Processes Influencing the Development of Graduate Nurse Capabilities in Clinical Risk Management

Outcomes of Effective Integration of Clinical Risk Management Into Health Care From Nurses' Viewpoints: A Qualitative Study

The aim of this study was to explore nurses' experiences and viewpoints about the outcomes of effective integration of clinical risk management (CRM) into health care. This qualitative study was conducted using purposive sampling and semistructured interviews with 19 nurses from three hospitals affiliated with a large medical university. Data were analyzed by the conventional qualitative content analysis method proposed by Lundman and Graneheim. Data analysis reflected the following concepts: improving the quality of services and promoting health, preserving and protecting patient safety, increasing satisfaction, improving staff morale, and improving organizational awareness and vigilance. According to the results, CRM with its positive outcomes can help the development of a patient-oriented culture. The results can be a starting point for further quantitative and qualitative research to explore other strategies, potentials, and capacities of quality improvement activities such as CRM in other contexts and cultures.

Assessment of Clinical Risk Management System in Hospitals: An Approach for Quality Improvement

Background:

Clinical risks have created major problems in healthcare system such as serious adverse effects on patient safety and enhancing the financial burden for the healthcare. Thus, clinical risk management (CRM) system has been introduced for improving the quality and safety of services to health care. The aim of this study was to assess the status of CRM in the hospitals.

Methods:

A cross-sectional study was conducted on 200 nursing staff from three teaching hospitals affiliated with the Kerman University of Medical Sciences in southeast of Iran. Data were collected from the participants using questionnaire and observational checklist in quality improvement offices and selected wards. The data were analyzed using SPSS version 20.

Results:

Almost, 57% of persons participated in at least one of training sessions on CRM. The status of CRM system was rated from weak to moderate (2.93±0.72- 3.18±0.66). Among the six domains of CRM system, the highest mean belonged to domain the monitoring of analysis, evaluation and risk control (3.18±0.72); the lowest mean belonged to domain the staff’s knowledge, recognition and understanding of CRM (2.93±0.66). There were no integrated electronic systems for recording and analyzing clinical risks and incidents in the hospitals.

Conclusion:

Attempts have been made to establish CRM through improvement quality approach such as clinical governance and accreditation, but not enough, however, health care should move toward quality improvement and safe practice through the effective integration of CRM in organizational process.

A patient safety focused registered nurse transition to practice program

Abstract As undergraduate rural nursing students approach completion of their degree and become eligible for registration as a nurse they anticipate becoming part of a transition to practice program. Promises of clinical support, guidance and being welcomed into the profession are provided. Unfortunately the reality for new graduate registered nurses is often quite different. Promised clinical support does not eventuate and patient safety is often compromised. Graduate nurse transition programs need to have the physical and human resources to deliver the clinical support that was promised in their prospectus. This paper describes the nature of professional support experienced by participants of transition to practice programs. Three core elements are recommended to ensure patient safety.

The nature and implications of support in graduate nurse transition programs: an Australian study

It is widely recognized that support is critical to graduate nurse transition from novice to advanced beginner-level practitioner and to the integration of neophyte practitioners into safe and effective organizational processes. Just what constitutes support, however, and why (if at all) support is important, when, ideally, support should be given, by whom, how, and for how long, have not been systematically investigated. Building on the findings (previously reported) of a year long study that had, as its focus, an exploration and description of processes influencing the successful integration of new graduate nurses into safe and effective organizational processes and systems, the findings presented in this article strongly suggest that support is critical to the process of graduate nurse transition, and that integration into "the system" is best provided during the first 4 weeks of a graduate nurse transition program and thereafter at the beginning of each ward rotation; that "informal teachers" and the graduate nurses themselves are often the best sources of support; and that the most potent barriers to support being provided are the untoward attitudes of staff toward new graduates. Drawing on the overall findings of the study, a new operational definition of support is proposed and recommendations are made for future comparative research on the issue.

Designing and delivering clinical risk management education for graduate nurses: An Australian study

In order to enhance their capabilities in clinical risk management (CRM) and to be integrated into safe and effective patient safety organisational processes and systems, neophyte graduate nurses need to be provided with pertinent information on CRM at the beginning of their employment. What and how such information should be given to new graduate nurses, however, remains open to question and curiously something that has not been the subject either of critique or systematic investigation in the nursing literature. This article reports the findings of the third and final cycle of a 12 month action research (AR) project that has sought to redress this oversight by developing, implementing and evaluating a CRM education program for neophyte graduate nurses. Conducted in the cultural context of regional Victoria, Australia, the design, implementation and evaluation of the package revealed that it was a useful resource, served the intended purpose of ensuring that neophyte graduate nurses were provided with pertinent information on CRM upon the commencement and during their graduate nurse year, and enabled graduate nurses to be facilitated to translate that information into their everyday practice.