Nursing: Safety of Patient Care

Significance of gaps between literature and practice

The information provided in nursing textbooks, published literature, and the hospitals’ policies and procedures all have something in common since they all outline how medical practitioners should handle patients. They all emphasize prioritizing the needs of the patients to ensure that they are comfortable and free of pain and suffering. However, many medical practitioners may not meet these requirements during actual practice.

A good example is the case of the experienced RN in the hospital. Drew noticed that despite having an understanding of the importance of washing hands and having experience in performing the sterile technique, she did not practice them. The gaps between literature and actual practice define the difference between a good medical practitioner and a bad one. Those who fail to adhere to the requirements put the lives of the patients in danger. These gaps must be addressed to ensure that patient care is enhanced and their lives are placed in good hands. As these gaps are bridged, better healthcare would be provided to the patients.

Culture of safety (how it benefits Drew’s case)

In healthcare, particularly nursing, a culture of safety has been identified as a key element in promoting safety (Woods, 2003). A culture of safety is necessary for a hospital setting to ensure that there is proper communication and social relations. It influences people’s actions and motivates them to observe the rules and regulations that have been set. Since human errors are likely to occur in the medical field, a culture of safety influences the process by which these errors are identified, reported, and communicated to the necessary individuals is accurate and reliable. Individuals who embrace a culture of safety understand and value the principles and practices of the hospital.

Drew’s case is one of negligence on one of the registered nurses (RN) in the hospital. She seemed to be neglecting some of the hospital’s policies and procedures especially when it came to hand washing and during sterilization. The personnel in Drew’s hospital, including the above-mentioned RN, should develop a culture of safety to place priority on adhering to the policies. This would enhance the safety of the patients and ensure that there is a high quality of care.

Drew’s options for managing his concerns (how he can protect patients from the unsafe environment)

Drew has a large part to play in addressing the issues that he witnessed in the hospital. He realized that he is not as experienced as the RN but can spot a misdeed. Since he has completed 75% of the competency check-offs, he has a good understanding of the hospital’s policy and procedures. Having an understanding of the requirements when it comes to hand washing and the sterile technique gives Drew the responsibility of correcting an error.

One option that Drew has is to approach the RN and remind her about the policy requirements when it comes to patient safety. However, this might not go very well since Drew is new and does not have much experience. Another option is for Drew to approach his preceptor or other management personnel and inform them of the RN’s behaviors. This way, she would be cautioned and advised. Keeping quiet about it is not an option since this would endanger the safety of the patients in the case where infections and outbreaks occur.

Drew’s role in continuous quality improvement

To ensure continuous quality improvement, Drew can ensure that he follows the policies and procedures as outlined. After ensuring that the issue of the RN has been resolved, he should act by example by following the correct procedures during practice. Drew should also work closely with the preceptor and raise issues whenever he notices any. He should maintain communication and not to hesitate from providing any information. Since he is a new RN, he is prone to make errors or have trouble while practicing nursing. Therefore, he should enhance a culture of safety by asking the preceptor for clarification. The preceptor, on the other hand, should also respond in such a way as to promote a culture of safety. He should understand that Drew is new and needs guidance as he becomes more experienced.

What to do first

After finding out that my best friend, Lindsey, is probably using the medication that is supposed to be administered to the patients, the first thing that I should do is to approach her and inform her of my suspicions. However, since she always appears short-tempered afterward, I would have to wait until she is sober. I will try to get the truth from her since she would trust me. However, if she does not cooperate, I will have to approach suitable personnel to report my suspicions.

Another thing I would do is to find out from the patients themselves. Since some of them may be aware of their usual dosages and time for taking them, they would be able to provide useful information. If I find out that she has been using the medicine, I will inform her of the dangers of using drugs that have not been prescribed. I will also inform her of the kind of suffering that the patients are going through as a result of her ignorance and greed.

Consequences of doing nothing

The consequences of doing nothing are dire. First of all, the patients will be at high risk of succumbing to the illnesses. The patients have complained of being in pain and this is a clear indication that no painkillers were provided. Nurses are expected to ensure that the patients are comfortable and that pain is relieved. These are fundamentals of nursing practice. The pain usually affects the functioning, health, and quality of life of the patients. Unrelieved pain may have several implications (Bernhofer, 2011). Examples include the following:

  1. Impaired mobility
  2. Cognition impairment
  3. Increased dependency
  4. Complications related to impaired mobility (depression and other mental issues)
  5. The impaired immune system, which affects the healing process

Apart from putting the lives of the patients in danger, Lindsey is also putting her health at risk. It is not wise to take medicine that has not been prescribed by the physician. The unusual behaviors shown by Lindsey are a clear indication that he is under some influence of drugs characteristic to those provided to the patients. To make things worse, there is a possibility that she is addicted to the drugs. If she is not, there is a risk of being addicted. Therefore, it would be wise to advise Lindsey to seek help from the relevant individuals.


Bernhofer, E. (2011). Ethics and pain management in hospitalized patients. The Online Journal of Issues in Nursing, 17(1), 1-50.

Woods, A. (2003). Patient safety: Not a question of competence. Nursing Management, 34(9), 1-6.

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