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E-Folio: Essential II
Margaret Anyiam
Frostburg State University












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E-Folio: Essential II
Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient
Safety discusses the role of leadership skills in improving the quality of care and focuses on the
issue of patient safety which can be addressed with references to nursing practice. According to
Essential II, leadership skills are necessary to accentuate ethical and critical decision making,
initiating and maintaining effective working relationships, using mutually respectful
communication and collaboration within interdisciplinary teams, care coordination, delegation,
and developing conflict resolution strategies (American Association of Colleges of Nursing,
2008, p. 13). Thus, the nurses leadership skills are significant to improve the healthcare
environment in relation to quality and safety nursing.
Exemplar
The principles of Essential II can be discussed with reference to module four (4)
assignments which involved discussion on two safety patient initiatives, accrediting and
regulatory agencies of healthcare facilities. Referring to the assignment, I have learned that
patient safety initiatives use reports and analyses in healthcare institutions to formulate measures
that are geared towards preventing medical errors (Amer, 2013).This process is associated with
the leaders decision making, thus, this assignment was selected for Essential II. Patient safety
initiatives are discussed and implemented to contribute to patient safety while decreasing the
number of medical errors (Jones, 2009; Sullivan, 2012). Some of the accrediting and regulatory
agencies are Joint Commission, food and drug administration (FDA), Institute of Medicine
(IOM). The process is based on using Six Sigma to assess patient safety and quality care while
the Plan-to-Study method is used to implement short-term patient safety initiatives. Both
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methods analyze the effectiveness of a proposed initiative to reduce the number of medical errors
while providing quality care and treatment.
Reflection
The analyses on patient safety initiatives are closely associated with the ideas in the
Essential II because the nurse implements safety principles and works with others on the
interdisciplinary team to create a safe, caring environment for care delivery (American
Association of Colleges of Nursing, 2008, p. 13). Thus, the proposition, analysis, and discussion
of the patient safety initiatives are the components of the nurses activities (Amer, 2013;
American Psychological Association, 2010). The reason for the statement is in the fact that the
focus on such activities develops the nurses leadership qualities along with improving
professional level. Following the topic and the idea that nurses should act as leaders in healthcare
organizations, I can state that the development and analysis of different initiatives and projects
such as the patient safety initiatives is important in promoting the quality of care (Bell, 2001;
Meister et al., 2002; Oermann, 2002)









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References
Amer, K. S. (2013). Quality and safety for transformational nursing: Core competencies. Upper
Saddle River, NJ: Pearson.
American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education
for professional nursing practice. Retrieved from
http://www.aacn.nche.edu/education/pdf/BaccEssentials08.pdf
American Psychological Association. (2010). Publication manual of the American Psychological
Association. Washington DC: American Psychological Association.
Bell, S. (2001). Professional nurses portfolio. Nursing Administration Quarterly, 25(2), 69-73.
Jones, S. (2009). Reducing medication administration errors in nursing practice. Nursing
Standard, 23(50), 40-46.
Meister, L., Heath, J., Andrews, J., & Tingen, M. (2002). Professional nursing portfolios: A
global perspective. MEDSURG Nursing, 11(4), 177-182.
Oermann, M. (2002). Developing a professional portfolio in nursing. Orthopaedic Nursing,
21(2), 73-78.
Sullivan, E. J. (2012). Effective leadership and management in nursing. Upper Saddle River, NJ:
Pearson.






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Two safety patient initiatives and accrediting and regulatory agencies (Exemplar)
Patient safety in the healthcare industry is an important matter that all institutions
providing healthcare aim at achieving. Patient safety initiatives are aimed at ensuring that high
quality care is provided to patients in ambulatory and inpatient settings (Sullivan, 2012). Patient
safety initiatives use reports and analyses in the healthcare institutions to formulate measures that
are geared towards preventing medical errors (Amer, 2013). It has been demonstrated that
medical errors cause adverse effects to patients and contribute to low quality healthcare offered
to patients. Errors that contribute to patients death and injuries are as a result of human factors,
system failures and medical complexity. Several initiatives have been proposed to minimize
and/or prevent medical errors that lead to patients injuries and death. Quality care is an essential
feature in nursing practices and healthcare institutions (Jordan, 2009). Some of the accrediting
and regulatory agencies are food and drug administration (FDA) and Institute of Medicine
(IOM).
Near-miss reporting patient safety initiative has been adopted in the healthcare
institutions to help report, analyze and document events. Although the events do not cause harm
or death to patients, they have the potential to do so (Sullivan, 2012). The initiative recognizes
that cause of adverse effects to patients may occur by chance. Observers report the unwanted
events to administrators in healthcare institutions who then analyze the events for future
prevention. For example, a nurse might be preparing to transfuse blood into a patient. He or she
realizes just before transfusion that the blood groups (of the donor and the recipient) would be
incompatible. Such an event would be reported to the nurse supervisors or administrators to
prevent similar detrimental events in the future. Correct labeling and handling of blood would be
addressed so that correct blood would be transfused into the right patient. Reduction of
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undesirable events helps improve the quality of healthcare provided to patients (Sullivan, 2012,
p. 78).
Institutions providing healthcare have adopted modern electronic health records to reduce
and prevent medical errors that would cause harm to patients (Sullivan, 2012). Electronic health
records incorporate automated systems for drug prescription (e-prescription), laboratory tests and
procedures, allergy checks and patient continuous education information. Misidentification
issues have also been addressed by electronic health records because they ensure proper entry,
storage and retrieval of patients data (Amer, 2013).
Patient safety and quality care evaluation methods and tools
Patient safety and quality care are valuable outcomes in healthcare institutions that need
constant evaluation. The evaluation tools and methods help determine the successes or failures of
patient safety and quality care initiatives. Initiative measurements and benchmarking are
conducted to assess quality improvement and patient safety initiatives in the healthcare industry.
One of the methods used to assess patient safety and quality care is Six Sigma (Sullivan,
2012). This method compares data at baseline to the outcomes realized at the end of a piloting
process (involving solutions testing). There are two methods within the Six Sigma method. One
of the methods compares process outcomes to process defects while the other method uses
estimation analysis to determine performance outcome.
Plan-Do-Study-Act method is used to implement short-term patient safety initiatives. The model
is characterized by cycles of impacts and assessments. The method attempts to associate process
manipulations with outcomes (Sullivan, 2012).


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Impact of patient safety initiatives on nursing leaders
Nursing leaders are crucial in implementing patient safety initiatives (Sullivan, 2012).
Achievement of patient safety initiatives is part of Magnet journey by nurses (Jordan, 2009).
Successful implementation of patient safety initiatives has positive impacts on nursing leaders.
Nursing leaders who have successfully implemented patient safety initiatives are motivated to
work, and their performance outcomes are improved. On the other hand, nursing leaders whose
teams do not implement patient safety initiatives spend most of their time implementing the
initiatives. Their performance outcomes are not improved.
How I would promote the patient safety and quality care initiatives?
First, as a nursing leader, I would understand that my interaction with my team members
would be essential in achieving the goals of the patient safety and quality care initiatives.
Research demonstrates that nursing leaders are crucial in effective coordination of care in
healthcare institutions. Secondly, I would inform my team members the importance of
implementing patient safety and quality care initiatives in our healthcare setting. Thirdly, I would
motivate my team members to work towards achieving the goals of the initiatives, and let them
know that their performance measurements would be based on the success of the initiatives.
Fourthly, I would implement the patient safety and quality care initiatives by adopting standard
methods of implementation and measurements. By adopting the standard methods, I would easily
detect failures and successes of the initiatives.
How I would use the evaluation methods and tools ?
The evaluation methods and tools would be essential in ascertaining the successes of the
patient safety and quality care initiatives. The tools and methods would inform on the types of
defects experienced during the implementation process. From this, I would propose ways of
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circumventing the defects in the future (Amer, 2013). If only a few of my team members
comprehend technical components in patient safety and quality care initiatives, then I would
restructure the initiatives to make them easier to follow and implement.




















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References
Amer, K.S. (2013). Quality and safety for transformational nursing: Core competencies. Upper
Saddle River, NJ: Pearson Education.
Jordan, Z. (2009). Magnet recognition and practice development: two journeys towards practice
improvement in health care. International journal of nursing practice, 15(6), 495-501.
Sullivan, E. J. (2012). Effective leadership and management in nursing (8
th
ed.). Upper Saddle
River, NJ: Pearson Education.