World Patient Safety Day - September 17, 2024 The Crucial Role of Nurses in Ensuring Patient Safety
Nurses are the backbone of the healthcare system, playing a pivotal role in ensuring patient safety. They are often the primary caregivers, spending the most time with patients and possessing a deep understanding of their individual needs and vulnerabilities. Their vigilance, knowledge, and clinical expertise contribute significantly to preventing medical errors, ensuring proper patient care, and maintaining safety protocols.
Nurses' role in patient safety is multifaceted. They are responsible for accurate medication administration, which is a critical aspect of preventing medication errors. According to the Canadian Patient Safety Institute estimated 165,000 Canadians annually experience medication administration errors. Nurses also play a crucial role in preventing falls which is a leading cause of injury and mortality in hospitals, particularly among the elderly. Studies conducted by the Registered Nurses' Association of Ontario have shown that falls can be reduced by up to 50% through targeted nursing interventions like fall risk assessment and implementation of preventive measures.
Furthermore, nurses are at the forefront of infection control, a vital component of patient safety. Their meticulous adherence to hand hygiene protocols and other infection control practices has been shown to reduce hospital-acquired infections by up to 30% (World Health Organization).
Additionally, nurses advocate for their patients, ensuring their voices are heard and their needs are met, thereby minimizing the risk of miscommunication and medical errors.
Nurses' role is Vital in preventing these safety issues through medication administration, fall prevention, infection prevention and control, and patient advocacy.
The impact of nurses on patient safety cannot be overstated. Their unwavering dedication, clinical expertise, and commitment to patient well-being are essential in creating a safe healthcare environment. As we strive to improve patient safety, investing in nursing education, resources, and support systems is crucial to ensure that nurses have the tools they need to provide high-quality, safe care.
In an exclusive interview, both Allen and Ngozi shared their experiences, challenges, and the transformative impact of the INLAP program on their approach to patient safety. Their responses offer a compelling glimpse into the journey of internationally educated nurses (IENs) adapting to and excelling in the Canadian healthcare landscape.
In the bustling corridors of Bruyère – St. Vincent Hospital, Allen Rose Tejido embodies the spirit of global healthcare collaboration. A Registered Nurse with over nine years of experience, Allen's journey from the Philippines to Canada is a testament to the power of international nursing programs in shaping patient safety practices worldwide.
Allen currently serves in the 3 North unit, a specialized short-term complex care facility dedicated to low-intensity rehabilitation for adults with multiple chronic and complex conditions. Her role demands a delicate balance of skills: providing bedside nursing care for patients with progressive diseases, collaborating with an interprofessional team, and facilitating patients' transition back to the community through wound healing and functional improvement.
But Allen's story is more than just her current position. It's a narrative of cultural adaptation, continuous learning, and the pursuit of excellence in patient care. Through the International Nurses Licensure Assistance Pathway (INLAP) program, Allen has not only bridged the gap between her experience in the Philippines and Canadian healthcare standards but has also gained invaluable insights into patient safety protocols unique to the Canadian system.
PCPI: In your experience as a nurse in your home country, what were the most critical aspects of ensuring patient safety?
Allen: As a nurse from the Philippines, ensuring patient safety encompasses several critical aspects. Patient-centered care involves respecting and accommodating patients' preferences, values, and religious beliefs. Acting as a patient advocate, it is vital to provide accurate reporting of patient conditions and treatment plans, while also conducting regular monitoring of vital signs and responses to treatments. Consistently documenting patient information accurately and promptly is essential for maintaining continuity of care. Additionally, implementing rigorous safety checks and double-checks plays a crucial role in creating a safer and more effective healthcare environment.
PCPI: Can you share a specific instance where you implemented or observed an innovative practice that significantly improved patient safety?
Allen: One innovative practice I observed aimed at improving patient safety through better staff ratios involved optimizing the nurse-to-patient ratio during the pandemic. I was actively involved in a program that implemented a flexible staffing schedule to address the challenges of fluctuating patient loads. During peak times, additional nurses were scheduled, including extra buffer staff to handle the increased workload. Conversely, during quieter periods, such as overnight shifts, staffing levels were reduced. This approach effectively addressed immediate concerns related to workload and patient safety for a short period of time, ensuring that care was consistently high-quality and responsive to patient needs
PCPI: How has the INLAP program enhanced your understanding of patient safety protocols in the Canadian healthcare system?
Allen: INLAP program has profoundly enhanced my understanding of patient safety protocols within the Canadian healthcare system. It provided a thorough overview of the specific standards and practices crucial for ensuring patient safety in Canada. Through the program, I gained detailed insights into national guidelines and standards for patient care, as well as a deep understanding of the regulatory bodies and legal aspects that govern patient care. Additionally, the program offered in-depth discussions on navigating the diverse cultures in Canada and emphasized the importance of maximizing interdisciplinary collaboration to deliver comprehensive, safe care.
PCPI: What key differences have you noticed between patient safety practices in your home country and what you've learned about Canadian standards?
Allen: The nurse-to-patient ratio is the most significant difference I've observed in terms of patient safety. In the Philippines, a single nurse typically manages 15 to 20 patients throughout an entire shift, which poses challenges for ensuring optimal care. In contrast, my experience at Bruyère in Canada reveals a much lower ratio: 4 patients per nurse during the AM shift, 6 during the PM shift, and 10 during the overnight shift. This lower ratio in Canada greatly enhances the ability to provide individualized and effective patient care, significantly contributing to improved patient safety.
PCPI: Based on your INLAP training, what do you consider to be the most important role of nurses in preventing medical errors?
Allen: The in-depth discussion on the "10 Rights of Medication Administration" provided valuable insights into the critical aspects of safe medication practices. Additionally, the program highlighted various systems employed in Canada to prevent medication errors. These systems include advanced technology, such as barcode scanning and electronic health records, as well as rigorous protocols and checks designed to enhance accuracy and ensure patient safety throughout the medication administration process.
PCPI: Can you describe a challenging situation related to patient safety that you encountered in your previous work, and how you addressed it?
Allen: Dealing with demanding family members has been one of the most challenging situations I have encountered, as it can sometimes pose risks to patient safety. Prioritizing patient autonomy is crucial, unless the patient is no longer capable of making sound decisions. Addressing family concerns with empathy and employing therapeutic communication techniques have proven to be effective strategies. By maintaining a compassionate approach and ensuring transparent, respectful dialogue, I have been able to navigate these challenging interactions while safeguarding the patient's well-being and upholding their rights.
PCPI: How has the INLAP program prepared you to better communicate with patients and their families about safety concerns?
Allen: During the soft skills workshop with Miss Donna Paty, the focus was on self-reflection and various therapeutic communication techniques. The activities helped me identify my strengths and weaknesses in addressing safety concerns with patients and their families. This increased awareness has been invaluable in improving my ability to communicate effectively and empathetically in challenging situations.
PCPI: What aspect of patient safety do you feel is most crucial for patients and their families to be aware of when interacting with the healthcare system?
Allen: The most crucial aspect of patient safety is effective communication through health teaching. Patients and their families must be thoroughly informed about procedures, expected outcomes, and any aspects of care during hospitalization. This clear communication helps to ensure they understand what to expect, how to engage in their care, and how to recognize and report any concerns, thereby significantly enhancing patient safety
PCPI: In your opinion, how can internationally educated nurses contribute to improving patient safety in the Canadian healthcare system?
Allen: Internationally Educated Nurses (IENs) must equip themselves with knowledge and skills tailored to the Canadian healthcare system. From my experience, I can attest that there is a significant difference in protocols, nursing procedures, and especially legal aspects compared to other systems. Understanding these differences is essential for delivering safe, effective care and ensuring compliance with Canadian healthcare standards
PCPI: Could you share a specific skill or knowledge area related to patient safety that you have gained through the INLAP program and how you plan to apply it in your future nursing practice in Canada?
Allen: Familiarizing myself with the legal aspects and ethical values, such as obtaining informed consent and understanding the role of substitute decision-makers, has significantly broadened my knowledge in promoting patient safety. I learned that in Canada, the power of attorney (POA) for healthcare decisions may not always be the spouse, which contrasts with practices in my home country where the legal spouse is automatically considered the decision-maker. Additionally, understanding the different scopes of practice between Registered Practical Nurses (RPNs) and Registered Nurses (RNs) has enhanced my ability to appropriately delegate tasks and collaborate effectively within the healthcare team.
Ngozi Tari Oniyeyone is an accomplished Internationally Trained Nurse and Midwife hailing from Nigeria, with seven years of extensive experience in the medical and surgical units. Her career has been marked by a strong focus on patient care, surgical assistance, and medication administration, showcasing her dedication to providing comprehensive healthcare services. Ngozi's expertise extends to documentation, admission and discharge processes, report writing, and the development of nursing care plans, underscoring her commitment to meticulous patient management.
Throughout her career, Ngozi has been deeply involved in health education for patients and families, ensuring they are well-informed about their health conditions and treatment plans. Her role as a midwife has further enriched her experience, allowing her to blend her nursing skills with specialized midwifery care. This dual expertise positions her uniquely to address a wide range of healthcare needs, making her a valuable asset in any healthcare setting.
Ngozi's journey as an internationally trained nurse reflects her adaptability and commitment to excellence in nursing and midwifery. Her diverse skill set and dedication to patient-centered care exemplify the vital contributions of internationally educated nurses to global healthcare systems.
PCPI: In your experience as a nurse in your home country, what were the most critical aspects of ensuring patient safety?
Ngozi: In my experience as a nurse in my home country the most critical aspect of ensuring patient safety is ensuring that patient care is delivered effectively and without harm this involves the proper identification of a patient, maintaining hygiene and sanitation, ensuring the availability of essential medications, accurate patient documentation, and continuous patient monitoring despite challenges like power outages and inadequate staffing.
PCPI: Can you share a specific instance where you implemented or observed an innovative practice that significantly improved patient safety?
Ngozi: One specific instance was when I was working in the female medical unit, the ward was very busy and we were also short-staffed, keeping the medical records for patients was very difficult because we were still using paper and pen records of taking history and further treatment method, sometimes we lose the continuation sheet of some patients. To address this situation the hospital introduced the computerized method by using the EHR system. The electronic health record system is an electronic method of documenting a patient's medical history maintained by the health care provider. This method provides up-to-date information about patient care, reduces medication errors, is easily accessible and helps continue care. implemented a power backup system using generators to ensure the continuous operation of essential medical equipment during frequent power outages. This significantly improved patient safety and care.
PCPI: How has the INLAP program enhanced your understanding of patient safety protocols in the Canadian healthcare system?
Ngozi: The INLAP program has significantly enhanced my understanding of Canadian patient safety protocols, including standards for medication administration, effective communication with patients and families, culture and beliefs, and the critical role of nurses in preventing medication errors.
PCPI: What key differences have you noticed between patient safety practices in your home country and what you've learned about Canadian standards?
Ngozi: In Canada, there is a higher emphasis on technology and innovation, more stringent patient safety protocols, better staffing ratios, and a stronger focus on continuous professional development and training compared to my home country where we are still battling with our health care system.
PCPI: Based on your INLAP training, what do you consider to be the most important role of nurses in preventing medical errors?
Ngozi: Based on my INLAP training, the most important role of nurses is to ensure accurate medication administration this is done by clarifying the drug, dosage, and frequency, maintaining clear and effective communication with the healthcare team, and engaging in continuous education and training to stay updated on best practices and protocols.
PCPI: Can you describe a challenging situation related to patient safety that you encountered in your previous work, and how you addressed it?
Ngozi: One challenging situation involved managing a critical patient during a power outage. By utilizing a generator for essential equipment and coordinating with staff to ensure continuous monitoring, we were able to maintain patient safety until power was restored.
PCPI: How has the INLAP program prepared you to better communicate with patients and their families about safety concerns?
Ngozi: The INLAP program prepared me to better communicate effectively with patients and their families by teaching me how to effectively discuss safety concerns, provide clear instructions, and ensure that patients and families feel heard and understood.
PCPI: What aspect of patient safety do you feel is most crucial for patients and their families to be aware of when interacting with the healthcare system?
Ngozi: It is crucial for patients and their families to understand the importance of medication adherence, recognizing signs of complications, and the need for open communication with healthcare providers about any concerns or symptoms.
PCPI: In your opinion, how can internationally educated nurses contribute to improving patient safety in the Canadian healthcare system?
Ngozi: Internationally educated nurses bring diverse experiences and perspectives that can contribute to a more comprehensive approach to patient safety, including innovative solutions to common problems and a strong emphasis on adaptability and resourcefulness.
PCPI: Could you share a specific skill or knowledge area related to patient safety that you have gained through the INLAP program and how you plan to apply it in your future nursing practice in Canada?
Ngozi: One specific skill I gained is the ability to conduct thorough medication reconciliations to prevent errors. I plan to apply this skill by meticulously reviewing patient medications during every shift change and ensuring that any discrepancies are promptly addressed.
International Nurses Licensure Assistance Pathway (INLAP)
The International Nurses Licensure Assistance Pathway (INLAP) of PCPI is a comprehensive program designed to facilitate the integration of Internationally Educated Nurses (IENs) into the Canadian healthcare workforce. Funded by the Government of Canada's Foreign Credential Recognition Program, INLAP aims to assist internationally trained nurses in their licensing and registration journey in Canada, ultimately addressing the critical shortage nursing professionals across the country.
INLAP has recently partnered with World Education Services (WES), which will benefit INLAP participants with expedited credential assessment.
To be eligible for INLAP, applicants must be Internationally Educated Nurse (IEN) who have received a positive assessment from the National Nursing Assessment Service (NNAS) or any other credential assessment body acceptable in the province they are intending to apply for registration. Additionally, participants must be a Permanent or Temporary Resident, Canadian citizen or person granted refugee status in Canada, who are legally entitled to work in Canada. The program is open to eligible IENs residing in any province or territory across Canada, making it a truly national initiative.
INLAP's innovative delivery model blends in virtual, in-person, and/or hybrid learning components, catering to the diverse needs and preferences of participants. Each cohort runs for 14 weeks, during which participants engage in a comprehensive curriculum covering licensing exam preparation, Canadian health care system and the role of Nurses, Human skills necessary for work and life in Canada, enhanced language training, cultural orientation, and professional development. The program also offers one-on-one support from experienced mentors and advisors, guiding IENs through the licensing process and job search.
In addition to the instructor led classroom instruction and mentorship, INLAP provides participants with access to a wealth of resources, including online self-paced modules, practice exams, and career counseling services. These tools empower IENs to overcome barriers, build confidence, and successfully navigate the complexities of the Canadian healthcare system.
The INLAP program is an asset for both IENs and the Canadian healthcare sector. By supporting IENs in achieving licensure and gaining employment, the program contributes to increasing the supply of skilled nurses, enhancing cultural diversity within the workforce, and ultimately improving patient care across the country. As a federally funded initiative, INLAP continues to play a crucial role in addressing the ongoing nursing shortage and fostering a more inclusive and equitable healthcare system for all Canadians.
If you are interested, register for an information session on September 17th, where INLAP will be shedding light on Patient Safety and providing more details about the INLAP program.
The INLAP Programme is funded by the Government of Canada’s Foreign Credentials Recognition (FCR) Program.
