Reflective journal entry for the Concept:  Quality improvement

Quality Improvement

            Nurses should endeavor to improve the quality of the care they offer to patients. Each nursing department should develop a set of quality objectives based on the identified gaps. The nursing staff can derive gaps in the quality of their services through patient and family feedback as well as incidences reported in the hospital. I experienced a case of a medication error that prompted the need for change in the procedure of drug administration. I had reported for the morning shift with two nurses when we received a distress call from the general ward. A previously stable patient suddenly became anxious and began trembling 30 minutes after an insulin shot. On taking the blood sugar measurement, the patient was critically hypoglycemic and needed urgent resuscitation. After the patient stabilized, it was discovered that the nurse working the night duty and injected insulin on the wrong patient. On further investigation, the nurse manager noted that the patient had been transferred to her current bed after the discharge of its former occupant.

Patient safety is a fundamental quality indicator in hospital wards. Medication errors compromise safety and cause deterioration of the patient involved. Medication errors are most common during the transition between nurses and other medical staff (Wheeler, Scahill, Hopcroft, & Stapleton, 2018). Khalil et al (2017) recommend a combination of professional, organizational, and structural interventions to reduce medication errors. One of the structural interventions includes quality monitoring. Thus, quality improvement offers a chance to detect errors before they occur. In this case, it was noted that due communication about bed changeover was not done. Additionally, the patient did not have an armband for identification. As a means of quality improvement, all nurses were encouraged to notify their colleagues every time a patient shifted beds. At the same time, the nurse manager established a system of daily monitoring of patients for armband identifiers.