Question

Improving performance to ensure safe and effective patient centered care outcomes often requires a change in nursing practice at the bedside. Give two examples of how you can use performance improvement and patient safety concepts to promote evidence-based patient centered care at the bedside. Include how you will you use change management to engage the staff into your performance improvement projects.

Answer 1

Improving Performance in nursing practice and providing competent care to the patient is important. In order to provide evidenced base care to the patient it is important to assess the performance of the nursing staff. Performance appraisal can be used the quality of care that is rendered to the patient.

Performance appraisal is a systemic evaluation of an individual with respect to performance on the job and individuals potential for development.The performance is measured against such factors as job knowledge, quality and quantity of output,initiative,leadership abilities, supervision, dependability, cooperation,judgement, and health.

Performance improvement includes

• setting goals
• implementing systemic changes
• measuring outcome
• making appropriate improvements.

Performance improvement plan can be used as a tool to give an employee with performance deficiencies the opportunity to succeed.

Two examples :

1. Nurses to be assessed if they are using hand washing technique before taking care of each patient so as to prevent cross infection among patients as well as to self.Performance of the staff should be assessed.If not practiced then teaching the importance of hand washing technique which is a evidence based practice to be followed.
2. Nurses performing OT procedures, should strictly follow aseptic technique to bring down any complications further like infection and to provide safety to the patient.So it can be assessed and the importance of it can be taught to the nursing staff.

Change management is the process and technique used to manage the nurses way of functioning into qualitative and productive way for the benefit of the patient.

The ways of implementing change can be  

1. Identify the need to change: So discussing with them the importance of qualitative care.
2. Preparing the team for change : Communicating with every staff nurse the vision of rendering evidenced based care is important to ensure cooperation from them.
3. Implementation: In this phase enabling them to implement the changes in performance of care is important.And look out for the outcome.