Culture Essay
This issue I identified during my clinical practices and this is related to the patient safety culture. Almost in any healthcare setup, the operation theatre staff has a prescribed surgical attire. Sometimes Operation theatre staff during or after completing the surgeries leave the OT room without removing the surgical attire. Exposing the surgical attire to the outside environment that has comparatively higher number of bacteria in air is one the major cause of nosocomial infections acquired during invasive procedures. For instance, the pathogens if directly exposed to the place of incision e.g as in laparoscopy. The number of bacteria multiply by thousands of times more rapidly as compare to the normal exposure and this exposure cause lethal infections at surgical site.Those patients who are undergoing some Invasive procedures are very much vulnerable to nosocomial infections. There may be many reasons but one I observed is due to keep wearing the surgical attire out of the operation theatre. The standard operating procedure is that it Must not be used again if entering in the surgery room. But, some of the OT staff do not care and they use it without laundering .There OT dress become one the major cause of nosocomial infection. HROs do not neglect Such negligence but it is common in those healthcare facilities that
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The simple proposition is that the greater the individual’s level of commitment to the safety the less formal control is needed . To promote a strict discipline in organization Amitai Etzioni in 1961 offered theory. Effective organizations need strict discipline and member compliance. In order to achieve that compliance three types of influence can be exerted on the members.. In thinking about the dynamic influence of organisational power Etzioni delineated three base forms of
The National Patient Safety Goals were first developed in 2002 by the Joint Commission. The goals are established to help guide medical organizations to focus on which areas of patient safety need improving (Hudson 2016). The first set of goals were released and put in motion in 2003, prior to 2003 there were no policies or goals for an organization to set their sights on (Hudson 2016 page 2). A panel of experts advises the Joint Commission on the development of new goals or the updating of old ones. The panel is called the Patient Safety Advisory Group and is made up of nurses, risk managers, clinical engineers, and physicians (Hudson 2016). The National Patient Safety Goals have specific goals geared toward the type of medical organizations such as a critical access hospital, home care, behavioral health, and long term care services to name a few (Hudson 2016 page 2). The National Patient Safety Goals help protect patients and make sure providers are practicing safely across the board.
Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency
Patient safety and risk management should be intertwined in the organization. Patient safety is where the patient does not experience unnecessary harm or pain or other suffering during their treatment (Youngberg, 2011). Minimizing risk is to decrease unnecessary losses or improve or implement process that will decrease adverse event (Youngberg, 2011). The Samantha Jones adverse event is a perfect example to enhance patient safety through improved process or project. To understand the event a root analysis needs to be done and action items are created from this analysis.
According to the Hospital National Patient Safety Goals, Goal 7 is to reduce the risk of health-care associated infections. NPSG.07.0.01 deals with surgical-site infections. The question to be asked is, “Why are surgical site infections a problem?” The prevention of surgical site infections can occur before and during surgery, with certain actions of the nurse, and when the patient is healthy. One way surgical site infections can occur is during surgery, or intra-operation. Sources of bacteria, exogenously, include the airborne route as a significant source of infection. Endogenously, infections can occur from the normal flora of a patient (Edmiston & Spencer, 2014a). Surgical site infections are a problem intra-operatively because of operating room temperatures not being controlled, misuse of sterile procedure, and improper hand hygiene. Operating room temperatures should be kept between 68 to 75 degrees Fahrenheit or 20 to 24 degrees Celsius. There also needs to be positive
Nurses are undoubtedly one of the most trusted professionals worldwide. Patients, family members, and doctors entrust nurses to provide the utmost quality care to sick individuals. Top priorities of all nurses are advocacy for their patients: including advocating for their physical health, holistic welfare, and utmost importantly, their safety. Patient safety will always be the top priority when providing patient care. The nurse’s responsibility during every patient encounter is to ensure that each patient under her care, receives no harm. As a direct result of the previous statement, it is crucial that every nurse knows their rights to refuse unsafe patient assignments, the process to refuse unsafe patient assignments, and the legal or ethical ramifications that could present themselves if proper judgement is not used. By understanding these rules, nurses not only achieve the responsibility of advocating for patient safety but also safeguard their careers and license.
Health Care providers must implement infection control at all times. This is essential in order to avoid any sources of contamination that would put patients at risk for infection as well as all hospital personnel. There are two important aseptic techniques: Medical Asepsis, and Surgical Asepsis. The first one includes hand hygiene, use of gloves, masks, gowns and routine
Patient safety is a primary goal for all health care workers, especially Registered Nurses who are the primary care givers for many patients. To promote safety and well-being it is important to provide the best possible care to all patients without spreading hospital acquired infections to patients that were previously free from certain diseases. Clostridium difficile infections (CDI) are a common occurrence within health care settings and can cause many complications, increasing length of stay, and could even cause death.
The hospital is compliant with infection control protocol according to the CDC standard guidelines. “Hand hygiene, contact precautions, as well as cleaning and disinfecting patient care equipment and the patient’s environment are essential strategies for preventing the spread of health care–associated infections. Hand hygiene is addressed in NPSG.07.01.01. Contact precautions for patients with
Patients have observed several physicians and nurses not washing their hands before interacting with patients. Hand hygiene is one of the largest tactics to combat nosocomial infections. The hospital should adopt a culture of 100% compliance with hand washing. The first step would be to increase handwashing stations and have more quick-dry alcohol-based antibacterial soap dispensers. Making access easier and decreasing the time taken to wash one’s hands would encourage adherence the policy. Furthermore, each floor should track hand washing and report data of potential nosocomial infections caused by improper handwashing. Keeping patients protected from bacteria is important especially when most are in an immunocompromised
Prevention strategies of nosocomial infections related to poor hand hygiene include revision of: orientation, training processes, competency assessments, equipment cleaning, handwashing procedures, switching to the use of single-use IV flush vials, adding strategically located waterless hand rubs, defining supervisory expectations, conducting in-services, team trainings, and tracking systems (Infection control related sentinel events, 2003). Potential solutions to noncompliance include: consistent skin protectant application, reduced time required for handwashing, and antiseptic stations at the bedside and room entry points (Boyce, 1999). Hospital administrators must create an organizational atmosphere in which adherence to recommended HH practices are considered an integral part of providing high-quality care (Boyce, 1999). Improvement in infection control
In furtherance of our patient safety culture at Baycare Health System, our management team and the physician's group have embarked on numerous approach to solidify the patient's safety culture at our organization. These approaches include the initiation of the patient safety portal, the implementation of the Computerized Physician Order Entry (CPOE) system, and the implementation of the Clinical Decision Support System (CDSS)/ Evidence Based Medicine (EBM).
In health care settings across the country patient care is compromised by various preventable mistakes. Health care workers (HCW) are continuously pushing the boundaries of time constraints. As these demands are increased the possibility for poor patient outcomes also increase. Prevention is the first line of defense and promotes healthy practices for HCW and patients. The Joint Commission (TJC) collects data pertaining to the incidences, information surrounding each case and establishes a national quality and safety standard. TJC accredits thousands of health care establishments with the goal to provide safety and increase the quality of care provided in each setting. In 2016 TJC released a new set of National Patient Safety Goals (NPSG). The goals are meant to bring awareness to the accredited facilities and HCW of concerning hazards that need to be focused on. For instance, using two identifiers when identifying a patient to prevent medical errors, and preforming hand hygiene to reduce the risk of infections.
There are multiple reasons that play into patients acquiring these infections. One of those reasons being the characteristics of the patients. For example infants, the elderly, people with compromised immune systems, and patients that have devices inserted for therapeutic purposes are all at greater risk to contract an infection (Feasey & Molyneux, 2011). The devices that are inserted for therapeutic purposes are a huge factor related to hospital acquired infections. Urinary catheters are the top device to cause an infection; in fact 97% of urinary tract infections are due to catheterization. 87% of people that obtain a bloodstream infection receive the infection from a central line. Lastly 83% of pneumonia acquired in the hospital is linked to the use of mechanical ventilation (Chang et al., 2011). Then there is the health care worker side that plays into effect. One of the number one reasons an infection is created or spread is because a health care worker did not properly wash his or her hands or their patient’s hands. This seems like an obvious way to prevent an infection but yet it still remains one of the top factors that leads to a hospital acquired infection. Hand hygiene is not the only hygienic issue. Health care workers do not always follow proper personal protective equipment guidelines. They may not always don gloves when
Every day while caring for patients, dedicated health care workers all over the world face potential risks of exposure to infectious disease bacteria or bloodborne viruses due to unintentional punctures with needlesticks or sharps, or accidental contact with bodily secretions, excretions and contaminated items (Wilburn, 2004). The occurrence of undesirable complications can arise from medical errors when safety guideline and control mechanisms are not followed. On occasion healthcare workers may accidentally acquire infections due to the misuse or improper fit of personal protective equipment (PPE) and coverings while attending to individuals seeking out medical attention that may be unexpectedly and unknowingly carrying a communicable disease
Protective clothing does not have to be worn at all times within the facility as there is a chance that instead of preventing the infection they could also carry around the healthcare associated infections if it is worn when it is not necessary. Before any member of the healthcare team decides to wear any kind of protective clothing it is important that they assess the risk of the transmission of the infection to themselves and the patient. Protective clothing must be worn at all times when there are bodily fluids, blood, secretions or excretions from the patient as this will prevent any