KONSEP PATIENT SAFETY

DALAM KEPERAWATAN

Dr. ADIB A YAHYA, MARS

WORKSHOP KESELAMATAN PASIEN DAN MANAJEMEN RISIKO KLINIS

DI RUMAH SAKIT
 Florence Nightingale

The first to measure nursing outcomes

– Wherever nurses were,
far fewer patients died.
– Wherever nurses were not,
far more patients died.
 Patient-Focused Outcome
Indicators

• Pressure Ulcers
• Patient Falls
• Nosocomial Infection Rate
• Medication Error
• Patient/Family Satisfaction with Nursing Care
• Patient Satisfaction with Overall Care
The Vision for Nursing in the 21st Century

“Make a Difference”

All nurses to seek out evidence and apply it

in their everyday practice

“Doing the Right things Right”

 Vigilance :
The Essence of Nursing

Vigilance has been defined as

"a state of watchful attention, of

maximal physiological and
psychological readiness to act and of
having the ability to detect and react to
danger"
Professional nursing vigilance may be defined as
a state of scientifically, intellectually, and
experientially grounded:

Attention to and identification of clinically

significant observations/signals/cues;
Calculation of risk inherent in nursing practice
situations; and
Readiness to act appropriately and efficiently to
minimize risks and to respond to threats.
Anticipating "what might be." While
assigning meaning to "what is" actually
happening with a patient is an essential
facet of nursing practice, the ability to
anticipate and observe for "what might
happen" is another critical component of
professional vigilance.
 Nightingale (1860/1969) recognized the
importance of vigilance in nursing

In Notes on Nursing, she wrote:

The most important practical lesson that

can be given to nurses is to teach them

- what to observe, ”how to observe”

- what symptoms indicate improvement,
”what the reverse”
- which are of importance, ”which are of
none”
-which are evidence of neglect, ”and of
what kind of neglect”.

-All this is what ought to make part, and an essential part, of the
training of every nurse
 Nursing Role
In Patient Safety
 Nursing Role In Patient Safety:

54 percent of all healthcare providers

Surveillance and “rescue” of patient
status
Coordination and integration of care
Therapeutics, support, and education
Intercepting errors
Commission of errors
NURSES ARE INVOLVED IN EVERY AREA OF
THE HEALTH CARE SYSTEM
(24 HOURS A DAY) CRITICAL ROLE IN
PATIENT SAFETY :

Through their vigilance, nurses act :

TO KEEP PATIENTS SAFE

IDENTIFY AREA OF RISK
RECOGNIZE SITUATIONS IN NEED OF
IMPROVEMENT
Why are nurses concerned about patient safety?

For nurses, patient safety is not just part of what they do;
nurses are committed through their code of ethics to
provide “safe, competent and ethical care”

Patient safety is fundamental to nursing care and is of

concern wherever nurses work – in the community,
acute care hospitals or long-term care facilities.

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 Challenges to safe nursing care

Nursing practice environment and

workforce issues
Teamwork and communication
Nursing perspective on patient safety
Patient perspective on patient safety
Technology
Culture of blame.

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 The Institute of Medicine report cautions that no single action will
keep patients safe; rather,“bundles” of patient safeguards are
needed in the work environments of nurses.
These include:
- governing boards that focus on safety;
- leadership and evidence-based management
structures and processes;
- effective nursing leadership;
- adequate staffing;
- organizational support for ongoing learning and
decision support;
- mechanisms that promote interdisciplinary collaboration;
- work design that promotes safety; and
- organizational culture that continuously strengthens patient
safety
(IOM, 2003).

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PERAWAT DOKTER

KOLABORASI

PRAKTIK
PRAKTIK
KEPERAWATAN
KEDOKTERAN

AREA KELABU  PADAT RISIKO/ ERROR

( PELIMPAHAN SECARA TERTULIS / STANDING ORDER dan
SESUAI KOMPETENSI)
PERAN LEADERSHIP
The guiding principles for nurse executive
in leading safety initiatives.

Lead Cultural Change

Provide Shared Leadership

Build External Partnerships

Develop Leadership Competencies

LEAD CULTURAL CHANGE
 LEAD CULTURAL CHANGE

Transforming culture change from that

of a silent, hierarchical structure of
blame to an open, team-oriented
culture
will improve patient safety.
PROVIDE SHARED LEADERSHIP
 PROVIDE SHARED LEADERSHIP

Shared leadership is when members

of a group accept responsibility for
the work and life of the group.
The group functions more effectively
when there is shared responsibility,
rather than a hierarchical leadership
model.
BUILD EXTERNAL PARTNERSHIPS
 BUILD EXTERNAL PARTNERSHIPS

External partnerships are essential

for driving patient safety agendas.
The nurse executives and the
external partners stand to gain great
benefits through collaboration.
 DEVELOP
LEADERSHIP COMPETENCIES
 DEVELOP LEADERSHIP COMPETENCIES

Leadership competencies around

patient safety are intended to identify
and establish skills common to nurses
in executive practice.
 NURSES LEADERSHIP
Staff nurses at the bedside 24 hours a day,
seven days a week are on the front lines and
have a distinct power to influence
sustainable outcomes and productivity.

They are, in fact, at the first level of decision-

making.

By permitting some autonomy in their decision-

making however slight, we lay the foundation of
leadership.
Transformational leadership promotes
change and suites the extremely
dynamic health care system.

Its focus on change

can be directly applicable to nursing.
TERIMAKASIH 32