A Culture of Patient Safety Read this article: Sammer, C. & James, B. (2011, September 30). Patient safety culture: The nursing unit leader’s role. OJIN: The Online Journal of Issues in Nursing,16(3), Manuscript 3. In the Hospital Hope scenario, what do you think was the most important factor that led to the change in practice in the SICU?

Leadership a Culture of Patient Safety

A culture of patient safety flows from leadership levels to all parts of patient care. The safety of a patient is a responsibility for everyone; however, healthcare leaders are responsible for the development of a patient safety culture. Such a culture can be developed and established only if the leadership commits to promoting safety and creating an environment within patient care settings that focuses on patient safety. Healthcare leaders must adopt and implement safety programs that create a climate of safety and influence safety behaviours. Research has linked healthcare leadership, communication, collaboration, and leader-led safety improvement initiatives to the development of a safety climate in patient care (O’Donovan et al., 2019). However, for the leadership to be able to establish and sustain a culture of patient safety, they must change from the current approaches to patient care to adopt new methods that promote a new culture of patient safety. This study will look at the case of Hospital Hope and Mrs. Jackson’s experience at the hospital’s Surgical Intensive Care Unit (SICU) for recovery and post-operative care. It will identify the most critical element that led to SICU practice changes and create a change framework appropriate for SICU practice change.

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The Most Important Factor That Led to The Change in Practice in the SICU

The provision of patient-centred care and setting the pace of delivering the highest quality and safest standards of patient care have been Hospital Hope’s mission. However, Mrs. Jackson’s experiences at the hospital’s Surgical Intensive Care Unit (SICU) show the failure of the hospital to live up to its mission. Various incidents led to the initiation of the change in practice in the SICU. Mrs Jackson developed hospital-acquired infections (HAIs) such as hospital-acquired pneumonia and central-line-associated bloodstream infections (CLABSIs), as well as three episodes of hypoglycemia. Although the other two incidents are issues of concern in relation to the safety of the patient, the case of Mrs Jackson developing CLABSI was a critical component of change in practice in Hospital Hope’s SICU.

Firstly, the CLASBI Mrs. Jackson acquired required her to have her central line removed and re-inserted (Sammer & James, 2011). This wasted the time of other people who spent time at her bedside and elongated her length of stay as she had to spend five more days after the SICU in a step-down unit for further recovery before she was discharged. Mrs Jackson needed an extended care facility after being discharged to assist with her further recuperation and rehabilitation before returning home. Mrs Jackson’s hospitalization did not result in serious harm, but the medical expenditures, psychological stress on her and her family, and discomfort and inconvenience from her unnecessary morbidity were significant (Sammer & James, 2011).

Additionally, the SICU nurse manager learned that incidences of CLASBIs were an issue of concern in the unit. Essentially, CLASBIs were preventable HAIs in which one in every four patients died, resulting in a mortality rate of up to 25 per cent. CLASBIs also added to high healthcare costs of up to $16,550 (Sammer & James, 2011). Aside from these immediate concerns about CLASBIs, more than half of SICU care professionals stated their unit lacked a strong culture of safety and cooperation.

The Effective Framework for Practice Change

Reducing the risk of HAIs and improving confidence in the culture of safety among SICU care providers requires a change of practice in the SICU. However, such a change is a process of constant transition with various barriers, such as resistance to the change, scepticism, system readiness, and communication issues, among others. Therefore, the adoption of a change management framework suitable for particular clinical settings is required. Kurt Lewin’s 3-stage model of change fits in the implementation of practice change in the SICU.

Kurt Lewin’s Change Model focuses on people’s behaviour during the process of change. The model considers that changes occur in three main stages: unfreezing, change (transition), and refreezing (freeze) (Krichten, 2022). The first stage of unfreezing involves creating a state of readiness and willingness of the individuals within the organization toward change. The stage creates a realization of the need to shift from the existing practices to adopt new practices with respect to the changing needs. The leadership creates awareness of the need for change and motivates people to engage in the change process. The second s