NR 360 Unit 4 Discussion Board: Workarounds and Their Implications for
Patient Safety
A. What is a workaround? Identify a workaround (specific to technology used in a hospital
setting) that you have used or perhaps seen someone else use, and analyze why you feel this risk-
taking behavior was chosen over behavior that conforms to a safety culture. What are the risks?
Are there benefits? Why or why not?
B. Discuss the current patient safety characteristics used by your current workplace or clinical
site. Identify at least three aspects of your workplace or clinical environment that need to be
changed with regard to patient safety (including confidentiality), and then suggest strategies for
change.
, Week 4: Workarounds and Their Implications for Patient Safety
Hi Everyone,
A workaround is a bypass of a recognized problem or limitation in a system. A workaround is typically a
temporary fix that implies that a genuine solution to the problem is needed. Or it can be defined as
shortcuts or ways to bypass troublesome technology. Placing pressure on a workaround may result in
later system failures (McGonigle & Mastrain, 2015).
One of the technologies used in the hospital setting for Workaround is computerized providers order
entry (CPOE). This is a process whereby medical professionals enter medication orders or other
physician instructions electronically instead of a paper chart. A primary benefit of CPOE is that it can
help reduce errors related to poor handwriting or transcription of medication orders. But in some cases,
nurses work around by beginning medication work based on the notes they took during medical rounds
from other health workers. The nurse’s intention for this risk-taking behavior is to save time, but such
behavior can cause more harm than good. It is not appropriate to use the information we got from a
previous shift or during rounds to administer medication to a patient. For example, due to patient
familiarity, some healthcare workers administer medication without looking at the patient chat which is
wrong. We need to check every patient’s chat before giving any medication and call for clarification if
needed. We need to check the patient vitals prior to administering a blood pressure medication. We
need to assess or recheck our patient as needed and at the beginning of every shift. If nurses are
chatting what they did not do, this can impact the computerized provider's order entry (CPOE)
negatively. It can affect patient outcome and harm patient or even cause death. However, if
computerized provider order entry (CPOE) is used properly it can help reduce errors related to poor
handwriting or transcription of medication orders (Debono et al, 2013).
The term patient safety is defined as a discipline that emphasizes safety in healthcare through the
prevention, reduction, reporting, and analysis of medical error that often leads to adverse effects. The
patient safety roles used in my current workplace or clinical site are as follows: Paper shredder to
protect personal information. Proper disposal of needles in the sharps container to avoid sticking other
people. Proper use of PPE to prevent the spread of disease. The use of the isolation protocol to prevent
the spreading of disease. There are various aspects of the workplace or clinical environment that need
to change regarding patient safety. Healthcare management should review policies and agency
regulation with caregivers at least once every month to ensure the safety of the patient. Proper in-
service should be conducted at least once a month or after an error has been noted in the workplace
environment. To decrease medication error, it will beneficial to review policy for the administration of
medication when the patient’s armband is not effective. In addition, cultural safety is very important in
all healthcare environment. It very vital that healthcare providers be culturally competent when caring
for patients, for this will greatly increase the patient outcome and nurse relationship. Finally, patient
safety and confidentiality must be made a priority in the clinical setting. Healthcare workers need to
acknowledge patient’s right when providing care because this will help eliminate most common error in
the workplace.
,References
Debono, Greenfield, Travaglia., Long, Black, Johnson., & Braithwaite. (2013). Nurses’ workarounds in
acute healthcare settings: a scoping review. BMC Health Services Research, 13,
175. http://doi.org/10.1186/1472-6963-13-175Links to an external site. (Links to an external site.)Links
to an external site.
McGonigle, D., & Mastrian, K. (2015). Nursing informatics and the foundation of knowledge (3rd ed.).
Burlington, MA: Jones & Bartlett.
Unit 4: Workarounds and Their Implications for Patient Safety
1. What is a workaround? Identify a workaround (specific to technology used
in a hospital setting) that you have used or perhaps seen someone else
use, and analyze why you feel this risk-taking behavior was chosen over
behavior that conforms to a safety culture. What are the risks? Are there
benefits? Why or why not?
2. Discuss the current patient safety characteristics used by your current
workplace or clinical site. Identify at least three aspects of your workplace
or clinical environment that need to be changed with regard to patient
safety (including confidentiality), and then suggest strategies for change.
● Collapse Subdiscussion
● Marissa Dopp
● Marissa Dopp
Jun 16, 2019
● Local: Jun 16 at 7:52pm<br>Course: Jun 16 at 6:52pm
● Manage Discussion Entry
● Hello Class,
I look forward to this weeks discussion focused on workarounds and their
implications for patient safety. Please be sure to address all aspects of the
question in your initial post.
, As a reminder:
You are required to post a minimum of two substantive posts in each graded
discussion.
These two posts must be on 2 separate days.
The first post in each graded discussion must be completed by Wednesday,
11:59 p.m. Mountain Time (MT).
Week 1-7 discussions must be completed by end of week, Sunday, 11:59
p.m. Mountain Time (MT).
For credit, you can start posting on Sunday of each week.
For weekly discussions, please do NOT use quotes. Information should be
paraphrased with an in-text citation. Quotes should be used in rare situations.
Hope everyone has a great week!
Dr. Marissa Dopp, DNP, RN
Reply
● Reply to Comment
○ Collapse Subdiscussion
○ Tracey Wendt
○ Tracey Wendt
Wednesday
○ Local: Jul 31 at 1:47am<br>Course: Jul 31 at 12:47am
○ Manage Discussion Entry
○ A workaround is a method for overcoming a problem or limitation in a
program or system. They improvise with materials on hand to create a
solution to an unexpected situation due to the supply and demand of a
unit not matching up (Stokowski, 2018).The definition of a workaround
seems positive the message overcome something, but in reality it's
cutting corners. There is a positive message behind workarounds,
though there are possible major safety concerns. Our textbook states
that many nurses who perform workarounds usually do not intend to
put the patient's safety at risk or harm the patient (McGonigle &
Mastrian, 2018). Programs are put into place for safety reasons
fairness and to be orderly. The example I have to deal with a lot is the
patient ID band. We scan the ID bands for safe medication passing
and documentation. I've had many agitated patients and the nurses
hang the patient ID band on the bed rail. Now if the band on the patient
was old, worn out or unable to scan I can understand having a backup.
In that instance you would still need to verify that you have the correct
patient. Some nurses only scan the band on the rail to avoid waking an
agitated patient and then proceed to hang say an antibiotic. How do
