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Table of Contents
Use of evidence-based methods
in health care
The origin and theory
evidence-based methods in health care
The legal and ethical
principle
Data collection process and
study selection
Abstract of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
The objective
of this work is to find evidences based on practice to support the importance
of a checklist as a strategic tool in order to improve patient safety outcomes,
in an acute environment.
As
Trainee Nurse Associate, based on my protecting learning hours, this would be
an important tool aiming to control all the tasks involved in a shift.
Currently, the ward does not use a checklist with procedures and tasks. The
normal behave is perform as it goes. In this essay I will explore
evidences-based practice of health professionals using a checklist in their
work as a tool management, aiming safety patient.
According
to Care Quality Commission (CQC)(Care Quality Commission, 2014), the
achievement of high-quality standards in health care services, patient safety
is fundamental. Understand the importance of developing checklist of procedures,
in an acute environment, to improve patient’s safety is the goal of this
literature review.
According
to NMC, any Trainee Nurse Associate, is expected to act under evidence-based
practice to promote patient safety. (Nursing & Midwifery Council (NMC),
2018)
Methods:
Search done on PubMed, Cochrane Library, Medicare, NICE, Best Practice, NHS
improvement, BMJ.
Keywords
used were a standardized checklist, Safety checklists, clinical practice,
questionnaire study, safety checks, the process of healthcare, care delivery,
safety attitudes questionnaire study, nursing observations, safety check items,
operations safety audits.
Importance
of a checklist to improve medical service
Introduction of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
Since
2009, the World Health Organization introduced the Safe Surgery Saves Lives
Program that indicates the importance of a safety checklist to improve the surgical
outcomes in the hospital. The program was widely accepted around the world.
Different countries, including France and Canada, made the surgical checklists
mandatory in their hospitals. The hospitals require a setup to foster a
supportive environment that can measure, monitor, and manage all the
information effectively. Safety checklist has been accepted in many hospitals
because it is an effective tool to improve patient safety in various clinical
settings by working under the guidelines. The benefits of using the checklist
in hospitals include improving human factors, decreasing mortality and
morbidity, and reducing the incidence of adverse events
To
keep the medical history of all patients is a difficult task that requires
proper assistance. The present work evaluates the effectiveness of the
checklist in the medical examination of patients and how it improves the
quality of services delivered to the patients. Present work aims to explore the
importance, implications, and challenges that induce an impact on the mechanism
of evidence-based safety and care protocols in the hospital. To implement a
significant mechanism,it is required to identify the need for a checklist in
the medical services.
Use of evidence-based methods in health care
Evidence-based
health care is an improved and appropriate way of using the current best
evidence of patient health in making decisions about the care methods and
mechanisms for individual patients. Evidence-based health care is an improved
way to deliver health services by reducing the possibility of wrong decisions.
Evidence-based practice involves three main components that improve the quality
of life. The clinical practice guideline is used to practice and support the
change in clinical practice. The randomized control trials are another strategy
to provide services to patients and the external evidence includes randomized
control trials and systematic reviews
In
hospitals, the number of patients is very large, and there is high feasibility
of human error in the diagnosis of a patient. Sometimes different factors are
overlooked under the strain of processing the event. The mechanism of
implementation of the checklist in hospitals is different and it considers
adhering with the safety standards of operations in the complex situation. In
hospitals, the high acuity areas are intensive care units, critical care units,
and operating rooms. The specialized considerations are required to be
addressed that are based on knowledge-based conditions, technology, and
clinical roles
In
medical, the checklist elements are considered as best practices and wise
methods that can help in translating the evidence into practice. The checklist
reduces risk and improves standardized information-based decision making.
Checklist plays a vital role in the decision-making process for the patient
about their care and treatment. The checklist is a systematic review for the
health of patients and feedback of doctors and surgeons is based upon thematic
analysis of checklist. Checklist Adoption for the patient’s variety of factors
that include information about effective technical strategies.Checklist as a
cognitive tool help in reducing human error by giving natural limitation about
the information. The standardized method of checklist ensures all the elements
and actions that are required to be addressed. The systematic information
structure and predicting the condition of the patient improves performance and
reduces variability
In the surgical site,the use of a checklist
reducesthe uncertainty of operation. Before having any decision in ICU,
clinicians revisit the checklist thoroughly and acknowledge all the complexity
during diagnosing, treating, and monitoring the patient. The decision can be
subdivided into three different phases. The first type is the decision that
includes whether or what to do. The
second type is the execution of the process Walther type interpretation of the
results and what does it mean. The
diagnosis phase checklist plays a cognitive role in recognizing the possibility
of VAP
The origin and theory evidence-based methods in health care
Research
and auditing have widely used as an intervention that enables the hospitals to
improve quality of care. The internal auditing system is continuously improving
Patient Safety and care. This internal audit system uses peers to peer
evaluation approach that engages Healthcare providers with the plan to do check
act (PDCA). Audits are considered as a chick stage for the improvement of the
quality cycle. The significant impact of auditing is on the team climate and
Patient Safety Culture. The effectiveness of safety auditing of the patient
depends upon the context in which safety auditing is performed. Research and
auditing both are a combination of factors that explain the improvement degree
for Patient Safety in hospitals
The
Internal auditing system provides a quality developed new mechanism that is
based upon controlling the precondition for good patient care. Team climate
measurements include collaborating patterns and standard part of Healthcare
providers. The Internal auditing results provide enough information regarding
the improvement plan. Some important factors are also considered in the
follow-up phase. The change in the unrealistic Healthcare provider behavior is
considered in Internal auditing. Some of the Other important factors that are
addressed in the hospital for patient care include team training
Winters, et al., (2009) worked on the clinical review of the checklists
with the consideration of translating evidence into the practices. In the
review, the authors analyzed the advantages of checklist and ability to control
the treatment process. The research analyzed the tremendous potential of a
checklist to improve the quality and safety of healthcare provided to the
patients and to reduce the cost of healthcare. The research analyzed types of
checklists, the structure of checklists, adoption and benefits of checklists, formulation
strategies used in the checklists and how the monitoring equipment are proved
helpful in providing advanced services of healthcare. The research analyzed
reliability, the information provided in the checklist, inter rated and
intra-rated reliability. The research concluded checklist must remain wise,
dynamic, evolving, and empiric that provides support to the evidence and
explores consequences. The research concluded final examples with smooth and
effective implementations. The research analyzed future directions based on
evidence. According to the authors, the checklist shows effective and efficient
knowledge about the patient including behaviours, tacit evidence, and
incorporating empiric situations
Jeffrey Robbins (2011) worked on transforming evidence-based care along
with the patient safety protocols along with the routine practices. According
to the author, World health organization safety measures include a checklist of
the patient as an important constituent of treatment. The research analyzed
clinical knowledge, implementation of extensive training programs, and ongoing
coaching as an important factor in the treatment of patients. The research
analyzed teamwork, cultural foundation, monitoring, accountability, successful
checklist, and management of a dynamic environment that improve checklists
Similarly, Henry et. al. (2011) conducted a systematic review regarding the safety checklists for the use of medical care and checklist in the healthcare units. The research analyzed limited evidence of effectiveness and applies safety checklist to improve the safety practices in healthcare. The methods used in the analysis are the Cochrane Library, MEDLINE, CINAHL, and EMBASE. The research concluded suggestions for the safety checklists and how it can improve protocol for patient safety and high-quality studies.
The legal and ethical principle of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
There are different ethical and
legal issues associated with health records and patient medical details. In the
auditing process, there is a possibility of sharing the patient's health data
without acknowledgment of the patient. Sometimes the patient can conceal
information because of a lack of confidence in the security of the auditing
system. Consequently, the treatment can be compromised and there is a risk of
improper treatment due to lack of information and the authentic medical history
of the patient. The health care service
providers and policymakers must discuss ethical implications of keeping the
record and auditing the patients. Although the auditing and research efficient
conditions provide complete support for patient care
Since
the 1990s,the checklist has gained a prominent role in surgical settings
because they are used to reduce and eliminate errors in Medical Services to the
patients. The checklist has reduced the possibility of operating on the
incorrect patient. In previous researches, it is observed that using a
checklist has reduced mortality, improved communication, and safety services,
and improved the quality of care provided to the patient
For
a better and improved checklist, it is important to meet legal and ethical
obligations. The common legal and ethical issues related to the checklist are
associated with consent pathway and how innovative tools can be used to resolve
the issues. Before completing the
consultation checklist, it is important to analyses all the ethical and legal
conditions that are fulfilled. Both ethically and legally the medical staff is
responsible for providing background information about the operation and
services provided to the patient. The information regarding the health of the
patient is confidential information that cannot be shared with other
persons. Before providing information
about the patient to anyone, it is required to keep the record of requester and
contact information of the requester
The
information about the staff physician in attending the patient will be kept
safe, and it will be not shared with anyone. Before having any operation, the
legal requirement is to have all the social information of patient search as
occupation, spouse, children, relevant family members, socioeconomic status,
financial concerns, family dynamics, age, living, situation, and gender. The
assessment consists of the capacity of patients in decision making and
different identified surrogate decision while making the checklist. The family
members of the patient must be notified about the ethical consultation and
medical procedures. In case family members are not addressed about the current
condition, it is a legal and ethical requirement is to keep the reasons. The
belief system of patients can induce an impact on the care; therefore, it is
required to be addressed first. Resuscitation status must be notified.
Appropriate referrals are recommended for the documentation and follow-up of
the case and these referrals consider information regarding psychiatry, social
work, chaplaincy, number and Palliative medicine
Methods of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
Data collection process and study selection
Primary
and secondary research was used in this paper, however, for the primary
research there was the use of the data that were collected from surgical
admissions (6714 patients) from March 2010 to June 2011 at 5 academic and
community hospitals
Search of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
However,
for the secondary research, there was the search of the article's example the
search done on PubMed, Cochrane Library, Medicare, NICE, Best Practice, NHS
improvement, BMJ.
Results of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
It
has been observed in all of these articles that these all written about the
development of the safety checklist. The safety checklist is considered as the
best importanttools that are required for measuring the safety of the patients
and least 1 of the 3 components was completed in 96.7% of cases; he entire
checklist was only completed in 62.1% of cases. The checklist can be utilized
as an important tool that can be used in any research.The clinical practice
guideline is used to practice and support the change in clinical practice. The
mechanism of implementation of the checklist in hospitals is different and it
considers adhering with the safety standards of operations in the complex
situation.The use of a checklist provides an ideal and beneficial way to comply
with all the standards of evidence-based care.The standardized method of checklist
ensures all the elements and actions that are required to be addressed
Discussion of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
Evidence-based
healthcare practices are provided based on conditions for different medical
conditions such as heart failure, asthma, and diabetes. However, the practices
are not limited to evidence basis but highly dependent upon the Patient Safety
research and checklists. Patient Safety research is mainly focused on data
analysis to identify the safety issues faced by the patients. It is also used
to demonstrate new practices that can improve the quality and safety of the
patient. Implementation of evidence-based safety practices is somehow difficult
because it requires a new and complex system of care. If enough search evidence
is available, it can improve patient values and clinical expertise that
ultimately improve in decision making for health care.Theconceptual framework
for health care assessment accelerates the research results and provide
efficient Patient Safety
The
model synthesizer concept of scientific information with behavioral change.The steps
of evidence-based practices can be viewed from the perspective of research
conducting person; it is also used for evidence-based information practices. The
first stage of evidence-basedpractice is to create and distill knowledge. In this stage, the research conducted
considers specific practice recommendations. The knowledge distillation process
uses such findings and implementation procedures for care delivery. The method
depends upon the perspective of end-user and general considerations of
traditional knowledge. The second stage is dissemination and diffusion in which
Healthcare organizations disseminate different information about the action and
potential users. The emphasis on this stage is towards most effective and user
segments such as a pharmacist, physicians and nurses
A
considerable effortis required to change the practice level for the
individuals. The existing evidence is helpful to address the clinical questions
from the end-users. Appropriate evidence and knowledge-based information are
required for the implementation of evidence-based practices.Arecent review is
conducted to identify evidence-based practices that improve patient care
It is important to understand that
checklists are critical for patients and their overall safety & wellbeing
because these checklists are helpful in keeping a few things on priority, which
are indispensable. It was found by Robbins (2011) through a research study that
hospital checklists are critical to making evidence-based care, as well as
ensuring the safety of the patients in routine processes followed in a
hospital. It was also found that hospitals should develop an environment, which
facilitates this kind of practice. In another review research article,
Thomassen, Storesund, Søfteland, &Brattebø (2014) tried to analyze the
effects of checklists in various kinds of clinical settings. It was found by a
systematic review that checklists are critical in any given clinical
environment, and it can have positive effects on the safety of patients. Same
to this article, another review research study was conducted by Boyd, Wu,
&Stelfox (2017) also proved that there is a great need to evaluate the need
for safety checklists to be implemented for inpatient healthcare. It means that
developing a safety checklist is critical in so many ways. A similar kind of
study was conducted by Hale &McNab (2015), which looked for safety
checklists during a ward round, and it was again found that if safety
checklists are there, then great improvements are seen in different procedures
such as documentation related to patients.
Conclusion of In An Acute Environment, Is There Any Advantage Of Having A Procedures Checklist To Improve Patient
In
summary, the whole discussion was about evidence-based practices and how it can
be helpful in decision making for patient care and safety. Using a checklist
and evidence-based practices in Healthcare depends upon different steps of
nonlinear processes and complex actions. Implementation of checklist usage in
Healthcare required several weeks, depending upon the nature of practice
change. Particularly in complex Healthcare settings use of the evidence-based
practice is not likely to work as it is supposed. The whole use of
evidence-based practices and checklist in the Healthcare provider induces a positive
impact on promoting health services and Patient Safety. Besides the checklist,
the evidence-based practices also include feedback and auditing. It is
important to consider best practices with enough characteristics for Healthcare
delivery and improvement in the services.
Suddenly if a checklist strategy is applied in a Healthcare service
provider, it could be reinforced Earth sustained with the change in the system.
The use of a checklist improves health care services by providing evidence of
the previous history of the patient and has a significant role with specific
context variable combinations. To improve evidence-based interventions into
practices, several practices and strategies are used.
References
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Checklist To Improve Patient
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