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Ensuring Patient Safety – The Ultimate Survivor Game – Part 2

This blog post series is based on a recent Webinar with HealthStream’s Joseph Caracci, AVP, Clinical Assessments.

Caracci is an RN and has been a thought leader in healthcare for the last 20 years. His extensive clinical, business, and IT experience has made him a well-respected expert and an innovator in helping healthcare organizations provide safe and effective care to patients. In this part of the webinar, Caracci focuses on strategies that nurse educators can adopt to prevent medical errors.

Strategies for Nurse Educators

As seen in Part 1 of this blog series, the list of contributing factors and stakeholders in the drive toward improved patient safety are both impressively long. Caracci believes that nurse educators can have perhaps the biggest role in the drive toward improvement.

Assessment: The Starting Point

Caracci singles out the four factors that can be most directly impacted by nurses and nurse educators: (1) Poor staff-to-patient communication, (2) Poor staff-to-staff communication, (3) Lack of appropriate education and training, and (4) The need for rapid decision-making.

With these four contributing factors in mind, Caracci recommends that nurse educators begin with assessments to identify gaps between best practice and actual practice. They should:

  • Use interpersonal assessments to help identify issues related to poor communication.
  • Use knowledge and skills assessments to help identify gaps in education and training
  • Use clinical judgment assessments to identify those gaps in critical thinking that interfere with a nurses’ ability to think clearly and rapidly through an emergent clinical situation.

HealthStream’s 360° Competency Assessment can measure each of these domains and provide the feedback needed for appropriate and effective corrective action. The knowledge exams and self-assessments include 10 unique specialty-based assessments and over 100 real-life scenarios that help evaluate key skills in high risk or high volume scenarios. The output is an individualized report that helps nursing leadership develop the kinds of action plans that will help nurses make meaningful improvements in these four domains.

Closing the Gaps Between Knowledge and Practice

Caracci recommends that these assessments be reliable and include measurement of the following elements to ensure that all gaps are effectively identified and corrected.

  1. When evaluating the knowledge domain, it is important to focus on the information that the nurse has acquired and retained with emphasis on theory, experience, and education. Caracci recommends using knowledge assessments that incorporate real-life scenarios that can help identify gaps in both experience and education.
  2. Use the skill domain to measure technical mastery. This domain can be assessed using self-assessments and comprehensive skills checklists. Preceptors and professional development can help to shore up those weaker skills identified by the assessment.
  3. The interpersonal domain should measure personality, self-awareness, and emotional intelligence. The assessment of interpersonal skills should also include questions about how the nurse would respond to various situations.
  4. Critical thinking, problem solving, ethical reasoning, and decision-making abilities should be evaluated in the judgement domain. This type of assessment is most effectively achieved by asking nurses to respond to real-life scenarios to evaluate the appropriateness of their evaluations and interventions. Caracci says that this type of assessment will answer some important questions. “Do you understand why you’re doing what you’re doing? Questions like this help us assess and understand clinical judgment.”

To learn more about the main causes of medical errors and the key stakeholders in their prevention, read Part 1 of this blog, posted earlier.

Listen to the Webinar and explore HealthStream’s Clinical Development solutions.

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