National Patient Safety Goals

In the review of the literature regarding National Patient Safety Goals and the reduction of healthcare associated infections by the implementation of evidence-based practice, one article addressed the education of patients and family to prevent catheter-related bloodstream infections (Dela Cruz et al., 2012). MD Anderson Cancer Center Infusion Therapy Team places 600 central venous catheters (CVC) and PICC’s and 100 implanted ports each month at their facility (Dela Cruz et al., 2012). Volume like this has lead to an extensive formal education program to assist the patient and family with care and maintenance of their CVC to reduce the number of catheter-related bloodstream infections (Dela Cruz et al., 2012). The education program consists

Nurses’ primary goals are to promote patient safety and give the best quality of care to the patients. They also play a vital role in preventing and reducing medical errors in their work place. Nurses must be fully aware of the new recommendations and guidelines to follow in the healthcare setting. The Joint Commission established the National Patient Safety Goals (NPSGs) in 2002 (The Joint Commission, 2015). The goal of this program is to assist the health care providers with issues and concerns regarding patient safety and to help solve them. Hospital National Patient Safety Goals include: a) identify patients correctly, b) improve staff communication, c) use medicines safely, d) use alarms safely, e) prevent infection, d) identify patient safety risks, and, e) prevent mistakes in surgery (National Patient Safety Goals, 2016).

Department of Health and Human Services established an objective for Healthy People 2020 to prevent HCAIs, this reflects that the U.S. health care system is committed to and serious about solving this issue. These objectives address two extremely important topics, central line-associated bloodstream infections, and methicillin-resistant Staphylococcus aureus (MRSA) infections. Also, there are other major causes of HCAIs that Health and Human Services is working on their prevention such as urinary tract infections (UTIs) associated with catheters, infections of surgical wounds and sites, C. difficile infections, and ventilator-associated Pneumonia. Researches done on HCAIs shown that we can prevent many of these infections by implementing effective strategies to eradicate it, adapting some advanced prevention tools, and following new prevention approaches. There should be a more focus on HCAIs prevention in acute care settings.

Better (2007), by Atul Gawande begins with the story of Dr.Gawande as a surgeon in his final year in medical school. The first struck me because of the patient’s story. It was an elderly patient who nearly died from septic shock had it not been for a senior resident who checked on the patient twice each time making a life altering intervention to prevent the patient with pneumonia from going septic shock from resistant, fulminant pneumonia. Dr.Gawande discusses the importance of handwashing. In my own practice, this is something that I can incorporate in my own practice.

An example includes respecting the decision when a patient refused to take lactulose because it made him have frequent bowel movements. In EPIC, we would chart patient refused the medicine resulting in providing patient-centered care. For quality improvement, the unit has data on how many infections have occurred with central lines and utilize benchmarks and evidence-based practice guidelines to prevent infections. For instance, I had to perform proper hand washing and scrub the hub for at least 30 seconds with alcohol pads to prevent infections in patients who have intravenous lines.

Through the learning from week 1 and week 2, I have learnt that the most frequent adverse event in health-care delivery is health care-associated infections. It is essential for us to follow the infection control practices that both patients and us are at a risk of being infected. Standard Precautions involve the use of safe work practices and protective barriers, for example, the use of personal protective equipment(PPE). At first, I think Standard Precautions are very easy. Everyone knows PPE can protect us from infections and hand hygiene is important throughout the process.

The primary prevention is the best way to eliminate the potential for exposure. Since hand washing is the most effective mean of spread of infection, it would be my primary goal to increase the compliance of hand hygiene among healthcare workers, but also an extensive education of patients and family members on hand washing before and after touching the patient as well as afar any contact with any potentially contaminated materials (surface, body fluids or respiratory secretions). Mandatory education of patients, visitors and healthcare workers, across the system as well as cross department compliance practices are single best mean of preventing the spread of infection. For example, every patient and family member can be educated about hand hygiene, use of PPE-personal protective equipment (face mask, gowns and gloves). Although, the practices are already being utilized, I believe the compliance is poorly monitored.

Identify current patient safety goals for one health care setting NPSG.07.06.01 Use proven guidelines to prevent infections of the urinary tract that are caused by catheters. Managing indwelling urinary catheters according to established guidelines is crucial for patient safety. It is important that health care providers are securing catheters for unobstructed urine flow and drainage, maintaining a sterile system for urine collection, and replacing the system when required. These things, along with collecting urine samples, are all examples of how to implement the evidence-based guidelines to ensure safety and quality health care to patients (The Joint Commission, 2015).

INTRODUCTION Infection Prevention and Control (IPC) is one of the most important agents in the prevention of hospital acquired infections or what we termed nosocomial infections. IPC channels every member of the hospital, which includes, healthcare providers (HCP), patients and the hospitals perse. It is important to practice IPC commandment to every hospital as well as community. The Palestinian Ministry of Health (MOH) adopted the national IPC protocol.

The facilities enforcing protocols and policies to secure that employees are meeting government regulations. Doctors, nursing staff and support staff I must use their best ethical and moral judge in most case to ensure patients are being retreated. Thus, sometimes causing conflict with health care administration because health care workers sometimes unknowingly break policies or protocol by putting patients first. As well as hospitals and clinics have so many departments that there can be conflict of interest with patient care that can cause inconsistency with patient care (Santilli, J. el al., 2015, Para

Central line associated bloodstream infections (CLABSIs) in 2009 were amongst 23,000 infections in the inpatient population of US hospitals. (Sweet, Cumpston, Briggs, Craig, & Hamadani, 2012) These infections increase morbidity of patients, mortality, and increase cost. Those that are at risk are the population with central venous catheters. This infection is commonly due to improper hub care and consequently provides the direct introduction of the bacteria into the blood stream. A fairly new intervention to prevent this morbid infection is the implementation of alcohol impregnated protective caps, otherwise known as the brand name Curos caps in addition to others.

Introduction Definition Patient safety mainly refers to the prevention of preventable errors and adverse effects to patients associated with healthcare(Rcn.org.uk).Personal safety requires knowledge and skills in multiple areas in order to be executed effectively(Pascale Carayon,2010). This is generally a nationwide priority particularly focused on preventing medical errors before they can occur and cause either death, permanent injury or temporary harm.(Nursingcentre.com,2015).Statistically, medical errors affect 1 in 10 patients worldwide (Who.int,2015), and implications could include death, permanent injury, financial loss or psychological harm to the patient or in some situations to the caregiver (Nursingcentre.com,2015).Therefore

Principles for safe medication administration: • All medications must be administered according to a physician’s orders. • The medication orders must be clear, legible and not open. • The same person should select, prepare, administer and record the administration. • Doses must be prepared for only one patient at a time, immediately before the intended use • Medications should be prepared for immediate administration to a single patient and not retained for later use due to the risks of contamination, potential instability, potential mix-up with other medications and to maintain security of the medication • All medications must be stored in patient care areas in the same container as received from pharmacy. • All RNs and ENs without notation must successfully complete the Medication Assessment Paper prior to administering medications.

The first element identified for the safety goal is staff and patient education on surgical site infection. Staff at my facility must undergo mandatory training upon hire and yearly regarding policies, procedures and protocols that need to be strictly adhered to in the prevention of surgical site infection. Patient’s are educated prior to surgery during the preoperative phone call and asked to bathe the morning of the surgery or the night before using antibacterial soap. For total joint procedures there are additional steps in the

Introduction Healthcare systems genuinely desire to provide the best possible, error-free care and treatment without causing any injury or harm to their patients and families (Gluyas & Morrison, 2013). The Australian government thru the Australian Commission on Safety and Quality in Health Care (ACSQHSC) gathered a remarkable set of standards to safeguard patients (ACSQHSC, 2014). National Safety and Quality Health Service Standards (NSQHS) are launched for the continual improvement and implementation of health practices and services with safety and consistency (Hamilton, Gibberd & Harrison, 2014). This discussion will be focusing the rationale for the implementation of national standards across Australia and three selected standards which