Quality Improvement Pp Flashcards
The Institute of Medicine (IOM) defines ______as “the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current and professional knowledge”
Quality
What is quality improvement
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QSEN -
Implementing
QSEN competencies are at the core of all Rasmussen Nursing Programs.
Research the QSEN competencies. What is the purpose that they were developed?
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How does QSEN define Quality Improvement?
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What part of the Nursing Process is most related to QI?
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When should a Nurse be using the principles of QI in practice?
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Statement of quality care
The Institute of Medicine (IOM) concluded that:
Quality can be defined and measured
Quality problems are serious and extensive
Current approaches to quality improvement are inadequate
There is an urgent need for rapid change
Ten Rules to Govern Health Care Reform for the 21st Century
- Care is based on a continuous healing relationship
- Care is provided based on patient needs and values
- Patient is source of control of care
- Knowledge is shared and free-flowing
- Decisions are evidence-based
- Safety as a system property
- Transparency is necessary; secrecy is harmful
- Anticipate patient needs
- Waste is continually decreased
- Cooperation between health care providers
Six Aims for Improving Quality in Health Care
Health care should be Safe Effective Patient-centered Timely Efficient Equitable
Safe: avoiding injuries to patients from the care that is intended to help them.
Effective: providing services based on scientific knowledge to all who could benefit and refraining from providing services to those not likely to benefit (avoiding underuse and overuse).
Patient-centered: providing care that is respectful of and responsive to individual patient preferences, needs, and values and ensuring that patient values guide all clinical decisions.
Timely: reducing waits and sometimes harmful delays for both those who receive and those who give care.
Efficient: avoiding waste, in particular waste of equipment, supplies, ideas, and energy.
Equitable: providing care that does not vary in quality because of personal characteristics such as gender, ethnicity, geographic location, and socioeconomic status.
Crossing the Quality Chasm Conclusions
The gaps between actual care and high-quality care could be attributed to key inter-related areas in the health care system
The growing complexity of science and technology
An increase in chronic conditions
A poorly organized delivery system of care and constraints on exploiting the revolution in information technology
Lack of access to resources across ethic groups and socioeconomic classes
This leads us to some important history
Factors Influencing Economic Climate
Economic
Regulation
Competition
Nursing labor market
SAFETY IN THE U.S. HEALTH CARE SYSTEM
discuss the history of quality and safety within the U.S. healthcare system.
Analyze historical, social, political, and economic trends affecting the nursing profession and the healthcare delivery system.
Examine factors contributing to medical errors and evidence-based methods for the prevention of medical errors.
Explain the use of technology to enhance and promote safe patient care, educate patients and consumers, evaluate healthcare delivery, and enhance the nurse’s knowledge base.
Promote the role of the nurse in the contemporary healthcare environment.
Types of Errors
Error Identification and Reporting
Developing a Culture of Safety
Organizations, Agencies, and Initiatives supporting Quality and Safety in the HC System
Government Agencies
Healthcare Provider Professional Organizations
Non-profit Organizations and Foundations
Quality Organizations
Integrating Initiatives and Evidenced-based Practices into Client Care
The Economic Climate in the Health Care System
Economic perspective
Regulation and competition
Nursing labor market
Defining and Identifying the Nursing Shortage
Factors contributing to the Nursing Analyze
historical, social, political, and economic trends affecting the nursing profession and the healthcare delivery system.
Explain the importance of quality improvement to the nurse, patient, organization, and healthcare delivery system.
Promote the role of the nurse in the contemporary healthcare environment.
Compare and contrast Quality Improvement and Quality Management
What is Continuous quality improvement (CQI)?
Continuous quality improvement (CQI) is a
process of identifying areas of concern (indicators), continuously collecting data on these indicators,
analyzing and evaluating the data, and implementing needed changes.
QM: a set of management practices throughout the organization, geared to ensure the organization consistently meets or exceeds customer requirements.
Focus Areas of To Err is Human
The IOM recommended (Box 10-3)
Enhance knowledge and leadership regarding safety
Identify and learn from errors
Set performance standards and expectations for safety
Implement safety systems within health care organizations
What is the nurse’s role in Quality Improvement?
Nurse Manager
Staff RN
LPN
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Types of Errors
Error Identification and Reporting
Developing a Culture of Safety
Organizations, Agencies, and Initiatives supporting Quality and Safety in the HC System
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What does manintaining a safe environment mean as a nurse?
Hand hygiene
Safety machine handling
Drug safety
Chemical hazards
PPE
What action should the infection control nurse take to most effectively reduce the incidence of health care-associated infections?
What are some common nosocomial infections?
C-diff
Catheter induced infections
MRSA
What does Risk Management do?
Risk Management Departments?
RM Addresses liabilities that could lead to financial losses in an organization. Assesses factors leading to such losses if they occur.
Most hospitals and health care agencies have risk management departments which are designed to handle situations that may put the facility at financial risk. These teams look at medical errors, patient falls, pressure wounds, hospital acquired infections, etc., in an attempt to do “damage control” and rectify problems. They also identify potential problems, and nurses may play a huge part in this by reporting risk.
There are behavioral changes needed for real quality improvement and for risk management. Occasionally, nurses do not report problems due to fear of punishment or job security. Short staffing, 12 hour shifts, floating to other units, etc. - all contribute to nurses’ anxiety. Making an error and failing to report it is a common, but potentially deadly, situation.
Service occurrence
Serious error
Sentinel event
in health care is a structured process in an organization which does planning for a continuous flow of improvements to provide quality health care.
Could be things already needing improvement or things in progress.
Quality Management aka Continuous Quality Improvement (CQI)
______is defined by American healthcare accreditation organization The Joint Commission (TJC) as any unanticipatedeventin a healthcare setting resulting in death or serious physical or psychological injury to a patient or patients, not related to the natural course of the patient’s illness.
Gather the care team and do a root cause analysis
Asentinel event
Be prepared to Assess, Know procedural safety guidelines & protocols, Know security plans
Of accidental and injury prevention
Discuss the following: Lifepan considerations Mobility, Cognitive or Sensory Impairments Emotional State Lifestyle Safety Awareness
How can Nurses Assist in Patient Safety and Risk Management?
https://www.youtube.com/watch?v=CAP8P8sz4gg
What can you change in this room to promote patient safety?
Equipment
Infection Control
Reporting Near-Misses
(Bed lowered time floor, call light, etc)
Nurse safety to prevent errors ?
Prevent Falls Know Restraint Policy Teach Fire & Home Safety Advocate for Community Safety Practice Ergonomics Administer Medications Safely Use Patient Identification
Organizations, Agencies, and Initiatives supporting Quality and Safety in the HC System
The Institute of Medicine, The Agency for Healthcare Research and Quality, The National Quality Forum, The Joint Commission, The Magnet Recognition Program,
The Institute for Healthcare Improvement,
and, of course, the nursing student’s friend, Quality and Safety Education for Nurses (QSEN).
Institute of Medicine (IOM) JCAHO Joint Commission Patient Care Partnership Can you find any others? Create an example of how these agencies are involved with Quality Improvement.
