Intervening corrective action

Intervene If indicated, corrective actions should be taken to improve processes, practices, or medication use. Possible actions include the development of consensus statements or guidelines when they do not already exist, providing feedback on performance, education of health professionals (seminars, newsletters, feedback letters, one-on-one communication), creation of tools to support use of guidelines and treatment protocols (such as standard order sets, computerized pathways, pocket cards), redesigned processes, or patient education. 

MEDICATION MEMORY JOGGER When answering test questions or when caring for clients at the bedside, the nurse should remember assessing the client may not be the correct action to take when the client is in distress. The nurse may need to intervene directly to help the client. 

Use defaults effectively. This guideline calls for making the correct action the easiest one. (A default is a standard rule/order that works if nothing else intervenes.)... 

Intervene and discuss. The observer discusses with the individual their personal safety performance. This step can take several forms. The discussion can simply be a comparison of their performance against the critical behaviour checklist, safe behaviours and an emphasising of the recommended advice on the immediate corrective action, that should be taken to remedy unsafe situations. 

The bottom line Before selecting an intervention strategy, conduct a careful analysis of the situation, the behavior, and the individuals involved in an observed discrepancy between desired and actual performance. Do not impulsively assume corrective action requires "training" or "discipline." A behavioral safety analysis will likely give priority to a number of alternative intervention approaches. Performing such an analysis before intervening will help ensure your correcHve action plan does not reflect malpractice. 

A second use of feedback is to detect faults and failures in the controlled system, including the physical process and any computer controllers and displays. If the operator is expected to monitor a computer or automated decision making, then the computer must make decisions in a manner and at a rate that operators can follow. Otherwise they will not be able to detect faults and failures reliably in the system being supervised. In addition, the loss of confidence in the automation may lead the supervisor to disconnect it, perhaps under conditions where that could be hazardous, such as during critical points in the automatic landing of an airplane. When human supervisors can observe on the displays that proper corrections are being made by the automated system, they are less likely to intervene inappropriately, even in the presence of disturbances that cause large control actions. 

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