Q: What can I do as an RT to enhance patient safety?

Q: What can I do as an RT to enhance patient safety?

A: Healthcare is more complex and diverse than ever before. We intuitively know that all healthcare professionals need to do their part, as we all play integral roles in providing both quality care and enhancing patient safety.  As Respiratory Therapists, we have specialized knowledge, skills, and expertise.  We critically think, we make evidence-informed decisions, prioritize care, and use our best judgement to carry out our diverse scope of practice in our various roles and with the responsibilities that come with each task or job.  We are responsive, adaptive, and trained to maintain composure in crisis situations.  We do this work utilizing our excellent interpersonal and clinical skills, because we don’t often work alone, but collaboratively within larger, interdisciplinary healthcare teams (Hamp, 2014; Barnes et al., 2010).

We can offer a unique perspective, as RTs often follow the patient throughout the healthcare system; this affords us an opportunity to identify when there are gaps in care or the system (Hamp, 2014).  Just think of the number of times you’ve come across an error with what we consider a simple task, such as an oxygen therapy set-up.  While this example is a bit dated in today’s Canadian healthcare context (large volume nebulizer?!?), it was a reported oxygen error not that long ago!

It is important to think about how we deal with relatively routine errors such as in this example.  In this case, the RT was paged as the patient’s “oxygenation remained poor despite O2 therapy”, and thankfully the error was quickly spotted, corrected, timely education was provided to nursing staff, and an unusual occurrence report was filled out and submitted.  What would you do in this scenario? It is important for each of us to reflect on this question, and some others below:

If you are unsure of something, do you speak up and seek clarification or support before proceeding?

  • Do you readily identify patient or staff safety risks to management?
  • Do you advocate for your patients’ best interests through voicing your opinion, perspective or insights gained?
  • Do you actively seek improvement opportunities to “raise the bar” of your practice?
  • Do you provide timely, responsive education, AND report errors or near misses when you come across them?
  • Do you strategize and test effective ways to support sustainable practice changes?

As RTs, we are experts in our field.  We have a phenomenal set of skills, from oxygen and airway expertise to lung protective ventilation.  We also have amazing problem-solving or “MacGyvering” skills. All of this greatness makes us ideal leaders in patient safety initiatives, but we also need to be communicative and collaborative on this front, too!

We know that hand hygiene saves lives, but in our busy, high tech world, we have also learned that distractions (phones, pagers, alarms, etc.) and interruptions are threats to performance and ultimately to patient safety, as they divert attention from the task at hand (Beyea, 2014). Alarm fatigue is an unfortunate reality in hospitals.

It is through bringing full attention to the present moment, making mindful observations, being vigilant in assessing, monitoring and responding, that we can do our very best work.  We also know we need to adhere to policy, follow quality and safety standards, support care bundles and best-practice guidelines while on the job.

RTs can and do make a difference…we can and do reduce preventable harm and improve patient care outcomes! 

“Quality improvement does not happen on its own, it can only happen with the help of practicing health practitioners to identify the need for and types of improvements.” (Quach, 2017).

Let’s all do our part!

References

Barnes, T. A., Gale, D. D., Kacmarek, R. M., & Kageler, W. V. (2010).
Competencies needed by graduate respiratory therapists in 2015 and beyond. Respiratory Care, 55(5), 601-616.
Retrieved from http://rc.rcjournal.com/content/55/5/601

Beyea, S.  (2014).
Interruptions and distractions in health care: Improved safety with mindfulness.  Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services.
Retrieved from https://psnet.ahrq.gov/perspectives/perspective/152/interruptions-and-distractions-in-health-care-improved-safety-with-mindfulness

Hamp, C. [2014, June 10].
The RT role in enhancing patient safety.  College of Respiratory Therapists of Ontario [blog post].
Retrieved from http://www.crto.on.ca/members-blog/rt-role-enhancing-patient-safety/

Quach, S. (2017).
Quality Improvement:  Relevance to Respiratory Therapy Practice.  RTSO Airwaves [Winter 2017], pp. 10-12.
Retrieved from https://www.rtso.ca/winter-airwaves-2017/

Institute for Healthcare Improvement. (n.d.).  Successful measurement for improvement.
Retrieved from http://www.ihi.org/resources/Pages/ImprovementStories/SuccessfulMeasurementForImprovement.aspx

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