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How radiology nurses can advocate for patient safety—even when radiologists can’ - News - Nurses Arena Forum

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How radiology nurses can advocate for patient safety—even when radiologists can’ by katty : August 07, 2018, 08:07:37 PM
Overburdened imaging departments and staff shortages are compromising the efficiency—and communicative abilities—of U.S. radiologists, one clinician wrote in the Journal of Radiology Nursing this month. But radiology nurses might be undervalued as resources in the fight to ensure quality care.

Communication errors aren’t limited to supporting staff, Shawna Butler, DNP, JD, RN, wrote, but malpractice claims that cite communication breakdown account for one-third of all nursing-related cases. A 2015 malpractice case analysis report found specific weaknesses within a healthcare team’s chain of communication ultimately affect patient safety, and more than 200,000 patient deaths a year are attributed to medical errors.

“Many of these errors can be prevented if solid communication systems are in place,” Butler, a clinical assistant professor and patient safety specialist at Massachusetts General Hospital, wrote. “For communication to be effective, it must include shared responsibility and accountability among the team members involved in care along with the patient.”

To be effective, healthcare systems should lean toward processes and a culture that encourages staffers across the institution to communicate risks and concerns, Butler said, and that includes nurses. Since patients sometimes confide in nurses what they fail to disclose to their doctors, radiology nurses are uniquely positioned to detect and communicate any red flags before a procedure is underway.

“This is where nurses can advocate for their patient and speak up before the procedure,” Butler wrote, noting nurses are also instrumental in assessing whether patients fully understand the risks associated with any given procedure and are therefore a key part of the informed consent process. “Nurses can be a strong voice to remind the team to follow the safety protocols if it is identified that they are not being followed.”

Apart from consent procedures, nurses can help spot inconsistencies in safety protocols that Butler says are vulnerable to distraction. They can aid in eliminating certain liabilities, like wrong patient, wrong site, wrong test or wrong procedure, but in an environment where the attending radiologist is prone to distraction or concurrent emergencies.

Communication obligations don’t end after the procedure, either, Butler wrote. Radiology nurses can ensure any post-op issues, like unexpected vital sign changes, are communicated to patients and their other care providers.

These cautionary steps and what may seem like over-vigilance is actually necessary to ensure top-of-the-line care, Butler said. Health institutions need to have effective communication networks and policies, as well as the ability to escalate urgent matters if necessary and disseminate all vital patient information. And breaking the chain of communication doesn’t just mean poorer care for patients, she said—it also opens physicians themselves up to lawsuits, board complaints and malpractice allegations.

“The necessity to include validated communication strategies in system processes cannot be stressed enough,” she wrote. “Healthcare teams that are able to successfully integrate both conveying and receiving information related to patient care create a model for clinicians across disciplines in healthcare which promotes optimal patient outcomes.”
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