National Safety And Quality Health Service Standards: Applying Five Standards To Mrs. Julia Brown’s Treatment

Partnering with Consumers

Discuss about the National Safety and Quality Health Service Standards.
 

The National Safety and Quality Health Service Standards (NSQHS) were created by Australian Commission on Safety and Quality in Health Care. The first standard aims at bringing together governance systems to improve and maintain the quality and reliability of patient outcomes and care. The second standard involves partnerships of healthcare professionals with patients. The third standard has been put in place by senior managers and clinical leaders to manage and control infections associated with health care. Medical safety is the fourth standard. Thus, the standard was intended to ensure that the qualified clinicians prescribe, administer or dispense the required drugs to patients who are informed. The fifth standard describes strategies and systems in patient identification while the sixth describes the strategies and systems for good communication in the clinic. The seventh standard deals with ensuring appropriate and effective management of blood and their products. The eighth standard prevents development of pressure injuries in patients while the ninth standard describes processes implemented when condition of a patient worsens. The last standard describes the strategies to prevent patient fall off (Boyd and Sheen, 2014). Mrs. Julia Brown, a 61 year old woman, has been referred to the service after a lap Cholecystectomy. Her past history includes T2DM, OA and toes amputation 2014. She is an independent client with a supportive family. She is retired but is an active member of the community. Her ongoing care requirements includes the administration of IVAB’s via a PICC line, monitoring wound area (dressing if required), vital sign assessment and general education. The ten NSQHS standards apply to Mrs. Julia Brown as a patient and in her home environment. This article describes five of the ten standards and how they apply in her case. The standards include:  standards two, three, four, five and six respectively.

According to Australian Commission on Safety and Quality in Health Care (2016), the second standard is ‘partnering with consumers’. In this standard, consumers are included in the design and development of quality health care by health service organizational leaders. This standard requires: structures of governance to be put in place so that partnerships between carers and clients are formed; health service organizations to support carers and clients for active participation of patient experience improvement; and information on the performance of a health organization is provided to carers and clients so that they can contribute to the ongoing performance measurement, monitoring and evaluation.

Prevention and Control of Infections Associated with Healthcare

Evidence indicates that it is essential for clients, carers, families, patients and health care professionals to partner. Partnerships ensure that health care is patient-centred. Gill and Gill (2015) point out that patient-centred care is a high quality healthcare element. If this standard is applied to Mrs. Julia Brown’s treatment, the quality of health care would be improved since there would be increased cost effectiveness, safety and staff, family and patient satisfaction. According to Bradley and Mott (2014), partnership between carers, patients, families and consumers has been recognized as important at the national and international level. There are more benefits when patients are placed at the center of their care and that of heath care systems.

The third standard is the prevention and control of infections that are associated with healthcare. According to Russo et al (2015), this standard requires: implementation and maintenance of healthcare management and governance systems associated with infections; development and implementation of prevention and control strategies of infections associated with healthcare; that patients who acquire infections or are colonized when receiving care should be identified and provided with the necessary management and treatment; and that the clinical governance system makes appropriate antimicrobial prescription their strategic goal. It is recommended that any information regarding infections associated with healthcare be provided to carers, service providers and patients.

Mrs. Julia Brown has a history of T2DM, OA and toes amputation 2014. She has also been referred to the service after a lap Cholecystectomy. These conditions increase the risks of Mrs. Julia getting other infections. However, this standard would help to keep her safe from healthcare related infections. Cruickshank, Ferguson and Bull (2009) point out that the most common complications that affect patients in hospitals are healthcare associated infections. According to these authors, patients in Australia contract approximately 200,000 infections that are associated with healthcare. The third standard provides a good range of strategies across all healthcare system levels that can help to minimize the preventable infections. 

The most common type of treatment used in all healthcare systems is medication. The fourth standard, medication safety requires that: there are safe mechanisms on prescription, dispensation, supply, administration, storage, manufacturing of medicine; a patient’s medication history is accurately recorded by the clinical workforce and the history made available throughout their care episode; the healthcare staff are supported on prescription, dispensation, supply, administration, storage, manufacturing, monitoring and compounding of medicines; a complete list of medicines is provided by clinicians to the patients and the receiving clinicians when medicine is changed or when handing over care (Coombes et al., 2011) . It is important that patients are informed by the clinical workforce about their responsibilities, risks and options for the agreed medication management plan.

Medication Safety

Since Mrs. Julia is under medication, the medication safety standard is very important for her recovery. The standard ensures that the medication she receives is well prescribed, dispensed and administered. It also ensures that she is well informed about the medicines that she receives. Semple and Roughead (2009) argue that high incidence of faults and adverse events are associated with medicines since they are largely used all over healthcare systems. Medication safety standard protects Mrs. Julia from adverse events of medication by ensuring that there is systemization and standardization on things to do with medication.

Identifying patients and matching procedures is the fifth important standard. It is important that the right care is provided to the right patients by providing them a safe care. According to Australian Commission on Safety and Quality in Health Care (2016), this standard requires: that when providing services therapy or care, the approved patient identifiers should be at least three; when responsibility of care is being transferred, the identity of the patient should be confirmed by at least three patient identifiers; and that the intended care is correctly matched with patients using explicit processes available within health service organizations. This standard is essential in ensuring that patients do not suffer from being identified wrongly.

Mrs. Julia Brown is one among many patients receiving care and services from this particular hospital. Improper identification can be done easily if the proper strategies are not put in place. Identifying and matching her to the intended treatment would ensure that she takes the necessary time for the intended treatment without any additional costs. Blay, Duffield and Gallagher (2011) argue that mismatch between patients and their care does not always result in harm, but sometimes there are significant consequences. Between 2008 and 2009 in Australia, there were about eleven cases where a life was lost or permanent function loss as a result of procedures on wrong patients or wrong body parts (Semple and Roughead, 2009). Standard five should protect Mrs. Julia from such events.

The sixth standard, clinical handover is another important standard to the care and services of Mrs. Julia and other patients. According to Pascoe, Gill, Hughes and McCall-White (2014), clinical handover varies in a number of ways including situation (change of shift, patient transfer between hospitals, patient referral or admission), method (through electronic handover tools or face-to-face) and venue (bedside of the patient, hospital reception or common staff area). Clinical handover standard requires: implementation of systems for clinical handovers within health organizations; documented and structured clinical handover processes to be in place; and establishment of mechanisms that include carers and patients in the processes of clinical handover.

Identifying Patients and Matching Procedures

This standard ensures that Mrs. Julia Brown receives the best care and service that she is supposed to even after her care is transferred to different healthcare professionals. Allen and Banks (2011) argue that a breakdown in information transfer is a contributing factor in adverse events and preventable causes of harming the patient. Resources may be wasted if poor handover would be involved in Mrs. Julia’s case. Apart from wastage of resources, the other consequences of improper handover include medication errors, incorrect treatment, repeated tests, delayed or missed tests, unnecessary treatment or diagnosis. A standard process of handover guaranteed by the sixth standard would ensure that Mrs. Julia Brown gets the right treatment through the proposed manner.

In conclusion, the NSQHS Standards were created to protect the general public from harm that can be prevented by the proper means. Each of the standards provides specific requirements that once followed, help in achieving the general aim of the NSQHS Standards. The standards provide a mechanism for quality assurance which tests whether systems within healthcare facilities have the ability to ensure that minimum quality and safety standards are met. Basically, the standards ensure that once a patient is admitted in a health care organization, he/she goes through the correct process of tests, diagnosis and treatment. The standards prevent any unnecessary costs, resource and time wastage as a result of poor care standards. 

References

Allen, S. & Banks, M. (2011). Improving clinical handover in Australian hospitals and community settings. Med J Aust, 195(11), 642. https://dx.doi.org/10.5694/mja11.s1205

Australian Commission on Safety and Quality in Health Care, (2016). Resources to implement the NSQHS Standards. Safetyandquality.gov.au. Retrieved 28 July 2016, from https://www.safetyandquality.gov.au/our-work/accreditation-and-the-nsqhs-standards/resources-to-implement-the-nsqhs-standards/

Blay, N., Duffield, C., & Gallagher, R. (2011). Patient Transfers in Australia: Implications for Nursing Workload and Patient Outcomes. Journal of Nursing Management, 20(3), 302-310. https://dx.doi.org/10.1111/j.1365-2834.2011.01279.x

Boyd, L., & Sheen, J. (2014). The National Safety and Quality Health Service Standards Requirements for Orientation and Induction within Australian Healthcare: a review of the literature. Asia Pacific Journal of Health Management, 9(3), 31-37.

Bradley, S., & Mott, S. (2014). Adopting a patient-centred approach: an investigation into the introduction of bedside handover to three rural hospitals. Journal of Clinical Nursing, 23(13/14), 1927-1936. doi:10.1111/jocn.12403

Coombes, I., Reid, C., McDougall, D., Stowasser, D., Duiguid, M., & Mitchell, C. (2011). Pilot of a National Inpatient Medication Chart in Australia: improving prescribing safety and enabling prescribing training. British Journal of Clinical Pharmacology, 72(2), 338-349. https://dx.doi.org/10.1111/j.1365-2125.2011.03967.x

Cruickshank, M., Ferguson, J., & Bull, A. (2009). Reducing harm to patients from health care associated infection: the role of surveillance. Chapter 3: Surgical site infection – an abridged version. Healthcare Infection, 14(3), 109-114. https://dx.doi.org/10.1071/hi09912

Gill, S. & Gill, M. (2015). Partnering with consumers: national standards and lessons from other countries. Med J Aust, 203(3), 134-136. https://dx.doi.org/10.5694/mja14.01656

Pascoe, H., Gill, S., Hughes, A., & McCall-White, M. (2014). Clinical handover: An audit from Australia. Amj, 363-371. https://dx.doi.org/10.4066/amj.2014.2060

Russo, P., Cheng, A., Richards, M., Graves, N., & Hall, L. (2015). Healthcare-associated infections in Australia: time for national surveillance. Aust. Health Review, 39(1), 37. https://dx.doi.org/10.1071/ah14037

Semple, S. & Roughead, E. (2009). Medication safety in acute care in Australia: where are we now? Part 2: a review of strategies and activities for improving medication safety 2002-2008. Aust N Z Health Policy, 6(1), 24. https://dx.doi.org/10.1186/1743-8462-6-24