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International Council of Nursing indicates that the shortages of pediatric nurses are associated with issues related to work environment (Aiken et al., 2014). There will be increased number of nursing professionals if the environment under which nurses work is improved. The involvement of the current professionals in the development of innovative care delivery models will have a positive impact on the future of the profession. Apart from improving the supply of health workforce and motivating them, creating a safe health care environment also helps the pediatric nurses to attend to their patients efficiently and effectively (Dubowitz et al., 2011). Patients will benefit from a safe environment by accessing high-quality care that improves their health.
Culture of Safety
Safety culture occurs as a result of values, attitudes, behavior patterns and competencies of an individual pediatric nurse or shared by a group of such nurses, determining their commitment to safety and health programs of the institutions. Safety culture also influences the style and proficiency of the programs. To foster a positive safety culture, pediatric nurses are expected to have mutual trustworthy communication, shared positive perceptions regarding the benefits of safety, and confidence in the efficiency of preventive measures (Sammer, Lykens, Singh, Mains, & Lackan, 2010). Pediatric nursing should adopt a continuous model of improvement of safety culture by continuously identifying weaknesses and strengths, implementing interventions, and evaluating them. The measurable elements of safety culture are referred to as safety climate. In pediatric nursing, safety culture is usually measured using quantitative questionnaires which are based on various elements such as ethical principles, accountability, responsibilities, teamwork, evidence-based practices, and patient-centered culture (Kieft, de Brouwer, Francke, & Delnoij, 2014)
Principles, Accountability, and Responsibilities
Pediatric nurses have a major role to play as far as safety and high-quality healthcare environment is concerned. Every country has specific laws, which every nurse is held accountable and responsible for to offer safe, effective care to patients. The personnel are also accountable and responsible for the judgment that they make and the actions they take while providing their services. Only the nurses with the appropriate nursing licenses, educational preparation, and recent clinical competencies are legally allowed to offer pediatric nursing services since they are the only ones who can offer such services competently and safely. If a pediatric nurse feels that he or she is not proficient enough to offer particular services, he or she should not perform the act and instead tell his or her supervisor that he or she is unable to render the service. All the nursing activities done by a pediatric nurse who is not qualified, licensed, or competent to perform are referred to as unsafe practices since they can have a negative effect on a patients health. If a pediatric nurse performs an unsafe practice, he or she also accepts the liability that may arise as a result of offering the service (Battié & Steelman, 2014).
There are various ethical principles that govern pediatric nurses. One of these principles is nonmaleficence, which requires the professionals to remain competent in their work so as to prevent injuries and suffering to patients under their care. Nonmaleficence is the heart of the ethics that all nurses are required to uphold, and they are supposed to take an oath on its regard. This ethical principle needs nurses to report all cases of abuse that they suspect to be taking place (Phang, 2014). The second ethical principle is beneficence, which requires pediatric nurses to be always good while offering their services and be the advocates of the patients that they look after. They should be compassionate and act positively to assist their patients in getting the best treatment for the achievement of optimal results.
Justice is another ethical principle, which governs pediatric nurses. The principle needs these nurses to treat all their clients fairly and in equal measures. These health care professionals should decide the amount of time that they spend with every patient, depending on each clients needs and distribute the resources equitably amongst them. Furthermore, fidelity is also another ethical principle in pediatric nursing. It encourages nurses to be dedicated, loyal, truthful, and fair to patients as well as being their advocates. Lastly, a pediatric nurse should observe totality and integrity while offering his or her professional services by taking into account all the needs of a patient when determining the kind of therapy treatments, procedures, and medications that the client ought to receive (Phang, 2014). These principles are geared towards offering a safe environment to patients.
Communication and Teamwork
Pediatric nurses handle patients suffering from diseases which require complex treatment processes and technologies. Therefore, they should work as a team and collaborate with each other for the achievement of a wide system of an enhanced culture of safety and quality care of the patients. These professionals should also work hand-in-hand with other non-nursing health experts. Shared working affiliations are created through the engaged experts cooperating and working in a harmonized way while demonstrating mutual reverence anchored in their knowledge and proficiency. Timely solutions to health problems are achieved on time when these health professionals exchange ideas and thoughts. However, uniformity in care or treatment is achieved when the communication amongst the experts is uniform and aligned with that of one another. For instance, structured communication such as read backs helps in conveying clear and accurate verbal communication amongst team members in a health care setting. On the other hand, hand-off communication is used in health care institutions to convey data consistently amid the different departments. Besides, effective communication between front line staff and managers is essential in creating a culture of safety since it provides important feedback, which assists in building trust and openness between the two parties (Kieft et al., 2014).
Evidence-Based Practices and Patient-Centered Culture
A culture of safety is usually evident in health care institutions that have adopted evidence-based best practices such as standardized processes, procedures, protocols, and checklists. Nurses and administrators in health care organizations should apply these practices by using the current best evidence while deciding on the best patient care. Evidence-based practices help the nursing personnel to evaluate research, clinical guidelines, as well as other sources of information which are as a result of high quality findings. The health care nurses then apply the results of these sources to their practice for the facilitation of the quality of care (Aiken et al., 2014). On the other hand, patient-based culture sees patients and their families as the only reasons as to why a pediatric nursing in a particular health care institution exists. The major objective of a health care organization that embraces this culture is to offer ultimate pediatric nursing services to patients by providing them with a healing environment when they are hospitalized and promoting their wellbeing.
Analysis and Measurement of Safety and Quality of Pediatric Healthcare Environment
The management of pediatric units uses various assessment tools to evaluate the work environment of nurses effectively for the maintenance and improvement of the environmental health. Some of those tools include Revised Nursing Work Index (NWI), Practice Environment Scale of the NWI, and Perceived Nursing Work Environment (PNWE) Instrument (Gu & Zhang, 2014). The nurse leaders also ought to use continuous quality improvement (CQI) to evaluate and assist in the improvement of the services offered by nurses. Through CQI process, a pediatric team of nurses and management will be able to regularly come together, evaluate their performance, and identify the areas that need improvement (Edwards, 2008). When proper measures are put in place, the nurses and patients enjoy a safe and high-quality healthcare environment with safety programs which are supported by the senior management and free from obstacles that hinder safe work practices. This ensures that the environment always has the personal protective equipment, minimal conflicts, clean work site, effective communication, and feedbacks that are related to safety. Being in a safe environment will help pediatrician nurses and their patients to avoid having or being exposed to injuries.
Conclusion
The management and all nurses in pediatric healthcare units should work together to ensure that they operate in a safe environment for their benefits and also to offer ultimate care to their patients. A safe and high-quality healthcare setting can only be achieved if all the stakeholders in the service delivery appreciate and adopt practices that are based on the culture of safety and quality care.
References
Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., Griffiths, P., Busse, R., & McHugh, M. D. (2014). Nurse staffing and education and hospital mortality in nine European countries: A retrospective observational study. The Lancet, 383(9931), 1824-1830.
Battié, R., & Steelman, V. M. (2014). Accountability in nursing practice: Why it is important for patient safety. Association of Operating Room Nurses Journal, 100(5), 537.
Dubowitz, H., Lane, W. G., Semiatin, J. N., Magder, L. S., Venepally, M., & Jans, M. (2011). The safe environment for every kid model: Impact on pediatric primary care professionals. Pediatrics, 127(4), 962-970.
Gu, L. Y., & Zhang, L. J. (2014). Assessment tools of nursing work environment in magnet hospitals: A review. International Journal of Nursing Sciences, 1(4), 437440.
Kieft, R. A., de Brouwer, B. B., Francke, A. L., & Delnoij, D. M. (2014). How nurses and their work environment affect patient experiences of the quality of care: A qualitative study. BMC health services research, 14(1), 249.
Phang, K. (2014). 6 Key Ethical Principles of Nursing. Nursing Community Journal. Web.
Sammer, C. E., Lykens, K., Singh, K. P., Mains, D. A., & Lackan, N. A. (2010). What is patient safety culture? A review of the literature. Journal of Nursing Scholarship, 42(2), 156-165.
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