Front Line of Defense: The Role of Nurses in Preventing Sentinel Events, 3rd Edition

ISBN: 9781635850611
ISBN-10: 1635850614
Copyright: 2019
Edition: 3rd
Author: The Joint Commission, with Meghan Pillow,
Doody's Expert Review    Score: 95
Reviewer: Debra DellaRatta,  MSN, CPHQ  (James A. Haley Veterans' Hospital)
This copublication from The Joint Commission and the American Nurses Association offers useful, practical guidance on the steps nurses can take to identify and help prevent sentinel events in hospital, ambulatory care, behavioral healthcare, home care, and nursing care settings. The Joint Commission and other accrediting bodies base their standards on the most current reported issues and evidence-based practices. The outcomes of the National Patient Safety Goals are monitored and not retired until a goal has met a positive percentage of compliance and/or is modified through feedback from the field. The ANA advocates for health promotion/safe environments for both patients and nurses. Because The Joint Commission highly values input from nursing, it created a Nursing Advisory Council (NAC). This update notes the multitude of changes in general healthcare since the second edition was published in 2007.
Nurses are at the bedside 24/7 and there are endless opportunities for them to lead continual improvement and sustainment activities in the varied settings. This book helps nurses review the most current literature and provide practical strategies to identify and help prevent sentinel events. The goal is to act in a proactive versus a reactive manner in a no-blame environment. Each scenario must employ root cause analysis (RCA) or failure modes and effects analysis (FMEA) (or both) to enhance the skills and knowledge of the healthcare team.
This book is written for nurses at all stages of their careers: novices, experts, leaders, staff nurses, educators, etc. It specifically notes that nurses are not solely responsible for safety events and are part of the larger, multidisciplinary healthcare team. The author is an MSN prepared RN who is working to complete a post-master's Family Nurse Practitioner certificate.
Each chapter of this book is well written with current data and resources/references. Among the many highlights are an instructive infographic on page 342 titled, "Facts on Health Care Associated Infections" with current reference data from 2016-2018 and chapter 7, Preventing Physical and Verbal Violence, with good examples that all may learn from, including leadership prevention strategies, behavioral emergency response teams (BERTs), and human factors, which emphasize the importance of training. Historically, the two factors cited in RCAs in this area are communication and education. Chapter 6, Preventing Maternal and Perinatal Injury and Death, is well written, explaining in exceptional detail the crucial needs to be considered in this type of specialty care.
I love this book. The chapters/topics are near and dear to my heart. It is a splendid and much-needed updated.
Review Questionnaire
Range Question Score
1-10 Are the author's objectives met? 10
1-10 Rate the worthiness of those objectives. 10
1-5 Is this written at an appropriate level? 5
1-5 Is there significant duplication? (1=significant, 5=insignificant) 5
1-5 Are there significant omissions? (1=significant, 5=insignificant) 5
1-5 Rate the authority of the authors. 5
1-5 Are there sufficient illustrations? 3
1-5 Rate the pedagogic value of the illustrations. 4
1-5 Rate the print quality of the illustrations. 4
1-5 Are there sufficient references? 5
1-5 Rate the currency of the references. 4
1-5 Rate the pertinence of the references. 5
1-5 Rate the helpfulness of the index. 5
1-5 If important in this specialty, rate the physical appearance of the book 5
1-10 Is this a worthwhile contribution to the field? 10
1-10 If this is a 2nd or later edition, is this new edition needed? 10