As a registered nurse, patient safety officer, and director of accreditation for a large health care system for many years, I see the challenges we face in trying to deliver excellent, safe care to every patient every time. In my experience, the patient safety message is: "Patient safety standards are not something that health care providers do; rather, patient safety provides the standards to help inform what health care providers do." After 12 years of working in the fields of patient safety and harm avoidance, I realized that I needed to validate my own experience and insights, to stay proficient and current, and to obtain a credential that would convey my competence to others.
There are several pathways available for nurses to attain certification. I chose to pursue the well-recognized Certified Professional in Patient Safety (CPPS) certificate, affiliated with the National Patient Safety Foundation. The certification curriculum in patient safety teaches how to understand key patient safety standards and ideals. Once certified, continuous education aids in assuring competency.
Although taking an exam is challenging for an experienced professional, I found that I learned a lot while preparing for the exam. The study material is helpful and easy to navigate. The test is comprehensive and requires critical thinking. Successfully receiving CPPS recognition is rewarding and is consistent with my longstanding belief in the principles of nursing professionalism.
The CPPS exam contains content that is usable and authentic. CPPS content includes culture, leadership, external influences, risk identification and analysis, data management, systems design, mitigating risk through systems thinking and design, and human factors analysis, which provide a thorough, well-rounded review of patient safety concepts needed for harm prevention. I see the relevance of this content in my daily fieldwork with staff. Together we look at communication, processes, data, and outcomes in hospital operations. During daily huddles, staff and leaders examine safety events from the past 24 hours and review quality metrics. Staff and leaders investigate near misses and errors through root cause analysis methodology. Proactive harm avoidance work is done utilizing the failure mode and effect analysis model. I have found that I am more skilled in all of these areas after completing CPPS certification.
My facility has a goal of zero harm. Our patient safety program embraces the high reliability concepts of resilience, reluctance to simplify, preoccupation with failure, sensitivity to operations, situational awareness, and deference to expertise. We use SBAR (situation, background, assessment, recommendation) as our methodology for nurse-to-physician communication and handoffs. Other techniques promoted through the patient safety program within my organization are clarifying through read-back, team training, paying attention to detail with self-checking, and having a questioning attitude. The culture of the organization is measured annually through the AHRQ Hospital Survey on Patient Safety Culture.
Through the CPPS course of study, I learned to more effectively implement important components of reaching zero harm, such as engaging patients and families in patient safety processes and expectations. By scripting our staff with certain key messages, patients and families learn why staff perform certain tasks, in areas ranging from patient identification to taking a time-out. The patient and family advisory council helps us identify concerns and ideas from patients and families. Having staff on the council maximizes idea sharing.
Earning the CPPS credential is a wonderful way to learn and validate experience, knowledge, and skill within the complex patient safety arena. The National Patient Safety Foundation and the Certification Board for Professionals in Patient Safety provide the CPPS credentialing opportunity, enabling patient safety experts to learn skills needed to work toward zero harm, a goal we all strive to meet.
Karen Frank, DNP, RN, MSHA Director Accreditation/Patient Safety Officer CHI Memorial Hospital Chattanooga, TN