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Patient safety in hospital setting
Patient safety in hospital setting
Safety in hospital essay
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Postoperative Respiratory Failure Hospitalizations affect a large number of the population in the United States (US). A large number of those Americans are hospitalized due to a surgical procedure that needs to be performed. Many people may suffer from postoperative complications while in the hospital that can be extremely serious or even cause death. The Agency for Healthcare Research and Quality (AHRQ) has established Quality Indicators (QIs) called Patient Safety Indicators (PSIs). The PSIs are used with hospital inpatient data to reflect quality of care and patient safety, primarily focusing on potential avoidable complications. The purpose of this paper is to define the purpose of the PSIs-90 and role in healthcare today. Discuss …show more content…
According to the Agency for Healthcare Research and Quality (AHRQ, n.d.) PSIs were developed to detect these potential complications that can occur within the inpatient setting, and serve as a tool to assess areas that require improvement of patient safety. These PSIs are captured through administrative data by the use of software that analyzes International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM). There are many ways the PSI postoperative respiratory failure can help guide the care of the patient within the healthcare organization. An example of a possible nursing opportunity to provide better care is to “evaluate opportunities to reduce incidence of postoperative respiratory failure such as protocols to increase incentive spiratory use and breathing exercises” (Zrelak et al., 2011, p. 103). In addition, proper documentation and a detailed patient assessment are always vital in providing quality of care and patient …show more content…
These protocols include performing preoperative and postoperative lung expansion exercises, assessing breathing patterns and most importantly performing a thorough preoperative evaluation. Lung expansion exercises such as incentive spirometry, coughing and deep breathing, chest physiotherapy and the use of CPAP mask are all important exercises that should be performed postoperatively and even in some cases preoperatively. Assessing breathing patterns can be an early indicator of imminent respiratory failure. Furthermore, performing a good preoperative evaluation can help the healthcare team become aware of any risks the patient may have and know how to prevent them or treat them (V. Horowitz, personal communication, September
This essay will discuss the risks for patients during the preoperative, intraoperative and postoperative stages of the perioperative journey and how both patients and healthcare professionals involved in the perioperative stages can work together to prevent perioperative hypothermia.
Additionally, the clinical staff has shown very low level of confidence in the RR documentation on observation chart. Lack of time, laziness, lack of training and knowledge and unawareness of the importance of the respiratory assessment are main reasons to neglect this important aspect of nursing as stated in this study (Philip, Richardson, & Cohen,
After reviewing six research studies varying from systematic, to meta-analysis, to experimental, and to quasi-experimental they all have identified that there are positive effects of pre-warming the patient prior to surgery. Andrzejowski, Hyle, Eapen & Turnbull (2008), performed a quasi-experimental study with 68 adult patients having spinal surgery under general anesthesia. 31 were pre-warmed for 60 minutes before induction and 37 were in a control group. All received forced air warming (FAW) during surgery. Pre-warming the patient had a significant effect on patient's outcomes, which resulted in a decrease incidence of perioperative hypothermia. When pre-warming by FAW, the patient experiences better outcomes and improved patient satisfaction.
Breathing is the most important AL (Roper et al, 1998). A detailed assessment of her airway would be performed because protection of the airway throughout anaesthesia is essential (Yates, 2000). This does not just include recording of respiration rate and oxygen saturation (SpO2) but also noting any use of accessory muscles, shortness of breath, auscultation of chest and lungs areas for wheezes/crackles and asking patient about history of any respiratory illness/smoking (McArthur-Rouse, 2007).
This paper will discuss a case study of Pritesh, a 26 years old man who is transferred from the emergency department (ED) to the high dependency unit (HDU) with the developing of a tension pneumothorax. Initially, a general description of the patient’s chief complaint which is tension pneumothorax will be introduced, following by assessments of the patient’s need. The paper will focus on the discussion of nursing care and management for the patient, and a brief summary and evaluation of the care will be given. Lastly, a conclusion of what author has learned from this case study will be present.
The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.
Safety is focused on reducing the chance of harm to staff and patients. The 2016 National Patient Safety Goals for Hospitals includes criteria such as using two forms of identification when caring for a patient to ensure the right patient is being treated, proper hand washing techniques to prevent nosocomial infections and reporting critical information promptly (Joint Commission, 2015). It is important that nurses follow standards and protocols intending to patients to decrease adverse
The Joint Commission was founded in 1951 with the goal to provided safer and better care to all. Since that day it has become acknowledged as the leader in developing the highest standards for quality and safety in the delivery of health care, and evaluating organization performance (The Joint Commission(a) [TJC], 2014). The Joint Commission continues to investigate ways to better patient care. In 2003 the first set of National Patient Safety Goals (NPSGs) went into effect. This list of goals was designed by a group of nurses, physicians, pharmacists, risk managers, clinical engineers, and other professionals with hands-on experience in addressing patient safety issues in a wide variety of healthcare settings (TJC(b), 2014). The NPSGs were created to address specific areas of concern in patient safety in all health care settings.
The use of incentive spirometry is an important aspect of overall lung health. In clinical, I am noticing that patient compliance with the incentive spirometer is directly correlated with patient education on the same. I have had the opportunity to educate almost all of my patients on the benefits of using the incentive spirometer. Incentive spirometer use promotes lung expansion which in turn will result in better lung compliance and reduce fluid accumulation. Most people associate the use of incentive spirometry in the post-operative period. Incentive spirometer use can be used on anyone to promote lung expansion and reduce disease progression. In this paper, I will discuss my experiences with patients and incentive spirometer use.
Inpatient quality indicators are a set of measurements used around the world for hospitals to measure inpatient stays and improve patient’s overall health. Hospitals are using patient stays as ‘makers’ to help guide mortality and improve disease process and decrease deaths around the globe. The purpose of this paper is to describe inpatient quality indicators.
“Whoa-oa-oa! I feel good, I knew that I would now. I feel good….”. My “I feel good” ringtone woke me up from the depths of slumber during my first night call in internal medicine rotation. My supervising intern instructed me to come to the 4th floor for a patient in distress. Within moments, I scuttled through the hospital hallways and on to the stairs finally arriving short of breath at the nurses’ station. Mr. “Smith”, a 60 year old male with a past medical history of COPD was in respiratory distress. He had been bed bound for the past week due to his severe arthritis and had undergone a right knee replacement surgery the day before. During evening rounds earlier, he had no signs of distress. However, now at 2 AM in the morning, only hours later since rounds, he was minimally responsive. My intern and I quickly obtained the patient’s ABG measurements and subsequently initiated a trial of BIPAP. This resolved Mr. Smith’s respiratory distress and abnormal ABG values. To rule out serious causes of dyspnea, a stat chest x-ray and CT were obtained. Thankfully, both studies came back normal.
In today’s health care system, “quality” and “safety” are one in the same when it comes to patient care. As Florence Nightingale described our profession long ago, it takes work and vigilance to ensure we are doing the best we can to care for our patients. (Mitchell, 2008)
Keeping patients safe is essential in today’s health care system, but patient safety events that violate that safety are increasing each year. It was only recently, that the focus on patient safety was reinforced by a report prepared by Institute of medicine (IOM) entitled ” To err is human, building a safer health system”(Wakefield & Iliffe,2002).This report found that approx-imately 44,000 to 98,000 deaths occur each year due to medical errors and that the majority was preventable. Deaths due to medical errors exceed deaths due to many other causes such as like HIV infections, breast cancer and even traffic accidents (Wakefield & Iliffe, 2002). After this IOM reports, President Clinton established quality interagency coordination task force with the help of government agencies. These government agencies are responsible for making health pol-icies regarding patient safety to which every HCO must follow (Schulman & Kim, 2000).
Pulmonary rehabilitation helps the lungs regain more breathing capacity after a surgery or traumatic event. This kind of therapy may be provided outside of the hospital by an
Good leadership, fostering a culture of change and safety, team work are essential in implementing quality improvement and risk management in the organization. Leaders and the governing body must demonstrate commitment to the processes and define their expectations for all stakeholders. Leadership team should make sure that the team’s attention is focused on the core business of the organization, which is to provide care and treat patients in a safe and high quality clinical environment. There are different tools that can be used for quality improvement that also applies to analyzing risk issues. These are measurement of quality, benchmarking, RCA, FMECA, and so