Quality Improvement Proposal

The nurse is challenged with the care of patients over a lifespan. Each stage of life brings its own physical and emotional changes which directs the care needs. The care needs of the pediatric patient will be much different from the needs of the geriatric population. The geriatric population has very specific needs which has prompted the government to establish the Quality Assurance & Performance Improvement (QAPI) program. The QAPI provides the framework for nursing facilities to develop and implement changes which address deficiencies the facility was found to have. Also, the QAPI program requires practices and policy be put in place to monitor care of the residents. The purpose of this paper is to list some of the changes the elderly go through as they age, and demonstrate these changes in a quality improvement project. After review of literature, I will discuss the challenges, barriers, and solutions as related to quality improvement. Lastly, I will discuss the quality of care for the geriatric in the future.

As a leader in health care, it is important that employees have the proper education and training for compliance with infection control. An infection control practitioner should be assigned surveillance of infections, calculate infection rates, and report these numbers to the appropriate personnel. Clinical nurses, such as nurses, should have periodic evaluations to ensure they are practicing patient safety. There are many other key factors that should be implemented in health care facilities to improve infection control. First is hand hygiene; there could be random observers periodically monitoring a certain floor or department for hand sanitation practices. Secondly, is the health care environment. This includes, making sure employees are sanitizing surfaces and equipment, educating visitors and families on infection control measures, and properly using personal protective equipment. Improper use, wear, and removal of personal protective equipment can cause serious health consequences to the worker and the patients, which means employees need be continuously trained and educated on this equipment.

Atul Gawande explains the single biggest problem facing hospitals in the spread of infection in his novel, Better. This is expressed in his conversation with the infection control team, where it is said that “their greatest difficulty is getting clinicians like me to do the one thing that consistently halts the spread of infection: wash our hands. (Gawande, 2007, 14)” He notes that diligence, one of his three core requirements for success in medicine, plays a huge role in enforcing a policy like handwashing. While everyone knows hand washing is important, especially in a hospital, letting health care professionals ignore the practice and make their own decisions about its criticality harms the whole population.

Propose how would you minimise the occurrence of hospital acquired infection and monitor degree of success of these measures.

Amidst the futile clamor and commotion of national healthcare reform legislation debated on the national political stage, everyone in the medical industry from patients to doctors alike are searching for ways to effectively and efficiently trim the cost of delivering quality healthcare. While the inexcusable waste and graft of the insurance industry, runaway medical malpractice litigation and the importance of lifelong preventative care are all issues that have been thrust to the forefront of the political discourse, a tremendous leak in the system has escaped notice and continues to drain resources from both hospitals and those they treat. The threat of additional infections afflicting a patient who requires treatment for an original condition is prevalent throughout American hospitals, and according to the U.S. Department of Health and Human Services "Healthcare-associated infections (HAIs)" or "infections that patients acquire while receiving treatment for medical or surgical conditions "¦ occur in all settings of care, including hospital acute care units and same day surgical centers, ambulatory outpatient care clinics, and long-term care facilities, such as nursing homes and rehabilitation centers" (HHS Action Plan, 2011). Whether one attempts to gauge the overall price of healthcare-associated infections in terms of the financial expenditure, the human suffering or the diversion of valuable resources they impose on the healthcare system, it is quite clear that these

Limited compliance with infection control recommendations and suboptimal care of indwelling devices are possible under the pressure of high workload. Hand hygiene compliance of ICU nurses was found to be inversely related with the number of their activities, while daily proportion of infected patients was significantly correlated with nurse : patient ratio of 2, 3 and 4 days prior.

Hospital acquired infections are one of the most common complications of care in the hospital setting. Hospital acquired infections are infections that patients acquired during the stay in the hospital. These infections can cause an increase number of days the patients stay in the hospital. Hospital acquired infections makes the patients worse or even causes death. “In the USA alone, hospital acquired infections cause about 1.7 million infections and 99,000 deaths per year”(secondary).

Seung, you are right. Some of the doctors assess patient and toughed them without even wearing gloves, or using hand sanitizer. I have seen a doctor toughing patient’s dialysis access site that was infected without gloves and after he finished assessing the patient, he just use hand sanitizer and continue with other patient. Another doctor was checking patient PT/INR with strip and used bare hand to wipe the initial drop of blood with gauze until it gets soaked and she used another. Do you want to tell me that those doctors do not know infection control protocol. When we talks about infection control protocol, nurses need to advocate and educate people on it including the patient, the family’s member and other healthcare personnel. Everybody

Similar to all other wards, infection control in Orthopaedic wards is difficult to keep abreast of up-to-date issues and best practices. Besides, HCAIs are still a great issue to date. A number of factors exist which can increase the risk of HCAIs and antimicrobial resistance to both patients and staff alike (Tsai & Caterson, 2014). Collins, (2008) proclaimed that these risk factors are generally categorized into three areas; iatrogenic, organizational or patient related.

After the interview with my nurse manager, I came up with the PICO question which states: “Does the computerized physician order entry (CPOE) system reduce the number of medication errors compared to the common paper system being used today?” This question is important and I selected it because the population that the Belvoir Community hospital serves includes army officers of all ages both active and retired including their spouses and children. This group includes two sub groups of highly vulnerable persons which include the very young and the very old, who have a high-risk effect for medication errors because the potential adverse drug event is three times greater than an adult hospitalized patient (Levine et al., 2001). CPOE is not a panacea, but it does represent an effective tool for bringing real-time, evidence-based decision support to physicians. Nurses are the last defense level of protection against medication errors, and are solely responsible for the dispensing, administering, and monitoring of medications. In healthcare, computers can be used to help facilitate clear and accurate communication between health care professionals. When using a CPOE system it allows physicians to type in prescriptions right into the device or computer which significantly lessens any mistakes that can occur when

The prevalence of hospital acquired infections (HAIs) has been on a constant level despite the efforts placed in minimizing these infections within clinical settings. The use of high technology, coupled with insistence of healthcare students curricula that focuses on patient safety and in priority the minimization of HAIs have not all achieved the ambitious struggle to avert these rates (DoH., 2003). The costs incurred by hospital settings as well as patients and their families in treating HAIs is tremendously high while they could have been essentially preventable if all measures were observed in the clinical process of care delivery. With the modified Medicare and Medicaid withdrawal of reimbursements for costs incurred in treating HAIs,

BRIEF ABSTRACT: Generally patients come to the hospital to recieve treatement and care, however over the years Hospital Acquired Infections has been a burden to patients and can have devastating effect on that which can potentially be fatal to the patient as well as costly for the hospital. Through continued education for hospital staff, patients as well as family members; promoting

Millions of people go into hospitals each day whether it's to receive a surgery or they just go in because they are sick. When people go into hospitals they do not realize that they are taking a huge risk by going in. There have been enough people that have claimed to have gotten very sick because of an infection after getting out of the hospital. This has been brought up as an issue and hospitals are trying to improve this is. There are several reasons why people get infections weeks after leaving hospitals and these reasons may be; that the patient was not given the correct antibiotics, they could have caught an infection from another patient in the hospital simply because they did not get the vaccinations that prevented them from getting that particular infection, they could have gotten sick from a nurse or doctor that came in contact with them but they were not bacteria free.

Patient placement should be a key area of focus in disease management. Hospitals should develop strict policies for patient access and ensure that they establish procedures to ensure compliance with the laid down policies. Also, the use of dedicated equipment is encouraged in such cases, and where such equipment are unavailable, cleaning and disinfection procedures for the equipment used on patients should adhere to the highest standards established by manufacturers and the hospital guidelines. Hand hygiene should also be practiced on a consistent basis across all levels of workers who come in contact with patients and supplies should be adequately provided by the hospital.

Infectious diseases can be a threat to the success of a hospital in managing the challenges that face its patients. As hospitals across the country invest in research and development to develop effective strategies to manage the diseases, some stubborn conditions pose serious challenges among patients. As a result, hospitals tend to face challenges in controlling certain infectious conditions that face patients that present to such hospitals. Infectious diseases in that respect are the conditions caused by microbes such as bacteria, parasites, fungi, or viruses. It is notable that most organisms tend to be harmless and they reside within the patients’ bodies. Occasionally, such organisms can cause