Competency Statement: The nursing student demonstrates the ability to anticipate and respond to human and systems factors that have the potential to jeopardise patient safety, and take appropriate actions to prevent reoccurrence of errors and near misses.
Knowledge
The nursing student:
- Defines the terms error, adverse event, near miss and violation
- Describes human and system factors that lead to potential high risk clinical situations and errors in healthcare
- Discusses professional factors (e.g staffing levels, skill mix, training opportunities, workload, leadership styles etc) that impact on patient safety
- Discusses environmental factors (e.g. lighting, noise, clutter etc) that impact on patient safety
- Discusses personal factors (e.g fatigue, stress, substance use) that impact on patient safety
- Discusses factors that contribute to a culture of workplace safety (e.g. open communication, teamwork, and error reporting systems)
- Identifies how vulnerable individuals and groups are at increased risk of adverse outcomes and discusses preventive strategies
- Analyses the benefits and limitations of technologies designed to reduce risk (e.g. barcodes, infusion pumps)
- Describes the importance and process of continuous quality improvement as a strategy to improve patient safety
- Describes the process for reporting errors and near misses
- Describes the process and purpose of open disclosure
- Describes how healthcare professionals can learn from errors and near misses
- Discusses strategies to minimise the risk of injury to self and others (e.g. safe patient moving and use of PPE)
- Discusses strategies for self-care and to enhance resilience and coping skills
- Acknowledges, takes responsibility, reflects on and learns from own mistakes
Skills
The nursing student:
- Uses appropriate patient identifiers and seeks consent prior to initiating care
- Practices within legal and ethical frameworks, relevant guidelines, policies and evidence-based resources
- Conducts regular and appropriate risk assessments (e.g. falls, pressure area, cognitive and nutrition etc.)
- Recognises particular risks associated with vulnerable individuals and groups and initiates actions to prevent adverse outcomes
- Implements appropriate nursing actions to address identified risks to patient safety or wellbeing
- Encourages patients and family members to speak up if they identify factors that may compromise safety
- Responds appropriately to people’s concerns and complaints with reference to organisational protocols and within own scope of practice
- Notices, anticipates and addresses human and system factors that may lead to errors
- Uses strategies to reduce reliance on memory such as checklists, cue cards, algorithms and mnemonics
- Uses technologies designed to improve patient safety accurately and effectively
- Contributes to the prevention and management of agitation, aggression and violence in the workplace
- Reports concerns related to hazards, errors and near misses in a timely manner using organisational reporting systems
- Seeks to understand the cause of an error or near miss rather than attributing blame
- Maintains own capability to practice and takes responsibility for personal factors (mental, physical or emotional) that have the potential to negatively impact patient safety
- Raises concerns about other healthcare professionals’ capability to practice and factors that have the potential to negatively impact patient safety (e.g fatigue, stress, substance use) confidentially and using appropriate channels
- Acknowledges, takes responsibility, reflects on and learns from own mistakes
Preventing and minimising adverse events refers to the ability to anticipate and effectively manage human and systems factors that have the potential to impact patient safety. Responding appropriately to adverse events encompasses the ability to recognise and manage patient deterioration, to participate in analysis of the events in order to identify system failures and appropriate solutions, and to provide honest and timely communication about the facts of the adverse event.