Gibbs Reflective Journal

The healthcare sector is one where all key players should strive to ensure that they do not commit any errors in their operations; because it mostly involves the decision of life and death to a human being. Hospitals, therefore, have to ensure that they work towards ensuring that their patients feel satisfied with the service that they receive upon visiting the hospital. Hospitals remain assured to improve their satisfaction scores by creating a conducive working environment that allows their employees to undergo career growth. They also align their behavior and set their minds towards the achieving the hospital’s goals and objectives. Hospital management needs to communicate with their staff and put into place measures that give priority to meeting of all the patients’ needs; so that they can successfully attain and maintain a respectable satisfaction

On October 27, 2016, we met to obtain clarification on your work destinations and work performed on the day prior.

Catheter related bloodstream infections are not only responsible for prolonged hospital stays and increased hospital costs, it is also responsible for increased mortality of the hospitalized patients. According to Centers for Disease Control and Prevention (2017), an estimate of 30,100 central line-associated bloodstream infections (CLABSI) occur in intensive care units and wards of U.S. acute care facilities each year. CLABSI is a serious hospital-acquired infection that occurs when bacteria enters the bloodstream through central venous catheters. CLABSI is preventable as long as health-care personnel practice aseptic techniques when working with the catheter. A blood culture swabbed from the tip of the catheter is needed to confirm the

The first step nurses can take to decrease the incidents of CAUTIs in older adults is avoiding unnecessary use of catheters altogether. Initially, this begins with nurses knowing both appropriate and inappropriate situations in which a catheter should be utilized. According to (Gould et al., 2017), an appropriate situation is one where a patient has acute urinary retention or bladder obstruction, whereas an inappropriate situation is one where a catheter is being used a means of obtaining urine for culture when the patient can voluntarily void. Nurses can also use basic techniques like palpation, percussion, and inspection to effectively assess urinary retention, which is the main reason for catheterization as mentioned earlier. When techniques like this do not achieve desired results,

Urinary tract infections are the most common type of healthcare infection, and CAUTI is the 2nd most common cause of nosocomial bloodstream infection in the healthcare setting. ("Catheter Associated Urinary Tract," 2011). The goal of our facility is to reduce CAUTIs by 50% by the end of the year, measured by the quality department on a monthly basis, and implemented through performance improvement factors including the interdisciplinary team through a strong focus on the nursing leadership team.

Also another serious complication of CAUTI is BSI (Blood stream infections) that can be fatal if not caught and treated promptly. “The Clinical Performance of Quality Health Care, along with Joint Commission” offers standards and objectives for facilities to assess measure and improve their standards at the lowest cost possible. The database covers nursing care and education, along with guidelines on prevention. Moreover the JCAHO regulatory standards for catheterized patients are explained and the documentation that is expected when JCAHO inspections are rendered in a facility. The source “Stop orders to reduce inappropriate urinary catheterization in hospitalized patients” states that by following standard precautions with every patient these infections can be prevented. . Also the source explored whether catheters should be used at all in an effort to decrease the incidence of CAUTI’s. Intermittent catheterizations along with supra-pubic were explored with a decreased incidence of bacteria being present in the bladder afterwards. The source “Strategies to prevent catheter-associated urinary tract infections in acute care hospitals” offered ways of cleansing and disinfecting the skin before insertion to reduce the risk of infection. Many CAUTI’s are linked to bacteria harboring in or around the site at insertion. By using not only aseptic technique but also cleansing the skin with chlorhexadine can decrease he incidence of infection

Urinary tract infections (UTIs) are the most common nosocomial infection; accounting for up to 40% of infections reported by acute care hospitals. Up to 80% of UTIs are associated with the presence of an indwelling urinary catheter. Catheter associated urinary tract infections (CAUTIs) represent the largest proportion of healthcare associated infections (HAI). Catheter-associated urinary tract infection (CAUTI) increases hospital cost and is associated with increased morbidity and mortality .CAUTIs are considered by the Centers for Medicare and Medicaid Services to represent a reasonably preventable complication of hospitalization. As such, no additional payment is provided to hospitals for CAUTI treatment-related costs.CAUTIs can lead to

By consolidating what these men learned in this group, we will be able to understand where each member stands. In this group, members should have learned how to deal with their stress levels and find meaning in their diagnosis. Ethically, I need to recap during the last sessions with the clients to remind them what they have learned so the group experience was not for naught. Accordingly, I want to summarize with the group what they learned about the challenges of being HIV positive while encouraging them to use the skills they learned in the group outside of the group, while keeping the confidentiality of the group members.

There is a problem of avoidable hospital readmission rates for the Medicare and Medicaid populations that lead to adverse consequences not only for the patient, but also the payer and hospital. In order to decrease these avoidable readmission rates it is important to identify processes that can be implemented at the health plan level such as pre-discharge hospital visits by health plan staff, and post-discharge care coordination.

CAUTI are a big problem within the clinical settings. Up to about 80% of individuals develop a UTI due to the presence of a urinary catheter (American Association of critical Care, 2015). Long lasting catheterization

Despite the challenges, this facilitating experice has instilled me a degree of appreciation of many staff who work hard behind the scene to ahcieve the common goal of providing the best care possible to patients within the scarce resources. It was possible to see how good working relationship with other disciplines can improve overall efficiency.

I worked directly with the HIV/AIDS population as well as individuals whose behaviors place them at high risk for becoming infected. I am currently the Supervisor for the AIDS Institute Linkage and Navigation Program where I am responsible for overseeing the delivery of services. These services encompass but are not limited to entitlements, referral to agencies that assist with identifying appropriate housing, referral to medical, mental health and substance use services. I also, oversee treatment adherence services which support clients in their readiness to begin (ARV) antiretroviral therapy and maintain adherence to their prescribed medication for treatment for HIV/AIDS.

The ICUs are associated with over 15 million catheter days while there is indication that only 24.4% of CVC use occurs outside the ICUs (Chopra, Krein, Olmsted, Safdar & Saint, 2013). This implies that millions of patients in the ICUs are at a high likelihood of developing CLABSI

The biggest take-away I have from watching the Improving Transitions of Care videos is that transition of care has been and continues to be a huge ongoing problem with poor communication between the healthcare providers and the patient. As posited by Dr. Eric Coleman in the Module 1 video, we should consider one in five Medicare patients being readmitted within 30 days of discharge from the hospital as unacceptable (Joint Commission Resources [JCR], 2010). According to the video series, there are several projects being implemented to improve the discharge planning process and thus decrease the need for hospital readmission (JCR, 2010). A few of the tools being used such as, the After-Hospital Care Plan, more comprehensive teaching about diagnosis,

How were staff involved in assuring that the patient experience would be at its highest levels?