Risk Management : An Organization

The main objective of Beaumont Hospital is to provide high quality, efficient, accessible services, in a caring environment for Southeastern Michigan residents. Beaumont Hospital believes that patient safety is just as important as medical progression. Therefore, Beaumont Hospital’s risk management program consists of identifying hazard associated risks, controlling risks, and monitoring the effectiveness of procedures/practices. Risk is a part of patient care and services because everything doesn’t always go according to plan. Catastrophic patient injuries often occur because of unanticipated failures. The risk management team is responsible of effective surveillance, analysis, and prevention of events which may injure patients, lead to malpractice claims, or cause loss to the health care system. The risk management staff at Beaumont use the Failure Mode and Effects Analysis (FMEA) as a tool to anticipate what might go wrong with a process or product and how that failure effects the patient. FMEA is designed to dissect a particular process into its individual steps, isolate the potential steps that could cause the problem, assign a specific risk level to each abnormal step, analyze the risk potential for the process, and assign and action plan to correct the problem (Fibuch & Ahmed, 2014). The risk management team also evaluates and modifies potential problems. Beaumont Hospital’s risk management team helps avoid or eliminate risks by identifying an alternate

There is much evidence-based precautions currently being practiced in prevention of CAUTI, so why does it still occur so frequently? You mentioned Thomas Jefferson University Hospital applies strict protocols in prevention on CAUTI. While their facility’s predicted infection rates were lower than the national average in the past few years, there was still an increase of incidence between the years of 2013 and 2014 (Thomas Jefferson University Hospital, 2017). This starts to bring an interest into the topic and possibly development of a research question. A research question that might be used is does the use of sterile technique and proper hand hygiene in application and removal of a urinary catheter always decrease incidence of infection among

However, there are additional guidelines in terms of assessing the patient for prolonged catheter use. There should be frequent assessment and evaluation of the patient’s need for continued use. It is important to note that in addition to determining the patient’s need for catheterization, prior to insertion the nurse should also complete the following:

In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were followed by the staff in the effort to reduce CAUTI. The six interventions included: “communication of CAUTI data to interdisciplinary teams, a nurse-driven, physician approved protocol, problem analysis using Lean principles, daily unit-based surveillance rounds, silver alloy urinary catheters, and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling urinary catheter” (Roser, Piercy & Altpeter, 2014). The nurse-physician protocol allowed for nurses to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014). An education session was implemented by nurses using principles from the Lean system that checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that no single intervention alone could reduce the occurrence of CAUTI development. Nurses must integrate several interventions to have an effective result at lowering the rates. However, this particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline. Roser et al. (2014) emphasized that education and awareness of

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

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.

A risk assessment is an important step in protecting residents and staff as well as complying with the law. The assessment helps focus on the risks that have the potential to cause harm and in this context, from the harm of acquiring an infection. In most instances, straightforward measures can readily control risks e.g. ensuring that clean and dirty linen are segregated to prevent cross contamination. The law does not expect that all risks will be eliminated, but requires that all steps that are reasonably practicable are taken to protect residents. The risk assessment is simply a careful examination of what could cause harm to residents in the workplace, including the risk of infection so that an assessment can be made on

Infection on the individual can be a risk to residents, Increase time in recovery, increase length of stay, loss of earnings and cause potential death.

The NIH supports the topic of CAUTI by providing education on CAUTI and ways that health care providers can take an active role in decreasing the incidence of it. The NIH focuses their research on evidence-base practice, and then shares their findings to local hospitals and local communities to follow. The organization provides resources, education and guides health care workers on the current best

According to the American Nurses Association (ANA) “there are three areas to improve evidence-based clinical care to reduce the rate of CAUTI: prevention of inappropriate short-term catheter use, nurse-driven timely removal of urinary catheters, and urinary catheter care during placement” (2016). Good Samaritan has done a wonderful job with maintaining the prevention of this source of infection with the last documented CAUTI being 11/14/2015. Their current high target achievement score is 0.5 and there low target achievement is 0.451. Actual measurement for CAUTI is 0 on a year to date accountability (Graphs B and C). I find that they are following the above three areas of prevention in their patient cares and this ongoing practice is

As a hospital, quality care should be a priority for patients that are going to be treated for a sickness, or any type of procedure that is going to take place. A lot of times a patient gets an infection while they were at the hospital, on top of being treated for what they original came in for. Health facilities should be environments of healing, which they are, but they also have tons of various types of germs and infections, which grasp onto individuals that have weak immune systems/are sick. Some infections that are at hospitals are Tuberculosis, VRE, VAP, C-Diff, UTI, and MRSA. Preventive measures to stop the spread of the infections is lacking tremendously in the work and aim to provide safety for all patient’s health. The work

As a participant in a scientific inquiry to make an informed healthcare decision, I did the following in the critical care unit. Evaluated who on the unit were at risk for a CAUTI, the number of days the indwelling urinary catheter had been in place, the reason for the urinary catheter, and the last time urinary catheter care had been completed for the patient. I then completed a daily audit on the patient to verify the need for the indwelling urinary catheter and for those who no longer needed it I requested they be discontinued.

Issues related to a lack of patient safety have been going on for a lot of years now. Throughout the first decade of the 21st century, there has been a national emphasis on cultivating patient safety. Patient safety is a global issue, that touches countries at all levels of expansion and is one of the nation's most determined health care tests. According to the Institute of Medicine (1999), they have measured that as many as 48,000 to 88,000 people are dying in U.S. hospitals each year as the result of lapses in patient safety. Estimates of the size of the problem on this are scarce particularly in developing countries; it is likely that millions of patients worldwide could suffer disabling injuries or death every year due to unsafe medical care. Risk and safety have always been uninterruptedly been significant concerns in the hospital industry. Patient safety is a very much important part of our health care system and it really

Outcome 4 Understand the importance of risk assessment in relation to the prevention and control of infections