Lack of standards in healthcareRegister Today!
This is a discussion on Lack of standards in healthcare in Nursing Issues On Patient Safety, part of General Nursing ... It seems like standards for safety are different depending on the nurse, unit, or if you are a...by esunada Mar 3, '12It seems like standards for safety are different depending on the nurse, unit, or if you are a different healthcare professional. I see nurses use alcohol wipes before giving a flush or an IV push, doctors I've seen just stick it in there without wiping. Some push air out of the saline flush before flushing, others don't because of how small the air bubble is. Some lpns can do more at certain hospitals or units, others can't. Some say a half hour from time to give meds some say up to an hour is okay to give meds. Its just gets confusing and everyone thinks their way is right because thats how they learned it. But if its a matter of safety shouldn't there just be one right way and everyone should be on board? How do you know what is right or wrong if you have one preceptor who you learn from or one professor who hasn't worked as a nurse in several years. Bah.
Print and share with friends and family.
Compliments of allnurses.com.
http://allnurses.com/showthread.php?t=681720©2013 allnurses.com INC. All Rights Reserved.
- 1,335 Views
- Mar 3, '12 by AltraI disagree that this is a lack of standards. I would be inclined to call it flexibility of standards to accomodate human beings, who are largely "nonstandardized".
- Mar 3, '12 by KelRN215I also disagree that this is a lack of standards and very rarely (not just in healthcare, but in life) is there only one correct way to do something. Heck, some complicated surgical procedures have more than one "right" way to do it.
Personally, I think it's a good thing to learn from multiple different people and see how they do things... then you can decide what habits you want to adopt from whom. Flexibility is a very important quality to have in Nursing- if you have 2 patients getting bolus feeds via G-tube, you may have one patient who tolerated the entire thing via gravity through syringe and another who needs it run on a pump over 2 hours. Both ways are perfectly safe and result in the patient receiving their ordered nutrition- why would one way be "right" and the other "wrong"?
- Mar 3, '12 by NicuGalThere are certain standards that have to be done per protocol, or your butt will be in a sling. Sometimes there are more than one way to do a procedure, both being right, such as how long to run feed or how to tape an IV. But, again,look at the hospital policy and procedure and follow that. Can't go wrong there.
- Mar 3, '12 by dream_nurseNice example!!
- Mar 3, '12 by GitanoRNunquestionably, this is clearly a situation of " do as i say, not as i do" therefore, follow the instructions by the book and no one will dispute that. wishing you the best in all of your future endeavors...aloha~
- Mar 4, '12 by romieWow this is potentially a loaded topic, which I think can benefit from a little clarification of the basic issues. I think the intent of the original poster was to point out the following:
There is an inconsistency among nurses when following certain care practices and standards.
There is an inconsistency across health disciplines when following certain care practices and standards.
Is there a one way to implement a specific practice or standard.
Some people, regarldess of their role think only their way is the correct way.
Some people may be out of touch with the latest best practices.
How can I keep from being confused?
As a professional nurse you have to ask yourself when it comes to standards of care, "am I utilizing the best evidenced based practices?" We do the things we do because there is scientific evidence that shows that it is the most effacacious and appropriate thing to do. The original poster pointed out that standards change; Good evidence based practices will always change because there is always new evidence. Years ago we used to flush peripheral lines with heparin (hence the old term "hep-lock" Now the evidence shows that simply flushing the PIV with NS before and after access and a minimum of every 4-12 hours depending on the site, the patency of the vein lumen and numerous other factors.
Some people may have different standards of professional expectations for themselves when it comes to keeping up with the best evidence based practices. Or they may be lazy and take short-cuts (potentially bad for patients and not a good habit--I understand emergecies arise, but as a general rule... this is just and example)
Some disciplines have different degrees of knowledge when it comes to evidenced-based practices or they may have different skill sets and are rusty in other areas. For example, a lot of MDs are used to working with catheters (and I'm refering to anytime of catheter, like an IV or any tube that goes into the body) that are sterile and not used to working with access devices outside of a sterile field. For example, a cardiologist who does 20 cardiac catheterizations a day may not be the best person to access a peripheral port at the bedside because she is used to working with a sterile field and forgets to scrub the hub.
Is there one way to implement a specific practice or standard? That is where your professional nursing judgement comes in. No the is no one right way. However, there are a lot of wrong ways. The latest evidenced states that patient response to certain IV antibiotics are actually better if the IV is infused over a longer period. But the order states infuse over 1 hour. It takes about 5 years for the research and evidence to actually make its way into the clinical setting.
Those who are rusty and out of touch with the latest practices need to brush up on their knowledge. Being a professor of nursing and being away from the bedside for years is no excuse to do things the wrong way. It's a professional's responsibility to ensure that their own knowledge and skills are current. This also applies to when you are doing an procedure you haven't done in a long time. I haven't done an NG tube in a few months so I will be sure to review the best way to put in an NG tube or grab one of my newer nurses who has been doing NG tubes to remind me of the landmarks or I will go look it up and find the latest best evidence.
How do you keep from being confused? Always remind yourself "am I utilizing the best evidenced based practices?" Always keep an open mind because if you see something being done that isn't harmful but just different, that person may have something to teach you. Always keep in mind patient safety. If you see something potentially harmful, like not using basic aseptic techniques, not assessing placement of dubbhoff before using, or anything that sends a red flag, speak up, but be professional about it.
I'm sorry for the long winded response. I have to learn how to be more concise. Everyone has great comments here.
- Mar 4, '12 by Esme12Hospitals May Be the Worst Place to Stay When You're Sick
www.aarp.orgAmericans are dying in hospitals from preventable medical mistakes. But, patients can minimize their risks by keeping a close eye on their care.
- Mar 4, '12 by GitanoRNQuote from esme12esme12, great link and video as a matter of fact you should start a new post regarding the above title. unquestionably, this is the reason why we nurses make the worse patients, because we are aware of what's coming next if you will. than you for sharing it with us...wishing you a great weekend as i send you hugs from across the miles...aloha~hospitals may be the worst place to stay when you're sick
www.aarp.orgamericans are dying in hospitals from preventable medical mistakes. but, patients can minimize their risks by keeping a close eye on their care.