The IPAC Program Flashcards
1
Q
define a toxoid
A
a modified bacterial toxin capable of stimulating antitoxin formation
2
Q
True or false. Passive immunization is effective, but protection is generally limited and diminishes over time (usually a few weeks or months)
A
true
3
Q
what is an immunoglubonulin
A
sterile solution containing antibodies from human blood
4
Q
what is an antitoxin
A
a solution of antibodies derived from the serum of animals immunized with specific antigens
5
Q
true or false. immunization is a broader term that encompasses the use of any immunobiologic to prevent infectious diseases by inducing immunity
A
true
6
Q
what are some whole-cell inactivated vaccines?
A
polio
HAV
rabies
7
Q
what are some inactive recombinant vaccines?
A
HBV and HPV
8
Q
Vaccines can be described as monovalent (a single strain or type of organism), trivalent (three types or strains of a single organism or three different organisms), quadrivalent (four influenza strains), or polyvalent (multiple strains or types
A
true
9
Q
what are some potential vaccine allergens?
A
-stabilizers
-preservatives
-animal proteins
-antibiotics
10
Q
the only vaccine virus that has been isolated in breast milk is
A
rubella
11
Q
what is a precaution
A
a condition in a potential vaccine recipient that may increase risk of a serious adverse event or comprimise the ability of the vaccine to produce immunity.
12
Q
what are some examples of precautions?
A
-moderate or severe acute illness with or without fever
-pregnancy
-previous history of guillian-barre syndrome
-immunosupression
-receipt of an antibody-containing product within a certain time period of vaccination
13
Q
in who should live vaccines be avoided?
A
malignancy, symptomatic HIV infection, treatment-induced immune suppression, and similar conditions
exception: MMR in asymptomatic HIV patients
14
Q
true or false. Inactivated vaccines are not problematic in immunocompetent persons
A
true
15
Q
true or false. patients with a mild acute illnesses accompanied by a low-grade fever and recent exposure to an infectious disease are not contraindicated for immunization if they are otherwise healthy
A
true
16
Q
who is the dengue fever vaccine recommended for?
A
anyone ages 9-16 who has had the disease and lives in an endemic area. Not for travelers. Do not vaccinate anyone who has not had dengue as it puts them at risk for severe disease. the second infection poses the highest risk of severe disease
17
Q
describe vaccine recommendations for Hib (haemophilus Influenza B)
A
-infants starting at 2 months should get a 2-3 dose monovalent series. booster dose at 12-15 months. not recommended above age 59. Can cause immunobiologic intolerance if administered at under 6 weeks old
18
Q
who is HAV vaccine recommended for?
A
adults with chronic liver disease, MSM, international travellers, drug users
not licensed as post exposure prophylaxis
19
Q
is history of GBS a conctraindication for HBV vaccination?
A
No
20
Q
at what age is HPV vaccine given?
A
females ages 11-12. As young as 9 if victims of sexual assault. catch up vaccination recommended up until age 26. no maximum interval between doses. Infection generally occurs after first sexual experience.
21
Q
who should get the rotavirus vaccine?
A
infants. there are 2 live oral vaccines. max age to be given is 14 weeks 6 days. 4 weeks between doses
22
Q
why are standing orders good?
A
improve rate of vaccination
23
Q
what 3 areas must HCP be trained in to give vaccines under a standing order?
A
-administering vaccine
-contraindications
-adverse events
24
Q
who is meningitis vaccine recommended for?
A
any aged up to 55 years. HCP that may be exposed. Two doses of under 16 and one if above.
25
differentiate between goals and objectives
Goals are desirable outcomes that are clearly but broadly stated (for example, improved patient care);
Objectives are well-defined, measurable actions that help forward IPCP goals (for example, preventing the spread of a particular infection, limiting the impact of an ongoing pandemic or outbreak, or increasing hand hygiene [HH] compliance among staff)
26
what are some quality improvement and patient safety activities that have arisen from goals and objectives to lessen HAIs
value-based purchasing
evidence-based best practices
technology use
safety culture implementation
and public data reporting
27
what are the 3 principle goals of the IPAC program?
1. protect the patient
2. protect HCP, visitors, and all other in the healthcare environment
3. cost effectively meet those two goals wherever possible
28
what are SMART goals
specific
attainable
measurable
relevant
time bound
29
what are some IPCP requirements?
-a documented IPCP
-at least one trained IP
-ASP
-QAPI program
30
a risk assessment typically uses what scale of ranking?
ordinal
31
a risk assessment helps direct resources
to areas of greatest need (greatest time and money impact)
32
The aim is for HAI rates to be
0
33
is an IPC committee required by TJC
no but some nations/regions may require and specify who must be on the team
34
define organizational culture
the set of values, guiding beliefs, or ways of thinking that are shared among members of an organization. It is the “feel” of an organization that is quickly picked up on by new members. Culture is, in short, “the way we do things around here.”
most felt when you do somethiing new
35
what are some risk and incident reporting terms?
-adverse event: negative impact on patient safety (drug error, HAI)
-sentinel event: “patient safety events resulting in death, permanent harm, or severe temporary harm.” Note that not all adverse events are considered sentinel events.
-near miss: “events in which the unwanted consequences were prevented because there was a recovery by planned or unplanned identification and correction of the failure.”
36
efective reporting programs should
-be voluntary and confiential
-include standard definitions
-include all populations
-dedicate sufficien HCP for tasks
-provide statistically appropriate sample size
-disseminate data
-monitor rates
37
what is one key component to establishing a culture of safety
avoiding a punitive
38
true or false. Traditional culture reacts to harm after it occurs. A safety culture tries to anticipate accidents and errors and to be proactive in identifying risks before they result in harm.
TRUE
39
define reciprocal accountability
everyone holds each other accountable for patient safety
40
what are examples of designing in safety to account for the human factor?
Human factors engineering (HFE) is the design of safe, comfortable, and effective tools, machines, and systems that account for human capabilities and limitations, intended to reduce the need for excessive physical exertion, and decrease physical constraints and workload.
Human factors analysis studies the human-machine interface with the intent of improving working conditions or operations.
Ergonomics helps design tasks, jobs, information, tools, equipment, facilities, and the working environment so that people can be safe, effective, productive, and comfortable. In the highly complex healthcare environment, understanding how humans interface with technology and equipment and mindfulness about failure points is crucial to understanding and preventing errors.
Reliability science helps achieve “failure-free” operation over time.
Resiliency helps a system to adjust and sustain operations during periods of stress or after an event.
41
what is an example of designing for human factors?
AP signage and PPE donning and doffing with numbered steps
42
what are the 3 error types?
skill based
rule based
knowledge based
43
differentiate between a slip and a lapse
A slip is an external failure in a plan due to reduced intentionality. A lapse is an internal failure occurring from failures of memory and memory storage.
44
describe a skill based error
An inadvertent mistake when conducting a routine or automatic task, due to distraction (e.g., forgetting to stop an insulin infusion after stopping tube feeding; or incorrectly connecting a feeding tube to an intravenous port)
45
describe a rule based erro
Rule-based mistakes occur when a rule or procedure is remembered or applied incorrectly (e.g., injecting a medication into the wrong site). When a contraindication is not recognized, an individual may misapply a seemingly good rule. Past experiences, training, or misunderstanding can result in the development and execution of bad or misapplied rules
46
describe a knowledge based erro
mistake resulting from incorrect or incomplete knowledge (e.g., administering penicillin to a patient without checking if they are allergic). Confirmation bias is common, and knowledge-based decision-making is highly prone to error. Typically, these errors occur when an individual is confronted by a new situation without all relevant information
47
define goals
statements that communicate the intent of the curriculum and provide a direction for planning the education session. Expectations should be clearly defined in terms of time and available resources
48
define facts
facts or information acquired by a person through experience or education; the theoretical or practical understanding of a subject
49
define skills
the ability to do something well; expertise.”
50
define knowledge
familiarity with factual information and theoretical concepts; while skills are the practical application of that knowledge
51
what are hard and soft skills?
hard are technical and soft are social skills
52
define competency
worker skills, knowledge, and the mindset necessary to achieve effective job performance
53
actions, which the learner should b able to perform after the educational session, are also known as what?
instructional objectives
54
properly written instructional objectives describe
learner outcomes in measurable terms and use action verbs such as discuss, describe, demonstrate, compare, or evaluate.
55
learning outcomes for HCP should increase competence in
Identifying problems.
Critical thinking.
Managing existing situations.
Coping effectively with stress.
56
Bloom's work identified what 3 domains of learning?
cognitive (mental skills)
affective (emtional or feelings)
psychomotor (manual or physical skills)
57
describe the levels of Bloom's taxonomy
Remembering. Can the learner recall or remember the information?
Understanding. Can the learner explain ideas or concepts?
Applying. Can the learner use the information in a new way?
Analyzing. Can the learner distinguish between the different parts?
Evaluating. Can the learner justify taking a stand or making a decision?
Creating. Can the learner create a new product or a new point of view?
58
what are some characteristics of adult learners?
They are autonomous.
They are self-directed.
They have a foundation of life experiences and knowledge.
They are goal-oriented.
They are relevancy-oriented (e.g., what is practical in healthcare settings).
They need to be treated with respect.
59
What are some components of Knowle's adult learning framework?
learners feel the need to learn
The learning environment is characterized by physical comfort; mutual respect, trust, and helpfulness; freedom of expression; and acceptance of differences
Learners see the goals of the learning experience as their goals
Learners accept a share of the responsibility for planning and operating the learning experience
Learners participate actively in the learning process
The learning process is related to and makes use of the experience of the learners
Learners have a sense of progress toward their goals
60
describe the 60/40 rule
learning should be 60% active and 40% passive
61
what are some methods to determine the needs of the learner population?
Learner self-assessment. The learner develops a self-achievement model and compares the present situation to the accepted standard.
Focus-group discussion. Learning needs are assessed in small groups, with members assisting each other to clarify needs.
Interest-finder surveys. These are data-gathering tools, such as checklists or questionnaires.
Test development. Tests can be used as diagnostic tools to identify areas of learning deficiencies.
Personal interviews. The educator consults with random or selected individuals to determine learning needs.
Job analysis and performance reviews. These methods provide specific, precise information about work and performance.
Observational studies. Direct observation of HCP working can be performed by quality management analysts or IPs (e.g., HH study).
Review of internal reports. Incident reports, occupational injury and illness reports, and performance improvement studies can be reviewed to determine the specific learning needs of healthcare providers.
62
Describe Grasha's teaching styles
Expert. IPs use their vast knowledge base to inform learners and challenge them to be well prepared. This can be intimidating to the learner.
Formal authority. This style puts the IP in control of the learners’ knowledge acquisition. The IP is not concerned with learner-educator relationships but rather focuses on the content to be delivered.
Demonstrator or personal model. The IP coaches, demonstrates, and encourages a more active learning style.
Facilitator. Learner-centered, active learning strategies are encouraged. The accountability for learning is placed on the learner.
Delegator. The IP role is that of a consultant, and the learners are encouraged to direct the entire learning project.
63
define competencies
describe worker skills, knowledge, and the mindset necessary to achieve effective job performance
64
what are the 7 domains of ongoing IPC education
-IPC informatics
-IPC oeprations
-quality improvment
-stewardship
-research
-leadership
65
hawthorne effect
practice improves when subjects are being watched
66
what is the difference between formative and summative evaluation?
formative evaluation is a training evaluation conducted during the planning of the educational session to provide immediate feedback and to allow appropriate changes to be made. Summative evaluation is a training evaluation that occurs after the program is completed to determine impact and overall effectiveness.
67
how can you measure whether a program was effective?
pre and post tests
direct observation
exit questionnaires
one on one interviews
68
what type of study would be used to examine an outbreak or cluster?
case control
69
what is a systematic review and meta analysis?
Systematic reviews identify, collect, analyze, and summarize empirical evidence related to a specific research question.
Some systematic reviews include a meta-analysis, in which statistical methods are used to integrate the results of multiple independent studies
70
descibr the introduction
presents the justification for and purpose of the research in the context of the existing problem and its relationship to other current research
71
describe materials and methods
describes the study population, inclusion criteria, and methods used to determine the sample and data analysis
72
describe results
directly address the research questions posed in the introduction. Data are presented narratively and summarized in tables and figures. Statistical analyses should include the appropriate measures of association, summary measures (such as the relative risk or odds ratio), and measures of precision
73
describe discussion
interpretation of the major findings of the study, a statement of study limitations, and suggestions for applications of the findings and future research. Ask:
Are the conclusions that are drawn reasonable and justified given the results?
Could alternative explanations account for the observed results
74
what are some implementation strategies for trnaslating evidence into practice?
Incorporate new practices. Institute a pilot program to test out newly discovered processes and practices before rolling it out across the facility (e.g., use of a new fluorescent marker to assess cleaning and disinfection practices).
Evaluation. Conduct audits and feedback sessions for any pilot programs or other process tests in order to discover whether the new practices are appropriate or whether they need to be tailored to the facility and staff’s existing processes and responsibilities.
Education. As with many aspects of IPC, incorporating new findings into staff education and training programs is a strong strategy for disseminating evidence-based information to those who are in a position to put it into practice.
75
Describe the Armstrong model (4 steps for translating evidence into pratice)
Summarize the evidence:
Summary can be constructed in the form of a checklist.
Identify interventions associated with improved outcomes.
Prioritize those with the greatest potential benefit and fewest barriers.
Design changes to procedures and behaviors, and the put them in place.
Identify local barriers to implementation:
Observe HCP performing interventions.
Engage all stakeholders in order to collect concerns and observations.
Identify gaps and potential gains or losses from implementing changes.
Potential barriers include: competing priorities (at unit, hospital, or possibly regional or state level), lack of leadership support, burden of data collection, challenges with sustainability.
Measure performance:
Select process or outcome measures.
Develop test measures; launch pilot tests.
Measure baseline performance.
Ensure that all patients get the evidence (the “Four Es”):
Engage: Explain to all stakeholders why the proposed interventions are important.
Educate: Share all supporting evidence with stakeholders. Provide ongoing education for stakeholders as new information and performance data becomes available.
Execute: Design a toolkit for the intervention, which will monitor barriers, standardization, checks, and notes to facilitate additional learning and training.
Evaluate: Conduct regular assessments of the intervention to identify additional performance measures and unintended consequences. Update training and education materials as a result if necessary.
76
What are two of TJC National Patient Safety Goals (NPSGs) for IPC program
-HH compliance
-managing cases of death or injury because of a HAI
77
define a breach of duty
a deviation from the recognized standard of care
78
what are 3 surveillance approaches for assessing hand hygiene?
1. direct observation
2. product volume monitoring
3. automated
79
When are PAPRs used?
PAPRs provide a higher assigned protection factor than N95s and other respirators, and they can be used during healthcare procedures in which HCP are exposed to greater risks of aerosolized pathogens
80
When a single-patient room is not available, patient spacing should be maintained at a minimum of
3 feet or more
81
what are some elements of respiratory hygiene?
Education of HCP, patients, and visitors on the signs and symptoms of respiratory illnesses.
Signage posted at entries in the languages of the local population.
Easy access to source control measures (tissues, surgical masks) and HH supplies, including at entrances to and in waiting rooms.
Encourage patients or visitors with respiratory symptoms to sit apart—at least three feet—from other people in the waiting room; or better still, place them in a separate area when feasible. (Patients exhibiting respiratory signs and symptoms will often be provided with a mask while they wait to receive care.)
82
what are the 4 main TBP?
1. contact
2. droplet
3. airborne
4. EBP
83
why do you want to avoid preopeartive hair removal by hsaving?
it damages the skin
84
define a bundle
a collection of evidence-based interventions and best practices that HCP should follow to prevent and control the transmission of particular conditions or infections. It is important that all interventions included in a bundle are applied for every patient, every time
85
what are some components of a care/maintenance bundle
dressing checks, monitoring for correct use of disinfecting solutions, educational programs for nurses, updates to hospital or facility policies, provision of visual aids, competency assessments, process monitoring, publication and dissemination of regular progress reports, and careful monitoring of supplies necessary for care (availability, accessibility, and so forth)
86
approximately ____% of UTIs are associated with the use of indwelling urinary drainage devices
80%
87
how do male catheterized patients contract a UTI?
infected via the intraluminal route from a contaminated drainage bag
88
how do female catheterized patients contract a UTI?
infected from contamination by the transurethral migration of bacteria up the extraluminal surface of the catheter
89
what is the most important factor in development of bacteriuria?
duration of catheterization
90
____ percent of patients with significant bacteriuria are asymptomatic for any signs or symptoms of a UTI.
90%
91
True or false. Pyuria development in short-term catheterized patients is not indicative of infection and should not be used as a criterion for urine culture or as an indication for antimicrobial treatment
True
92
what are some appropriate reasons for using a urinary catheter?
When there is acute anatomic or functional urinary retention or bladder outlet obstruction.
To obtain an accurate measurement of urinary output in critically ill patients.
To assist in healing open sacral or perineal wounds in incontinent patients.
To improve comfort for end-of life care if needed or patient preference.
For perioperative use in select surgeries.
When strict immobilization is required for trauma or surgery
93
what are some inappropriate reasons for using a catheter?
For the convenience of nursing care.
To obtain urine for culture or other diagnostic studies when the patient is able to cooperate and voluntarily void.
For prolonged postoperative duration without appropriate indications.
94
cathtere bag shoulld be where in relation to the bladder?
below
95
what are some methods for reducing inappropriate catheter use?
-computerized order forms that require you to justify why it is needed
-nursing policies
96
VADs are available to meet the needs of both short-term (usually _____ than three weeks) and long-term (_____) infusion therapy
fewer than 3 weeks; weeks to months
97
what are the 2 major sources of VADA BSI?
(1) colonization of the VAD, or catheter-associated infection; and (2) contamination of the fluid administered through the device.
98
what are risk factors associated with developing a bsi?
age (elderly and neonates)
under or malnourished
severe chrnoic conditions
multiple invasive procedures
immunocomprimised
99
describe pneumonia
an inflammatory process of the lung parenchyma caused by a microbial agent. Microaspiration of oropharyngeal secretions is the most common route by which these microbial agents reach one or both lungs; and once having reached the lungs, the microorganisms are able to kill the defense cells and the lungs then develops a local inflammatory response, which leads to a systemic inflammatory response
100
initial treatment of pneumonia patients is usually
empiric while awaiting culture results
101
what are the 4 most common pathogens that cause CAP?
Streptococcus pneumoniae, Haemophilus influenzae, Moraxella catarrhalis, and Staphylococcus aureus
102
What are some risk factors for pneumonia with an MDRO?
Antimicrobial therapy in preceding 90 days.
Current hospitalization of five days or more.
High frequency of antibiotic resistance in the community or in the specific hospital unit.
Presence of risk factors for HCAP.
Immunosuppressive state or therapy
103
what are CAP prevention strategies?
quit smoking and vaccination
104
What are HAP, HCAP, and VAP prevention methods?
Regular oral care, with toothbrushing.
Diagnosis and management of dysphagia.
Early mobilization.
Multimodal interventions to prevent viral infections.
Compliance with prevention bundles.
Influenza and pneumococcal vaccination.
HH.
Respiratory therapy equipment maintenance.
Avoidance of endotracheal intubation (use noninvasive ventilation when possible; use orotracheal intubation unless contraindicated, since nasotracheal intubation has higher incidence of nosocomial sinusitis).
Subglottic secretion drainage.
Isolation of patients with resistant organisms.
Reduced use of nasogastric tubes.
Enteral feeding 24 to 48 hours after intubation.
Post-operative prevention, including:
Deep breathing
Moving about the bed.
Ambulating, unless medically indicated.
Incentive spirometry.
105
what are some risk factors for VAP development and related outcomes?Risk factors for VAP development:
Risk factors for VAP development:
Intubation type: emergent versus nonemergent (emergent intubation may be associated with aspiration and development of VAP).
Initial route of intubation: any endotracheal intubation is a risk factor.
Etomidate use for intubation (etomidate has immunosuppressive action).
HOB not elevated.
Suboptimal oral care.
Risk factors for poor VAP outcomes:
Patient comorbidities (including trauma, chronic obstructive pulmonary disease).
Inappropriate prior use of antibiotics.
Decreased level of consciousness.
Presences of gastric or small intestine tubes.
Enteral feedings.
106
Describe a VAP prevention bundle
Elevating the head of the bed (avoid prone positioning).
Limiting use of sedatives when possible.
Spontaneous awakening trial or sedation protocols (strategies to minimize sedation in adults).
Daily assessment of readiness to extubate.
Avoiding intubation and prevent re-intubation (whenever possible, use noninvasive ventilation—e.g., nasal oxygen).
Daily spontaneous breathing trials without sedatives.
Maintaining and improving physical conditioning by facilitating early mobilization.
Changing ventilator circuits only if they are malfunctioning or visibly soiled (per manufacturer’s IFU).
Regular oral care with toothbrush (without chlorhexidine).
Using endotracheal tubes with subglottic secretion drainage ports for long-term patients.
Considering early tracheostomy.
Providing early enteral nutrition.
Considering post-pyloric rather than gastric feeding in patients with high risk for aspiration.
107
___ colonization of associated with VAP
plaque (oral care)
108
define ventilator associated event (VAE)
a condition that results in a significant and sustained deterioration in oxygenation
not all VAEs are caused by VAP
109
How is a VAE identified?
Patient must have been mechanically ventilated for four calendar days.
Respiratory status deteriorates after a period of stability or improvement on the ventilator.
Infection (e.g., fever) or inflammation is evident.
Respiratory infection (e.g., via culture) is confirmed via laboratory evidence
110
What are some components of an action plan?
-priority/targeted objective
-straegies/plan
-evaluation method
-responsible persons
111
what is the primary way we implement and promote policies and procedures?
education
112
define quality assurance
defined as a process for achieving quality standards and meeting an acceptable level of patient care. Healthcare facilities typically use regulatory guidelines when setting quality assurance thresholds, but they may also create their own standards that exceed these minimum threshold
113
define performance improvement
an ongoing cycle that focuses on continuous improvement of patient clinical outcomes, patient satisfaction, and service. While quality assurance focuses on finding outliers (for example, noncompliant HCP) from recognized standards of care, performance improvement focuses on overall processes and systems
114
quality assurance is ____; performance improvement is _____
reactive; proactive
115
true or false. QAPI is usually a regulatory requirement
true
116
what are the 5 elements of a QAPI program?
1. design and scope the QAPI program
2. govern and lead the QAPI program
3. leverage data systems, gather feedback, and monitor the QAPI program
4. plan and execute performance improvement projects
5. perform systematic analysis and take action to put things in practice
117
what is a vision statement?
snapshot of the organizations intended future
118
what is a mission statement?
way to describe the organization’s purpose or primary goal and is used to guide decision-making and actions
119
when is a SWOT analysis used?
can be used either at the organizational level as a strategy-setting process (i.e., what services will and will not be provided or enhanced) or in an IPCP to set priorities and tailor the program to the needs of the organization and its patient population
120
describe flowcharts
Flowcharts describe the intended state of a process, procedure, or decision tree so that deviations from this standard can be determined
121
describe pareto analysisPareto analysis
Pareto analysis is used to rank potential root causes of an issue so that the team can identify where to focus on the “vital few” causes first
122
What is lean (part of DMAIC) used for
identify and eliminate waste in processes and systems
123
what are PIPs
PIPs are used to implement specific improvements in a timely fashion with a customized team after getting required approvals in a project charter
124
describe behavioral interventions and hierarchy of actions
Behavioral interventions are used when implementing changes to influence the human behavioral aspect of IPC. A hierarchy of actions is used to differentiate different types of improvements as either “weak,” “intermediate,” or “strong”; it helps guide effective change
125
define a performance measure
a quantitative tool that provides an indication of an organization’s performance in relation to a specified process or outcome. Types of performance measures include structural measures, process measures, and outcome measures
126
define a structural measure
indicates an organization’s, a medical subunit’s, or an individual clinician’s capacity to provide healthcare relative to the needs of patients. Structural measures relate to the environment of care and related administrative policies and procedures from a capacity, system, and process perspective. Structural measures also relate to the quality of physical equipment, facilities, technology (for example, electronic health records [EHRs]), and human resources
an indirect measure
127
what is a balancing measure
looks at a system from multiple angles or dimensions to avoid unintended consequences from a change in a different part of the system—for example, looking at re-intubation rates to see that they are not increasing when reducing the time a patient spends on a ventilator after surgery
128
define a clinical measure
designed to evaluate the processes or outcomes of care associated with the delivery of clinical services
example: med use, infection prevention
129
define minimum performance threshold
the level below which the process used to reach a goal needs revision or improvement
130
what are 4 criteria for good accountability measures?
research
proximity
accuracy
adverse effects
131
teamwork is a ____ process
deliberate
132
what is a project charter?
a brief document (for example, one page) that adds formality and importance to a process, sets the scope of the project, identifies a project manager and invests that person with budget and staffing authority, discusses high-level risks and assumptions, and sets budget and resource constraints. The leader or committee with budget authority needs to sign this charter to make it an official project.
133
why is the chartering process beneficial?
give team members clear objectives and a collective mission. It is also used to determine which team members are right for the project
134
define product evaluation
process of appraisal that considers the value and significance of quality, cost, safety, and practitioner choice for product selection.”
135
who are the members of a product evluation committee
executive champion
key executives
clinical leaders
136
what are some goals of product evluation
Meet specific performance criteria, including clinical and financial criteria.
Are safe for patients and HCP.
Contribute to positive patient outcomes, such as fewer infections and injuries.
Are cost-effective for both the facility and the patient
137
what does product evluation process begin with?
identification of a need
138
true or false. ordering inventory on a just-in-time basis can save on holding costs and reduce space constraints
true
139
should products be standardized wherever possible?
Yes
140
define off-label use
the application of a product for a purpose that is not included in the approved device labeling
example: reprocessing single use devices
141
describe group purchasing agreements
they create a system for coordinating product selections so that the process is streamlined and group costs are managed.
better product prices
142
differentiate between technical and adaptive work
“Technical [work] is defined as those [problems] that can be solved by the knowledge of the experts, whereas adaptive [work] requires new learning.” Technical work is easier than adaptive work.
Adaptive work represents the greater percentage of transition; it is the “how”—where the community must engage in the process, overcome resistance
143
how should IPs address behavior change?
start with behavioral objectives then move backwards to address factors that need addressing
144
describe a predisposing factor to behavior change
those that help motivate HCP to make a change (HCP will know the consequences of exposure to most common HAIs)
145
describe en enabling factor to behavior change
ability to change in terms of skills, capacity, and resources (ABHR in clinical areas)
146
describe reinforcing factors of behavior change
those that occur after the desired behavior is initiated and help determine whetehr it will continue in the future (HCP awarded when washing hands after leaving a patient room)
147
what are some common behaviroal theories?
the health belief mode
positive deviance
social cognitive theory
transtheoretical model (stage theory)
148
differentiate between weak, intermediate, and strong actions
weak- reinforce current processes, require recall, incorrect assumption that a lack of knowledge contributed to an event
intermediate- provide memory aids or communication clarification tools
strong- modify the process or environment and don't depend on memory
149
define reproducability
the evluation of whetehr findings can be repeated consistently when applied to new populations, to different institutions, or by different individuals
150
data collection methods should have a high degree of inter-reliability which means
at least two raters reviewing the same set of information would consistently classify the performance measure in the same way
i.e., 2 ICPs doing CLABSIs
151
define reliability
the ability of the indicator to accurately and consistently identify the events it was designed to identify across multiple healthcare settings
152
Describe PDSA steps
Plan: identifying ICP resposniblities, risks, resources, goals, planning on meeting needs.
Do: impleent strategies specified in the ICP plan. Surveillance, education, communication, etc.
Study: RCa or FMEA to identify failures and look at change, Data display, benchmarking, etc.
Act: eecuting strategies
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describe FMEA steps
Failure: lack of success
Mode: the way of operating or using a system or process
effects: results or consequences
analysis: examination of element or structure
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what is a flowchart?
a diagram with boxes that show process steps, questions, people, or data of interest with lines showing how they are interrelated.
Useful at showing the intended process.
