NURS 6341 Week 9 Discussion: Analyzing Patient Risk

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“Through direct observation, interviews, and surveys, [researchers] Tucker and Spear identified a number of major categories of obstacles to nursing care, including physician orders, obtaining equipment and supplies, and staffing. These researchers reported that the average time nurses in this study spent at one task was 3.1 seconds and that nurses were interrupted mid-task eight times per shift.”

—From “The Complex Work of RNs: Implications for Healthy Work Environments” (Ebright, 2010)

What comes to mind as you consider the estimate of 3.1 seconds per task—and the multiple interruptions per shift? Even considering the likelihood of improvements in management of nursing tasks since the study year, how does this statistic speak to the inherent potential for mistakes and misjudgments?

It is recognized that nursing complexity and the stress that it generates can lead to medication errors, mislabeling of specimens, and procedural breakdowns. This week’s readings focus on strategies to address nursing complexity, including stacking, a strategy that nurses with advanced knowledge use to prioritize responsibilities and focus on quality of patient care.

To Prepare

  • Review this week’s Learning Resources on nursing complexity and stacking.
  • Review this week’s media, “Complexity of Nursing Practice.” Reflect on the insights and strategies shared by the Dr. Ebright and Dr. Sitterding.
  • Locate current research articles that discuss complexity of nursing practice and stacking specific to your specialty of interest.
  • Reflect on your practicum experience. Identify a situation in which the principle of stacking might have prevented an error, helped to decrease stress, or mitigated ambiguity/miscommunication for an individual nurse or group of nurses. If necessary, you may also select a situation from your past or current workplace or the current literature.
  • Thinking broadly about your specialty area of interest, consider stacking as a means of addressing nursing complexity and improving quality care.

By Day 3

Post a brief description of the situation you selected. Explain how the principle of stacking might have improved the quality of care and/or safety of the patient(s). Then, explain a stacking strategy you might use to manage complexity of nursing practice in your specialty area of interest. Support your response by citing specific references to your practicum experience and current literature.

Note: With the exception of an example from a research article, maintain the privacy of those involved in your sample situation by changing the names of patient(s) and nurse(s).

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days using one or more of the following approaches:

  • Offer and support an additional strategy a colleague might use to integrate the principle of stacking into his or her specialty of interest.
  • Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

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