Ambulatory Patient Care
Ambulatory care, sometimes called outpatient care, is when a patient comes to a doctor’s office, a surgical center or a hospital for a procedure or surgery and is expected to recover sufficiently to return home the same day. Nurses in an ambulatory care setting are expected to monitor their patients before, during and after their procedures. They will usually take a patient’s medical history, make sure that pre-surgical instructions have been followed, monitor the patient’s blood pressure and other vital signs, and give appropriate post-surgical medications for pain and nausea as needed.
Nurses working in outpatient facilities have their hands full. They are usually required to prepare multiple patients for different procedures while also monitoring most other patients as they come out of sedation and prepare to head home. As important as all of these duties are to the health and well-being of their patients, there is one additional concern that is even more important; nurses must always make patient safety a top priority.
Four Goals for Ambulatory Patient Care Safety
The Joint Commission, a nonprofit organization that certifies health care organizations and programs in the United States, has set four goals for patient safety in the ambulatory care setting. Here is a summary of those four goals and what they mean to you as a nurse.
•Correctly identifying patients – Identifying a patient correctly is essential to giving them the best care. News stories of patients having the wrong procedure done are the obvious result of misidentification. According to the Joint Commission’s safety list of goals, at least two different forms of identification for a patient should be used before any medication is given or any procedure started. For example, a patient should be asked to give both their name and date of birth before they are given medication.
•Infection prevention – Infections can be a serious and life-threatening complication of surgery. According to the Center for Disease Control (CDC), surgical site infections can range from superficial skin infections to serious infections involving muscle tissue, organs or even implanted material. To help prevent these infections, ambulatory care nurses should follow all proven infection-prevention guidelines. In addition, they should follow the World Health Organization‘s hand cleaning protocol, which includes keeping nails short, changing gloves between patients and the appropriate use of antimicrobial soaps.
•Safe use of medication – There are certainly two goals when making sure that patient medications are used safely. The first is if proper medication is given. This can be ensured by labeling all medications that are not in their original container. Medicines that have been transferred to cups, basins or syringes, for example, must be labeled with their contents. This way, when nurses hand out medications, they know exactly what they are giving their patients. The other safety concern with medications is how they will interact with any other drugs a patient might be taking. As an ambulatory care nurse, you must be aware of all of the medications your patients are taking. It is also wise to advise them to carry an up-to-date medicine list with them whenever they visit the doctor or are scheduled for any medical procedure.
•Prevention of mistakes during surgery – Despite recent efforts by the medical community to eliminate errors during surgery, a recent article in U.S. News and World Report states that a “huge numbers of patients” are still being harmed by medical errors. Before surgery, nurses should, according to the Joint Commission, make sure that the surgery being done is on the correct site and on the correct patient. Before the patient is sedated, the nurse should mark the place on the patient’s body where the surgery or procedure would be completed. The whole surgical team should also pause briefly before beginning and make sure that everyone understands what is happening, and no member of the surgical team has any unanswered questions or doubts.
By trying to meet the Joint Commission’s four simple ambulatory care national patient safety goals, nurses can be sure that their patients are getting the one thing they need: the best nursing care available.