Risk Management Strategies for Nurses

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Risk Management for Nurses
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You have recently been appointed to a risk management position in a large hospital.

Risk Management Strategies for Nurses
Risk Management Strategies for Nurses

On you first day in your new position, several key staff approach you individually to discuss their opinions concerning the use of Failure Mode and Effects Analysis (FMEA). Several of the staff expressed their view that FMEA was not designed to be used in healthcare and to “force” it to work with a healthcare based risk management program will result in faulty analysis and actually increase risks. Other staff clearly supported FMEA and believe it is the future in healthcare risk management.

Before you meet with staff to discuss FMEA you need to know the following:
•What is Failure Mode and Effects Analysis (FMEA)?
•In the context of risk management, how can it be used to improve processes in healthcare organizations?
•What impact can it have on preventing sentinel events?
•What are the Joint Commission’s requirements in this case?

Risk Management Strategies for Nurses Assignment Expectations

Prepare a response to the above stated questions concerning FMEA. Your response should also answer the concerns of staff in a 4- to 6-page paper.

Introduction

Risk management programs were initially developed to reduce the incidents of malpractice lawsuits. However, risk management programs have evolved to a higher level of sophistication and are not designed to reduce preventable injuries and accidents and, of course, minimize financial severity of claims.

An effective risk management program usually operates on 18 basis to improve the quality of care by eliminating or minimize the number of accidents or medical errors that occur in a health facility.

Risk management programs should include the following elements:
•A grievance or complaint procedure which is processed, investigated and resolved in a timely manner
•Collection of data related to all negative healthcare outcomes that occur with in the health facility
•A medical care of evaluation process which will periodically assess the quality of medical care provided in the facility
•Educational programs for staff which focuses on patient safety, medical injury prevention, legal aspects of patient care, problems with communicating and establishing rapport with patients

Although risk management programs should include the elements mentioned above they should also carry out the following functions:
•Prepare incident reports
•Evaluate the frequency and severity of incident exposure
•Develop and implement corrective actions to reduce risk and exposure to liability
•Develop policies and procedures to ensure early intervention and sympathetic care after accidental injury to a patient
•Identify and investigate specific incidents of patient injuries and provide appropriate intervention if required
•Train and educate all staff, including clinicians, to minimize exposure and lower risks
•Maintain a public relations program

And some health-care facilities, the risk management program also includes a health risk assessment program. The purpose of this program is to educate staff and patients about the connection between lifestyle habits and disease with an outcome of lowering potential risk factors for disease. In other words, and effective health risk assessment program will lower individual health risks.

Risk Management Strategies for Nurses Required Reading

Anand, U. A., Asif, A. S., Muhil, S., & Thomas, L. (2015). Healthcare risk evaluation with failure mode and effect analysis in established of new dialysis unit. The Journal of National Accreditation Board for Hospitals & Healthcare Providers, 2(1), 15.

Asefzadeh, Saeed; Yarmohammadian, Mohammad H.; Nikpey, Ahmad; Atighechian, Golrokh, (2013).Clinical risk assessment in intensive care unit. International Journal of Preventive Medicine4(5), 592 – 598.

Aurel Oiuga, Aurel, McGuir, Marua J., (2014). Adherence and health care costs. Risk Management and Healthcare Policy, 7, 35-44.

Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2015). Assessment of clinical risk management system in hospitals: An approach for quality improvement. Global Journal of Health Science, 7(5), 294-303. Retrieved from http://search.proquest.com/docview/1667361206?accountid=28844

Fibuch, Eugene, Ahmed, Arif, (2014). The Role of Failure Mode and Effects Analysis in Health Care. Physician Executive40(4), 28-32.

Murphy, J. S., Reid, M., Ali, A., Harrington, L., & Sandel, M. (2015). Applying Failure Modes and Effects Analysis to Public Health Models: The Breathe Easy at Home Program. Frontiers in Public Health Services and Systems Research, 4(4), 29-35.

Rodríguez-Pérez, J. & Peña-Rodríguez, M. E. (2012). Fail-safe FMEA: Combination of quality tools keeps risk in check. Quality Progress, 45(1), 30-36.

Shea, M. J. (2014). Assessing a risk management programme. Pharmaceutical Technology Europe, 26(9), 48-50. Retrieved from http://search.proquest.com/docview/1625580328?accountid=28844

Shirouyehzad, H., Dabestani, R., & Badakhshain, M. (2011). The FEMA approach to identification of critical failure factors in ERP implementation. International Business Research, 4(3), 254-263.

Stewart, A. (2011). Risk management: The reactive versus proactive struggle. Journal of Nursing Law, 14(3/4), 91-95.

Risk Management Strategies for Nurses Optional Reading

Fassett, W. E. (2011). Key performance outcomes of a patient safety curricula: Root cause analysis, failure mode and effects analysis, and structured communication skills. American Journal of Pharmaceutical Education, 75(8), 1-5.

Websites

Richards, E.P., & Rathbun, K.C. (n.d.). Chapter 2 – Risk Management. Medical Risk Management. Retrieved from the web November 2012 at http://biotech.law.lsu.edu/Books/aspen/Aspen-Chapter-2.html

Risk Management Strategies for Nurses Sample Answer

 

RISK MANAGEMENT STRATEGIES

Risk management programs are developed for the purposes of reducing potential risks to patient safety which could lead to malpractice suits. Risk management programs have evolved to greater levels of sophistication. The programs are designed to reduce preventable accidents, injuries and financial implications. An effective risk management program consists of the following elements including a well illustrated procedure on ways to collect data related to potential negative outcomes, and periodical evaluation process that will assess the quality of medical care in the healthcare facility. Proper implementation of such programs should focus on patient safety, injury prevention and legal aspects of patient care in order to establish good rapport with the involved stakeholders. An example of risk management program is Failure Mode and Effects Analysis (FMEA) (Murphy, Reid, Ali, Harrington, & Sandel, 2015).

What is Failure Mode and Effects Analysis (FMEA)?

Failure Mode and Effects Analysis (FMEA) is a system designed to aid in identification of the potential risks and failures in an organization, its causes, impacts of the failure on the workers and end users for a given process. The system also do assess the risks associated with identified  potential failures so as to identify ways to prioritize the best corrective action that can address these concerns (Anand, Asif, Muhil, & Thomas, 2015).

The use of FMEA is aimed at preventing safety hazards in order to minimize loss of product performance and performance degradation. It is used by engineers in aerospace, aviation, nuclear power, automotive industries and chemical processing industries. The FMEA has been around for three decades.  In healthcare, FMEA is a prospective assessment system that identifies steps that will reduce potential risks, thereby ensuring that they achieve a clinically safe and desirable outcome.  This systematic approach ensures that potential risks are identified and prevented before they occur. If effectively implemented, FMEA can be used to prevent the following vulnerabilities including ferromagnetic objects from MRI incidents, bed rail entrapment, gas usage for medical purposes, and power failure in major medical centers (Asefzadeh, Yarmohammadian, Nikpey, and Atighechian, 2013).

In the context of risk management, how can it be used to improve processes in healthcare organizations?

The FMEAN process consists of five steps a) team selection, b) identification, c) preparation, d) failure mode identification, e) scoring based on risk priority, f) establishing an action plan.  In identification process, the healthcare facility identifies high risk processes within the department. This marks a significant opportunity to enhance patient safety and sustain quality team performance in an institution. This step focus on defining the scope of FMEA with clear definitions and processes that needs to be analyzed. Multidisciplinary team selection is the second stage. This must include an expert advisor. Their role is to reflect on the previous failed experiences (Murphy, Reid, Ali, Harrington, & Sandel, 2015).

The third step is that of graphically designing the process. This includes developing and verifying the flow diagram. The number of each process step must be numbered consecutively in the process flow diagram. All the sub-processes under each block of the flow diagram must be identified and named consecutively using alphabetical letters (Anand, Asif, Muhil, & Thomas, 2015).

The fourth step involves conducting of hazard analysis. The main purpose of this step is to develop list of hazards that are likely to cause reasonable illness or injury if not well controlled or monitored. This includes listing of failure modes, determining probability and severity, using decision tree and listing the causation of all failure modes listed.  The last step is action and evaluating the outcomes. An action for each failure mode cause that will control it must be described. The outcome measures that will be applied to analyze and test the process should also be identified. It is important to indicate if the action recommended will be completed as a single or as group action (Fibuch and Ahmed, 2014).

What impact can it have on preventing sentinel events?

Healthcare leaders are expected to ensure that there is an ongoing proactive program that can be used to identify patient potential risks to providers and service users safety, outline effective and implement effective strategies that mitigates occurrences of the potential errors- which is adequately achieved using the FMEA system (Asefzadeh, Yarmohammadian, Nikpey, and Atighechian, 2013).

Secondly,  the programs aids in identifying strategies that reduce potential sentinel events and health system errors incidences that occur by conducting proactive risk assessment practices using the existing information about the sentinel events specific to that healthcare organization. The assessment is done so as to design or redesign processes and functions that can prevent similar incidences in the future. This is beneficial because it helps prevent adverse occurrences instead of reacting to it when they have already occurred. This approach also reduces the barriers to accepting the risks developed by hindsight bias, embarrassment, disclosure fears, punishment and blame that arise in the wake of the potential actual event (Anand, Asif, Muhil, & Thomas, 2015).

What are the Joint Commission’s requirements in this case?

The Joint Commission have outlined the requirements for health facilities to undertake Failure Modes and Effects Analysis (FMEA). The list of requirements is fairly detailed and healthcare organizations needs to adhere to these regulations in order to ensure that they deliver safe and quality patient care (Anand, Asif, Muhil, & Thomas, 2015).

The joint commission considers FMEA as an important and effective tool when evaluating risk of patient injury. This tool is popular and proactive preventive measure that effectively gauges risk of healthcare provider and service users risk to injury before it actually occurs. The approach of this technique is to prospectively identify as well as to prioritize potential system failures in a comprehensive approach. The requirements by the Joint commission is that each  member of a healthcare facility should seek at least one process that is considered as high risk every year, and perform proactive risk assessment (Asefzadeh, Yarmohammadian, Nikpey, and Atighechian, 2013).

These requirements are spelled out in FMEA code Requirement LD.5.2. In addition, the selection of risk based process should focus (but not mainly based) on information published by the Joint Commission. These refer to the most occurring kinds normally referred to as “sentinel events.” In addition, patient safety risk factors should be identified. The healthcare facility’s leadership members are expected to define, design and implement strategies that identify patient safety risks and reduce potential medical and health errors using a proactive and ongoing program. The common processes identified by the Joint commission that could possibly lead to sentinel events includes  medication use, operative procedures, seclusion, use of blood samples, resuscitation and use of restraint as part of care to  high risk patients (Rodríguez-Pérez & Peña-Rodríguez, 2012).

Risk Management Strategies for Nurses References

Anand, U. A., Asif, A. S., Muhil, S., & Thomas, L. (2015). Healthcare risk evaluation with failure mode and effect analysis in established of new dialysis unit. The Journal of National Accreditation Board for Hospitals & Healthcare Providers, 2(1), 15.

Asefzadeh, Saeed; Yarmohammadian, Mohammad H.; Nikpey, Ahmad; Atighechian, Golrokh, (2013).Clinical risk assessment in intensive care unit. International Journal of Preventive Medicine4(5), 592 – 598.

Fibuch, Eugene, Ahmed, Arif, (2014). The Role of Failure Mode and Effects Analysis in Health Care. Physician Executive40(4), 28-32.

Murphy, J. S., Reid, M., Ali, A., Harrington, L., & Sandel, M. (2015). Applying Failure Modes and Effects Analysis to Public Health Models: The Breathe Easy at Home Program. Frontiers in Public Health Services and Systems Research, 4(4), 29-35.

Rodríguez-Pérez, J. & Peña-Rodríguez, M. E. (2012). Fail-safe FMEA: Combination of quality tools keeps risk in check. Quality Progress, 45(1), 30-36.

 

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