Quality and Safety. Health, Medicine, Nursing Research Paper

Quality and Safety
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Institution
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Quality and Safety
Introduction
The concept of quality improvement (QI) is considered as a central part of the work of medical practitioners within the health care system. This is since it is conducted under clear scientific principles that provide a valid way of identifying and measuring change including having valid theories of reliability alongside human factors that act as the basis for various interventions. In this case, the Neonatal Intensive Care Unit (NICU) provides a highly complex adaptive system that can easily provide a platform for the application of Quality Improvement principles (Harriman et al., 2018). This calls for the development of a safety culture that requires continuous improvement. However, the process requires that those working in NICU be taken through training in various cases such as patient safety and principles of QI. There are various challenges associated with the implementation of good practice owing to the development of new interventions capable of improving results for children in the NICU in the case where it is applied reliably. Such complex adaptive systems in health care such as NICU apply the concepts of high reliability being aware of the existing inherent risks to safety and their prevention mechanisms. From the perspective of the NICU, such perspectives would entail the involvement of Anticipation of events happening in real-time alongside the prevention of any form of unsafe events. In this case, the concepts of Anticipation encompass preoccupation with various potential as well as actual failures at any point in the process in the pursuit of delivering care before and after events happen. This requires the medical professionals to take into consideration the root causes, mechanisms of running NICU, the challenges and mitigating mechanisms. In this case, dealing with the existing challenging events alongside high-risk situations requires high-level organizational learning for the purposes of developing resilience (Harriman et al., 2018).
Current practice and potential areas of improvement at NICU
The whole concept behind this scenario involves an attempt to adapt the theory into the existing complexity in the health care system which entails different events and occurrences. These may involve different babies, variable service delivery and involving health care professionals not trained in theories involving patient safety. Resiliency in healthcare is developed through adaptation to the nature of variability while delivering the required reliability in care. However, the solution points towards consideration of standardization of processes to help obtain less variable results. In this case, the need of patients should be taken care of by the standardization process, therefore, resulting in reliable care. At the same time, having a high degree concerning safety awareness, a clear vision on better performance and cohesive teamwork is a necessity for achieving excellence in NICU. This requires a thorough assessment of safety within every environment that associates with the NICU and development of a culture that promotes and enhances safety in line with Quality improvement principles (Harriman et al., 2018).
The various intervention measures associated with NICU include thermoregulation that involves increasing temperature for the purposes of minimizing neonatal heat loss. This calls for the use of some devices that include plastic wrap, stocking-knit caps that are applicable in the delivery room. There is also the use of warming mattresses as well as modification of the technique applicable in the wrapping of infants for the reasons of improving the integrity in the process of resuscitation. The modification calls for the use of plastic head coverings as opposed to the use of stocking-knit caps. The other intervention measure involves the aspect of glycemic control which ensures the achievement of early initiation of glucose infusion by the use of peripheral IV access (Harriman et al., 2018). Such a case requires the development of a NICU-specific system applicable in ordering umbilical line placement films for the purposes of reducing the time required for confirmation of central placement. Then there is intervention by infection control through the establishment of vascular access that helps in the treatment of sepsis. This process requires timely collaboration with the pediatric pharmacy that helps improve the timing of delivery of drugs, especially antibiotics at the bedside. Further, respiratory management is also one of the intervention measures provided by the NICU. Then finally, the whole process at NICU requires teamwork as well as effective communication amongst the stakeholders. This requires the involvement of different medical practitioners such as physicians, neonatal nurses and other staff whereby each team member is charged with responsibility around the radiant warmer to help improve team dynamics. There was also the involvement of Just-in-time training mechanisms that help in solidifying various intervention measures.
Evidence-Based
According to Evidence-based medicine (EBM), for quality of care to be improved, there is a need to identify and promote workable practices and at the same time eliminate harmful practices. However, there exists a considerable gap between the research and the actual clinical practice. In this case, the quality improvement initiatives provide the necessary framework that is required for the purposes of doing the right things in the right way. The quality improvement initiatives enable clinicians to offer better care outcomes to patients. For instance, there have been various medical improvements in neonatal care that focuses on reducing mortality as well as morbidity. However, there is still an instance where despite these rapid improvements one can question the cases for quality improvement. The key underlying factor is the experience of the neonates as well as the parents and most importantly the experience of the child in the course of time spent in the NICU. The measure of the real outcome in health care concerns the rate of survival of the neonates. In this case, the lifetime outcomes help to improve care for patients, therefore, provides important measures for consideration. The aspect of examining the results from different neonatal units helps in discovering the real issues (Harriman et al., 2018).
The concept of quality improvement entails a combination of ceaseless efforts from various quarters such as health care professionals, patients, family members, educators as well as researchers on ensuring that the required changes leading to better outcomes in the system are adopted. The ultimate purpose of QI is ensuring the provision of a methodology capable of improving care and ensuring that the neonates receive care that is reliable always. The value of healthcare is accurately defined from the perspective of the patient as well as the individual-centered care that considers the quality values. This is since the parents' expectation is more than just ensuring the survival of the babies, because parents also have safety concerns that include reliability as well as consistency. Additionally, they also expect high levels of pain management, careful handling as well as necessary attention towards the development of their children's needs (Harriman et al., 2018). The neonates are at high risk of hypothermia owing to their limited abilities to respond to various body mechanisms effectively such as limited ability in initiating non-shivering thermogenesis. They are always at a risk of being victims of hypoglycemia owing to the decreased nature of glycogen storage, therefore, the inability to producing sufficient glucose. The neonates also have a high probability of increased metabolic requirements owing to the existence of stress, respiratory distress syndrome, alongside other factors that ensure an increase in glucose utilization. Preterm infants contrary to term i...