Quality Improvement and Safety in Nursing Essay Example

Quality Improvement and Safety in Nursing Essay Example

Over the last few years, the United States has experienced a significant technical complexity in the healthcare system. In detail, the complexity evolves around three levels, including the system, national and individual provider level. Clinicians and other healthcare providers are determined to utilize the quality of care acquired by patients. However, the bulkiness of data and new understanding acquired from the annual clinical studies can be overwhelming. Additionally, the performance and quality of care are greatly impacted by the lack of an appropriate system and also the lack of a better system that allows clinical practitioners to enhance their knowledge, particularly at the system and individual levels.

Individuals should acquire multiple skills to succeed in the nursing profession. However, the essential elements in a healthcare system include patient safety and patient quality of care. The two elements should be the core objective of every healthcare facility. The primary role of nurses is to provide safe and quality care to the patient and system level.


The case scenario evaluated, in this case, involves a 79-year-old female admitted for sepsis in Pennsylvania (Miller, 2017). The patient has also suffered from other diseases such as peritonitis. The patient reached her primary care doctor complaining of severe abdominal pain. After the admission, the physician recommended the patient undergo a chest X-ray test and EKG test. However, according to the results, the patient had no signs of sepsis, but her abdominal worsened later, and the physician decided to take her into an emergency room. She was later diagnosed with sepsis and other diseases such as peritonitis and necrosis.

The Role of a Nurse

The nurse responsible for taking care of this patient has been instructed to provide an EKG test and a chest X-ray. Therefore, the nurse failed to provide an abdominal CT test when conducting the other scans despite being aware of the patient’s past medical history. As a result, individuals can suffer from necrosis (Nuttall et al., 2016). The patient also complained of the wrong catheter placements after the physician used an arterial line placement rather than a central line placement. Furthermore, the physician noticed that he had administered the patient’s medication through the wrong catheter placement. Therefore, the physician had to reach the manager, who had to seek the risk management team to take care of the patient.

Patient’s Role

The patient was not responsible for the medical error. She sued the entire medical team for failing to conduct an abdominal scan despite being aware of her medical history. Due to necrosis, which was diagnosed after being taken into an emergency room, the patient had to undergo arm surgery for normal restoration. The patient would have a better feeling in his arm and little use of force in the end.

Care Environment

The patient failed to apply due diligence to ensure that he conducted the right tests to provide the patient with the right surgery and treatment. Therefore, there was some confusion since some tests demonstrated the patient was not experiencing any case of sepsis; however, after more tests in an emergency room, the patient was diagnosed with sepsis, necrosis, and peritonitis. The manager questioned the physician for ordering the wrong tests, including KUB diagnostic test and EKG test, yet he was aware of the patient’s past experiences with sepsis.

Additionally, the manager questioned the physician for conducting the wrong catheter placement when treating the patient. Therefore, the patient’s physical and mental issues declined after conducting appropriate tests and arm surgery. After completing his task, management instructed the physician to join an educational meeting to understand the need to conduct the right medical tests, consider the patient’s medical past, and reassess the ICU policies. Additionally, the physician was instructed to gather more information while the risk management investigation addressed the problem.

Quality Model

            In this scenario, the health facility can introduce different quality models to address the issue and improve quality care. However, through different studies, the Competency Outcomes and Performance Assessment model best suits this case, and the management should consider employing it. In detail, the model’s framework focuses on several competencies, including competency performance assessments and practice-driven competency (Lockyer et al., 2017). Additionally, the model enables nurses to improve their workplace performance by portraying clinical behaviors offering proof of competence. The physician and management could have used multiple skills from this model.

Recommendable Actions

The management, physician, and other healthcare providers can introduce multiple steps to prevent this medical mistake from occurring in the future. For instance, the management instructed the physician to learn more about the KUB diagnostic test and EKG test and understand when to apply another test such as an abdominal CT scan. Therefore, healthcare facilities should provide other nurses with the correct protocols about any health issue. Healthcare facilities should ensure the appropriate installation of systems for monitoring the use of the right equipment. Moreover, healthcare facilities should ensure that physicians and other healthcare providers practice quality controls within the emergency rooms. Furthermore, nurses should ensure proper utilization of the input from the medical personnel.


Lockyer, J., Carpaccio, C., Chan, M. K., Hart, D., Smee, S., Touchie, C., … & ICBME Collaborators. (2017). Core principles of assessment in competency-based medical education. Medical teacher39(6), 609-616.

Nuttall, G., Burckhardt, J., Hadley, A., Kane, S., Kor, D., Marienau, M. S., … & Oliver, W. C. (2016). Surgical and patient risk factors for severe arterial line complications in adults. Anesthesiology124(3), 590-597.

Miller, R. (2017). Sepsis Misdiagnosis Wrongful Death Cases in Maryland. Retrieved from https://www.marylandinjurylawyerblog.com/sepsis-misdiagnosis.html