AHRQ Accountability of Nursing Professionals Thesis

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Another problem is that of "infections, such as nosocomial and post-surgical wound infections' (Medical errors, 2009, AHRQ). Careful hand-washing to prevent infections is a required part of most hospital procedures. Nurses should take additional precautions during times when the flu is likely to be spread or epidemic outbreaks. Nurses must strive to spot epidemics or a spike in communicable diseases or infection in their daily work. Once this is spotted, patients can also be educated about minimizing their exposure to harmful infections, by being encouraged to wash their hands, shield their mouth and nose when they cough or sneeze, and engaging in appropriate aftercare.

Nurses are often overtired and overstressed on hospital wards. A lack of sleep can result in a higher propensity to commit errors. The shortage of nurses in America results in the current ranks of nurses required to work longer hours, often back-to-back, and a greater likelihood nurses will be called upon to work at eccentric times, such as nightshifts. This can make it difficult for nurses to become patient advocates, because they are overburdened with nursing duties, and even duties not germane to their profession of nursing.

Yet nurses must act as advocates within the hospital environment to reduce stress upon the members of their profession, and as professionals nation-wide to call for a greater drive to recruit competent students and career-changers into the profession of nursing, which will reduce the pressure upon the current ranks of a rapidly-aging profession.

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The AHRQ article emphasizes that "most of the medical errors are systems related and not attributable to individual negligence or misconduct. The key to reducing medical errors is to focus on improving the systems of delivering care" (Medical errors, 2009, AHRQ). In other words, there are elements outside of the healthcare practitioner's immediate control. However, the article also shows that having individuals with the needed background on hospital wards dramatically decreases the rate of error and improves the functioning of systems and processes.

For example, "including a pharmacist on medical rounds reduced the errors related to medication ordering by 66%, from 10.4 per 1,000 patient days to 3.5 per 1,000 patient days," at one hospital (Medical errors, 2009, AHRQ). Having trained anesthetists on staff reduced hospital error rates "nearly sevenfold, from 25 to 50 per million to 5.4 per million and "hand-held, wireless computer technology and bar-coding…has cut overall hospital medication error rates by 70%," at facilities where they are used. All of these statistics are a call for expertise and bold use of technology -- nurses must use their specific skills and resources as advocates, to reduce nurses' patient load, to gain complete medical histories for patients, and to work with the administration to create a system more responsive to the needs of patients and nurses (Medical errors, 2009, AHRQ).

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