Adaptation of a Lean Tool Across Surgical Units to Improve Patient Experience

Enhancing High Reliability in Oncology Care: The Critical Role of Nurses-A Systematic Review and Thematic Analysis

Background/objectives: The oncology setting is complex and recognized as a high-risk area, with an increased potential for errors due to the complexity of therapeutic modalities and different processes. Nurses are pivotal in fostering a culture of patient safety and high reliability and actively contribute to the enhancement of safety standards in oncology care. This review systematically identified and examined the critical role of nurses in promoting high reliability within oncology organizations to ensure optimal patient outcomes. Methods: A systematic review was performed in the PubMed, CINAHL, and Cochran Library databases in accordance with PRISMA guidelines. Using Tomas and Harden's three stages, 12 studies were deductively and thematically analyzed to discover themes. Results: We identified eight themes concerning nurses' roles in achieving high reliability in healthcare within oncology organizations: establishing standardized and safe administration, enhancing situational awareness, promoting effective communication, advocating for patients, building a culture of safety, leading safety culture improvements, engaging staff, and fostering patient engagement. Conclusions: Nurses play a critical role in identifying, communicating, and correcting safety threats, overcoming various organizational barriers to safety concerns, and maintaining and developing a culture of safety for patients and families. Although this review included a relatively limited body of literature, the findings highlight the need for further research that considers the unique characteristics of health and healthcare systems. Protocol registry; UMIN Clinical Trials Registry (UMIN-CTR) Registry No. UMIN000056140.

Best practices for implementation of Kamishibai cards in the healthcare setting to improve nursing-sensitive indicator associated outcomes: An integrative review

BACKGROUND

Many adverse events are identified as nursing-sensitive indicators (NSIs) and have evidence-based care bundles known to reduce risk of occurrence. Kamishibai cards are a tool from the manufacturing industry used for practice auditing and improvements. Use of Kamishibai cards is believed to be common in the healthcare setting, but true evidence-based guidelines do not yet exist to guide their implementation.

AIMS

The aim of this integrative review was to identify best practices around the implementation of Kamishibai cards in the healthcare setting for improvement in NSI-associated outcomes.

METHODS

Eleven nurses at three facilities worked through the evidence using the Johns Hopkins Evidence-Based Practice Model.

RESULTS

Ten articles were included for this review. Broad themes included direct observation with non-punitive and timely feedback, clearly visualized results, use of evidence-based care bundles, pre-implementation education, and both leadership and frontline-staff involvement. All facilities showed improvement in NSI-associated outcomes after the implementation of K-cards.

LINKING ACTION TO ACTION

In health care, K-cards can be implemented and designed with additional focus on the bundles of care they are intended to audit and staff support, but further evidence would better define guidelines around implementation.