsoever. A workplace where people criticize mistakes and embarrass others is unhealthy. It encourages the erring staff member to hide future errors.
The goal of proper communication is to prevent accidents and improve quality care. Use words that mean to assist and not to criticize. "Let me help you put up the side rails" is calling the staff's attention to the potential problem. It serves as a reminder that they can prevent an accident from happening if they secure the patient in bed.
Maintaining a culture of safety is of utmost importance to ensure that patients receive the best quality care possible. While it is vital to ensure patient safety yourself, helping coworkers prevent patient harm is your duty, too.
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