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Quality and Safety Education for Nurses (QSEN) aims at meeting the challenge of preparing nursing individuals with the right knowledge, skills and attitudes (KSAs) to undertake their responsibilities in the society in the best way possible. KSAs are necessary for sustainable development in the quality and safety in healthcare systems where the nurses are expected to work in. The competencies required of the nurses are in six key areas. These key areas are patient-centered care, team-work and collaboration, evidence-based practice (EBP), quality improvement (QI), safety and in informatics (Hughes, 2008). Competencies in the above areas are important in that they help towards success and in developing proper relationships between the individual nurses and the patients, workmates, the seniors and the wider society for improved health care.
On the other hand, Patient Safety Goals for hospitals are goals aimed at achieving two main objectives. These objectives are in helping to make a reliable identification of an individual as the right person for whom a certain service, treatment or care is intended and to assist in matching a treatment or service to that individual who rightly requires it. Acceptable identifiers in hospitals include the individual’s name, any assigned identification number, telephone number or any other reliable person-specific identifier. Among un-acceptable identifiers is the patient’s room number or physical location as these may change from time to time (2010). Among the advantages of using acceptable identifiers is that, they help in eliminating blood transfusion errors associated with misidentification of a patient, assist in reporting critical results of tests and diagnostic procedures on a timely basis and also help to eliminate the likelihood of harming a patient through use of anti coagulant therapy. Identifiers also allow for maintenance and delivery of accurate patient medication information all the times when required (Wachter, 2008).
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The essential knowledge/skills/values the nurse must have to eliminate blood transfusion errors related to patient misidentification
Blood transfusion is a very sensitive medical procedure considering that different people have different blood groups, most of which cannot be used interchangeably. This is because transfusion of blood that does not match with the recipient’s blood group would lead to adverse reactions. A minor mix-up during blood transfusion can lead to serious medical complications for the patient, which can result to death. Therefore, it is important to ensure that the recipient gets proper identification before transfusion takes place. The nurse in charge has to ensure that the blood or blood component matches with the order requested while the patient should match with the blood or blood component ordered. A verification process should follow this process. One or two people do verification either. When it involves one person, this should include automated identification procedure such as using a bar code or any other technological means to support the effort (2010). For a two-person verification process, one person has to be a qualified expert in blood or blood component transfusion. This key person has to be the one to undertake the transfusion process. The second person should be qualified to take part in the process as the hospital may determine.
During the process, high safety standards should be followed. Safety helps in minimizing harm to both the patients and care-givers through system effectiveness and personal performance. Among the KSAs necessary to ensure this are a proper understanding of technology use and standard practices that support safety and quality. Others are an all time vigilance and maintenance of a record of all errors and near errors, safety hazards, and potential sources of hazards or errors. Use of error reporting systems and inculcating a culture of safety helps enhance safety. Use of right strategies towards minimizing errors, addressing possible root causes of errors and giving the due value to vigilance, evaluation and monitoring help in maintaining the safety standards required. Others are offering proper individualized care plan, respect of the patient’s values and rights and use of ethical conduct during research and quality improvement (Hughes, 2008).
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Use of evidence to base actions taken in nursing is quite essential. The nurse should demonstrate a good understanding of the scientific methods and procedures required in blood transfusion. Basic knowledge on this is important as it helps during interventions that may be necessary. The nurse should be involved in proper collection, analysis and storage of vital data that may be required during blood transfusion. The nurse is expected to adhere to the set Institutional Review Board (IRB) guidelines always while basing individualized patient care on values, clinical expertise and evidence. Reading widely on publications highlighting scientific research and strategies and the emergence of new technology is important to increase levels of understanding of expectations and new processes (Wachter, 2008). Constant research on the topic is essential in understanding the new technological advances made in this area time on time.
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Non-compliance during nursing is very dangerous. This is because nursing deals with human life and a minor mistake may lead to an individual’s death. Therefore, compliance should be observed all the time. During the transfusion of blood or blood component to a patient, prior screening of the blood should be done to prevent infections passed through blood. Among the common infections as a result of infected blood transfusion, include Hepatitis B and C and HIV/AIDS. After screening the blood, proper identification of the recipient patient should be done to prevent the patient from being transfused with the wrong blood group or blood component. Transfusion with the wrong blood group or blood component is both inappropriate and a waste of precious life-saving commodity. Wrong blood transfusion causes blood transfusion reactions, which can range from mild to serious. The reaction occurs when the body’s immune system attacks the blood received or when there is an allergic reaction caused by the transfused blood. Whereas serious ill-health or death may result from this, the nurse responsible may have to contend with the consequences which include professional disciplinary actions and prosecution in a court of law. Such actions would have profound effects to an individual both personally and professionally (Hughes, 2008).
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Nursing is guided by a set of rules and processes. These should be complied with and where possible improved to ensure safety for the patients and the caregivers. Safety procedures help in minimizing complaints and assist in doing things the right way. Safety should be observed (Wachter, 2008)
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