Prospective Auditing Case Study: How Nurses Turned The MRSA Outbreak

Providing the best care to each patient starts with providing the proper amount of staff members to each unit. Looking at the needs of different units not only allows administration to see areas for improvement, but also areas that are being handled correctly. Utilizing the indicators provided by The Joint Commission, 4 East, a pediatric medical/surgical floor, has a high rate of falls and nosocomial pressure ulcers that appears to be related to the increase overtime nurses have been working for that floor (Nightingale, 2010). Research has shown increases in adverse events have been related to nurses working over 40 hours a week (Bae, 2012).

Managers also inform Specialist personnel who include the Health and Safety Executive, the Department of Health and the Infection Control Doctor. The Specialist personnel such as The Infection Control Team, then inform the media if the case is in the public’s interest for example if it was a case of HIV, Swine Flu or measles. The Non-Care staff, such as a Domestic Assistant, needs to report anything they have seen or heard during work to the nurses.

Where I work the CNAs are the ones that closely care for the patients on daily basis, for this reason it is critical for them to be able to detect subtle changes and report them to the managers. I believe that educating staff on how to detect a change in a patient’s condition can be very challenging, especially considering the complexity of each individual’s illnesses and the fact that there is not always a continuity of staff. Also, new staff may not be fully aware of the individual’s behaviors and misinterpret them as normal. I am fortunate to work for a facility that provides training and tools like the Stop and Watch and SBAR. Interact provides tools and resources that are all examples of current evidence based practice known to improve the safety and quality of patient care (Ouslander et al.,

The nurses noted unsafe and illegal practice by Dr. Arafiles and reported it to the medical board after the hospital board failed to investigate the concerns that had previously been reported by two staff physicians. The reporting of Dr. Arafiles was done by Mitchell and Galle with the intent to prevent additional patient harm by Dr. Arafiles.

The research directed by Stalpers, DeBrouwer, Kaljouw, and Schuurmans (2015) explains their aim was wanting to accumulate knowledge in addition to previous studies referring to the outcome measures such as mortality, length of stay, and healthcare associated infections. To systematically review the literature and establish an overview of associations between characteristics of the nurse work environment (nurse staffing ratios and nurse-physician collaboration).

For many years, undocumented families have worried about getting deported, their kids not being able to have a higher education or not being able to have jobs. It soon all changed when President Barack Obama, our 44th president, created a program named “Deferred Action for Childhood Arrivals (DACA).”

As a result of this project, I have made an audit tool for myself as nursing supervisor to complete every two weeks. I will check the EMR to make sure the medication list was reviewed accurately and I will check to make sure the patient education tool added to the resources is being given to all patients. “Improvements in patient safety in the clinic setting require physicians, nurses, and administrators to commit to identifying structural and process changes that make it easier to provide consistently safer care” (Schauberger, & Larson, 2006, p. 421).

Fakih and Jones (2013) really bring home the fact that once you communicate to your colleagues that infection reduction is an organizational priority, the first step to reduce CAUTIs is to implement a Comprehensive Unit-based Safety Program (CUSP) developed by Johns Hopkins Medicine Armstrong Institute for Patient Safety and Quality. This starts with senior leadership commitment, then involves physicians, nurse leaders,

A significant quality improvement issue that has been implemented triggering one to reevaluate how their tasks are performed and care is given is a sentinel event. The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) describes numerous patient safety measures with a sentinel event being one. The purpose of a sentinel event is to recognize an event, reduce further risk, prevent future injury or harm, learn from the experience, and prevent it from happening again. A sentinel even is defined as an unforeseen incidence that may include serious physical, psychological injury or death and can include loss of limb or function (www.jointcommision.org). Implementing sentinel events by educating staff on what a sentinel event

The American Nurses Association defines accountability as “to be answerable to oneself and others for one’s own actions.” Accountability is part of nursing and it is important for the nurses to recognize the importance of being accountable (Battie & Steelman, 2014).

Moreover, it is their duty to make sure that risk assessments are done and standard prophylactic measures are being implemented. Every nurse is encouraged to document and report any delay or substandard delivery of care. On the other hand, the QRS is a one-week review, which takes place every three years in preparation for announced Joint Commission visits. The purpose of the QRS is to evaluate the hospital’s policies, processes, and structures, and the employees’ performances. Thus, staff nurses are expected to fulfill their competencies, strictly comply with hospital policies, and participate in unit- and hospital-wide QI projects. Some of the ongoing projects in the hospital are reducing Catheter Acquired Urinary Tract Infections (CAUTI), Zero Falls, and Line

For example, a hospital-wide policy can be made making it mandatory for all critical results to be documented and reported within the hour. Attestations can be put in place for all hospital staff to sign, holding them responsible if policies are not followed. Another suggestion would be to have all critical results reported to two sources, for example the patient’s nurse and charge nurse, to increase the likelihood of rapid documentation. The point of the corrective actions is to ensure that each staff member knows what they are responsible for. For example, laboratory staff knows to document the critical values and alert the appropriate nurse or charge nurse, the nurse or charge nurse knows to document the critical lab values or test result and to alert the ordering physician, the ordering physician knows to discuss a treatment plan with the patient and to document appropriately in the chart, etc. The point is, every staff member has a role to play in assisting the hospital in becoming one hundred percent compliant. This corrective action plan holds each staff member accountable. Those who do not comply can easily be tracked and disciplined by their supervisor.

The inspection visit at Forth Valley Royal Hospital was unannounced and lasted a total of two days (NHS News, 2015). HEI is a vital component of Healthcare Improvement Scotland, which is a public health organisation dedicated to improving the NHS quality of Scottish healthcare (NHS News, 2015). Their primary focus is assessing the standard of patient care through a well-defined framework. By ensuring proper care within a safe and clean environment, HEI can provide public assurance and protection (HEI, 2015). This allows the Scottish community to maintain trust and confidence when affiliating with NHS members under a health center or hospital setting (HEI, 2015). HEI also aids in reducing the risk of healthcare related infections, through a rigorous assessment protocol (NHS News, 2015). The necessity of this procedure is vital as it evaluates the ability of healthcare workers to handle infection control between patients, staff, and themselves. The capacity in which they prevent the spread of infections is reflected upon their KSF management of the third core dimension. To uphold health, safety, and security, healthcare workers are expected to have a continuous working knowledge and practice of infection control policies (Barraclough, 2010). Standard infection control policies include an

The topic in education that I am interested in exploring is “The impact that the ESE (EBD) label have on the school to prison pipeline involving black male students?” During my years of providing instruction to students with severe emotional/behavioral disabilities I have seen at least eighty percent of the students in the program end up in jail or prison. Things that I need to take into consideration as I explore this topic is that fact that most of the students that have the label come with baggage. I hope to learn and explore the dynamic of the household, socio economic status, educational level of completion, pregnancy evaluation, as well as mentally compacity of biological parents. I believe the topic is worthy of studying so that

Many of the world’s largest companies own land and have ties with endless communities, so corporations are the forefront of social and economic change that will determine if our society can become sustainable. Since multinational business run the world, sustainability within business is a way to initiate major change in terms of our society’s opinion and commitment to sustainability. As Richard T. Watson states in his book Information Systems, “organizations are the major force for innovation in most societies, and corporations in particular are major change agents” (Boudreau). This statement supports the theory that a company’s decisions within itself can and will determine the societies in which it is located. Some corporations are taking major steps towards becoming sustainable within themselves, therefore starting the change within our whole society. Understanding that corporations strongly determine our economy which is heavily correlated with our society makes it clear that businesses must be sustainable if we ever want our culture to be sustainable.