Quality, Safety, and Informatics in Nursing

What is the Institute of Medicine?

What is the Institute of Medicine?

• Concerted efforts focused on evaluating, informing, and improving quality healthcare

• The health arm of the National Academy of Sciences which was charted under President Abraham Lincoln in 1863

Institute of Medicine Patient Safety rights

Patients have the right to

• Self-care

• Practice that is consitent w/ the current medical knowledge

• Customization of that care to meet the indivudal needs of the patient

List the 4 Quadruple Aims

• Enhancing the patient experience

• Lower costs

• Improving Clinical outcomes

• Improving Clinician experience

What is patient safety?

The prevention, avoidance, and amlioration of adverse injuries or outcomes originating from the process of healthcare

What us an setinel event?

An unexpected occurence involving death or serious physical or psychological injury. Life-altering and Life-threatening

List the Joint Commission Patient Safety goals

• Identify patient by confirming identity in 2 ways

• Improve communication

• Identify patient saftey dangers & risks

• Prevent infection by hand washing, post-op antibiotics, catheter changes, & central line precautions

• Prevent mistakes in surgery by making sure correct surgery & corect body part; pause before surgery to double check

• Use device alarms. Ensure alarms are heard and checked quickly

• Use meds correctly & safely, double check labels & communicate w/ next shift

• Label all meds, even those in syringes in location where medications prepared

• Take extra time w/ patients prescribed w/ anticoagulants & chemotherapeutic agents

• Prevent nosocomial infections w/ routine hand washinf before & after each patient

List the 2021 National Patient Saftey Goals chapters

• Ambulatory health care

• Behavorial health care & human services

• Critical access hospital

• Home care

• Hospital

• Laboratory

• Nursing care center

• Office-based surgery

List the 2021 Patient safety goals for hospitals

• Improve accuracy of patient information

• Improve staff communication

• Improve safety communcation

What is the Culture of Safety?

A set of core values and behaviors resulting from a collective and sustained commitment by organizational leadership, managers, and healthcare workers to EMPHASIZE safety over competing goals

What is ther benefit of creating a culture of safety in hospital environments?

Creates openness and mutual respect

Reduces adverse events

Improves patient experience

Enhances the work environment for all

Saves lives!

What is patient centered care?

Patient-centered care entails the understanding of a person's multidimensional aspects to include cultural, ethnic and social backgrounds, as well as their individual, family and community values

What does PDSA stand for in regards to quality improvement model in nursing?

Plan

Do

Study

Act

Plan in PDSA meaning

• Identify issues

• What could change?

• What will happen?

Do in PDSA meaning

• Test your idea

  • prepare

• start small

Study in PDSA meaning

• Reflect on your test

• What has changed?

  • positive? negative?

  • who was affected? how?

Act in PDSA meaning

• act on your reflection

  • implement positive changes

  • modify/remove negative changes

Lewin’s Theory of Planned Change Model

• Unfreeze

• Change

• Refreeze

Unfreeze Lewin’s Theory of Planned Change Model

1. Recognize the need for change

2. Determine what needs to change

3. Encourage the replacement of old behaviors and attitudes

4. Ensure there is strong support from management

5. Manage and understand the doubts of concern

Change in the Lewin’s Theory of Planned Change Model

1. Plan the changes

2. Implement the changes

3. Help employees to learn new concept or potns of view

Refreeze in the Lewin’s Theory of Planned Change Model

1. Changes are reinforced and stabilized

2. Integrate changes into the normal way of doing things

3. Develop ways to sustain the change

4. Celebrate sucess

What are nursing informatics?

The speciality that integrates nursing science with mutlple information management and analytical sciences to identify, define, manage, and communicate data, information knowledge, and wisdom, in nursing practice

What is an example of healthcare informatics?

Electronic Health Record (EHR) and Electron Medical Record (EMR)

What are the benefits of EHRs?

• Improve quality care and convience of patient care

• Increase patient participation in their care

• Improve accuracy of diagnoses and health outcomes

• Improve care coordination

What us the Health Information Exchange?

Standard for sharing health care information across organization as well as the name of central organizations that facilitate the exchange

How do EHR/EMRs prevent errors?

• Improve communication

• Provide centralized, concurrent access to patient data and healthcare and treatment resources

• may force required information entries (e.g. allergies, drug doses, etc.)

• Assist w/ calculations

• Perform accuracy checks in real time

• Assist with/ real-time monitoring

• Provide immediate decision support

• Track and alert to adverse effects