Patient Safety in Ambulatory Care

Patient safety is one of the priorities of healthcare professionals as it ensures positive patient outcomes. Ambulatory care has been seen as a “more logistically complex and challenging” setting since nurses have minimal control over patient environments which has a considerable effect on the treatment and the overall healing process (Martinez et al., 2015). It has also been found that nurse practitioners receive less training related to patient safety issues (Centers for Disease Control and Prevention [CDC], 2016). It is estimated that approximately two million healthcare-associated infections (HAI) take place in the USA, costing up to $33 billion per year (Markley & Stevens, 2018).

It is noteworthy that a substantial decrease in such cases in inpatient care is reported, while this trend is absent in the outpatient setting. According to CDC (2016), the lack of knowledge and training is one of the primary reasons for this problem.

One of the strategies to implement change in every healthcare facility is to hire a nurse practitioner (or assign a nurse leader) who will run training sessions for the medical staff on a regular basis. The training sessions will address diverse issues related to the most common issues associated with patient safety. The evaluation of this program will involve the use of a mixed-method research design. The research questions to be addressed during this study will be as follows:

  1. How has the healthcare-associated infection rate changed after three months after the start of the project?
  2. How effective is the training program as seen by nursing professionals?

Mixed-method research is the most appropriate type of study in this case as it is instrumental in identifying the exact change if any. The researchers will calculate the HAI rate before and three months after the beginning of the training project. However, different variables can affect HAI, so it can be beneficial to estimate the attitudes of the medical staff towards the program. The use of quantitative analysis exclusively may lead to wrong conclusions. It is critical to identify nurses’ engagement and their willingness to apply acquired knowledge. Focus group discussions will be held to collect qualitative data and analyze nurses’ perspectives regarding the effectiveness of the project.

The qualitative data will shed light on such areas as nurses’ skills and knowledge, their confidence, engagement, and commitment to following the existing guidelines. Clearly, the use of the qualitative research method only will also provide rather incomplete data. Although the researchers will identify the nurses’ attitudes towards the program and overall patient safety program, this type of study will not shed light on exact outcomes that could be quantified.

Therefore, it is important to develop and implement a new training program and evaluate its effectiveness at a healthcare facility. The data should be properly analyzed and disseminated so that other healthcare centers could create their own projects and improve patient safety in the outpatient setting. Clearly, these programs can be implemented alongside other programs that, for instance, concentrate on surveillance, technology, or reporting.

In conclusion, it is necessary to note that patient safety in ambulatory care is becoming an urgent issue due to the increasing number of patients. Nurse practitioners should be properly equipped with resources and knowledge to ensure that the highest standards of patient safety are met. The development of a training program for a healthcare facility and its evaluation with the help of a mixed-method study can contribute to achieving this goal.


Centers for Disease Control and Prevention. (2016). Guide to infection prevention for outpatient settings: Minimum expectations for safe care. Web.

Markley, J.D., & Stevens M. P. (2018). Infection control in the outpatient setting. In G. Bearman, et al. (Eds.), Infection prevention (pp. 35-53). Springer.

Martinez, K., Battaglia, R., Start, R., Master, M. F., & Matlock, A. M. (2015). Nursing-sensitive indicators in ambulatory care. Nursing economics, 33(1), 59-64.

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