Workplace culture includes attitudes, beliefs, and behaviors that define the work environment. A healthy culture aligns employee behaviors and policies with organizational goals. A safety culture combines attitudes and behaviors toward patient safety conveyed when entering a healthcare facility. Creating a culture of safety enables sustainable improvements in safety.
Simple and Safe Approaches Towards Patient SafetyEhi Iden
A conference presentation on simple approaches and steps in achieving and managing patient safety in health. It talks about team approach, mutual support, just system, leadership commitment, complications of blame game and case study of the popular Kimberly Hiatt story.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
patient safety and staff Management system ppt.pptxanjalatchi
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Simple and Safe Approaches Towards Patient SafetyEhi Iden
A conference presentation on simple approaches and steps in achieving and managing patient safety in health. It talks about team approach, mutual support, just system, leadership commitment, complications of blame game and case study of the popular Kimberly Hiatt story.
Patient safety is the absence of preventable harm to a patient during the process of health care and reduction of risk of unnecessary harm associated with health.
patient safety and staff Management system ppt.pptxanjalatchi
Patient Safety is a health care discipline that emerged with the evolving complexity in health care systems and the resulting rise of patient harm in health care facilities. It aims to prevent and reduce risks, errors and harm that occur to patients during provision of health care.
Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Supporting and developing patient safety collaboratives - Phil Duncan and Fiona Thow, Patient safety collaborative delivery leads, NHS Improving Quality
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
Strategic priorities in Patient Safety. Philip Hassen. IV International Conference on Patient Safety. (Madrid, Ministry of Health and Consumer Affairs, 2008)
Presentations from the patient safety conference held at Teesside University on 1 and 2 September 2014 - Students at the forefront of continuing and improving our culture of safe care
Supporting and developing patient safety collaboratives - Phil Duncan and Fiona Thow, Patient safety collaborative delivery leads, NHS Improving Quality
Presentation from the Patient Safety Collaborative launch event held in London on 14 October 2014
More information at http://www.nhsiq.nhs.uk/improvement-programmes/patient-safety/patient-safety-collaboratives.aspx
PurposeThe purpose of this assignment is to identify nursing carTakishaPeck109
Purpose
The purpose of this assignment is to identify nursing care models utilized in today's various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.
Course Outcomes
Completion of this assignment enables the student to meet the following course outcomes.
CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)
CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)
CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)
CO4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO4)
CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)
CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)
CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)
Read your text, Finkelman (2016), pp- 111-116.
You are required to complete the assignment using the template.
Observe
staff in delivery of nursing care provided. Practice settings may vary depending on availability.
Identify
the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model
Review
and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting.
Review
and summarize one scholarly resource (not including your text) related to a nursing care model that is
different
from the one you observed in the practice setting.
Discuss
the nursing care model from step #6, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.
Summarize this experience/assignment and what you learned about the two nursing care models.
Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.
References and important information:
Week5 leader Examplar Audio Transcript
After working a number of years in home health, I made the decision to return to the acute care setting and accepted a ...
Write a 3 page evidence-based health care delivery plan for one .docxowenhall46084
Write a 3 page evidence-based health care delivery plan for one component of a heart failure clinic.
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
In an effort to improve the patients' health literacy concerning heart failure, it is important that the clinic staff and the hospital staff present a consistent, evidence-based message on self-care to these patients and their families in order to decrease acute exacerbation and re-admissions. Review current evidence for clinical practice guides or protocols when developing your patient teaching plans and materials. Consider the following:
What does the patient know about the disease process as a baseline?
What does the patient need to do understand as far as the best self-care processes?
Can the patient identify proper medication compliance?
Is there a financial issue that affects compliance?
Who buys and prepares the food in the home?
Can the patient verbalize when to seek medical assistance?
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocol.
ITS IMPORTANT TO MEET THE COMPETENCES (Thats how they evaluate the mariuse18nolet
ITS IMPORTANT TO MEET THE COMPETENCES (That's how they evaluate the work).
Nursing within an organization is a critical component of health care delivery and is an essential ingredient in patient outcomes (Kelly & Tazbir, 2014). The concern for quality care that flows from evidence-based practice generates a desired outcome. Without these factors, a nurse cannot be an effective leader. It is important to lead not only from this position but from knowledge and expertise.
By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:
Competency 2: Explain the accountability of the nurse leader for decisions that affect health care delivery and patient outcomes.
(IMPORTANT) -Describe accountability tools and procedures used to measure effectiveness.
Competency 3: Apply management strategies and best practices for health care finance, human resources, and materials allocation decisions to improve health care delivery and patient outcomes.
(IMPORTANT) -Develop an evidence-based plan for health care delivery.
Competency 4: Apply professional standards of moral, ethical, and legal conduct in professional practice.
(IMPORTANT) -Apply professional and legal standards in support of a care plan.
Competency 5: Communicate in manner that is consistent with the expectations of a nursing professional.
(IMPORTANT) -Write content clearly and logically, with correct use of grammar, punctuation, mechanics, and current APA style.
Preparation
Refer to the Capella library and the Internet for supplemental resources to help you complete this assessment.
Instructions
Deliverable:
Develop an evidence-based plan for health care delivery.
Scenario:
The hospital where you work has an issue with increased readmissions within 30 days of discharge. After examining the core measures, it was found that heart failure was the most common core measure disease process experiencing the highest rate of readmissions. The leadership team has given your team the charge of developing a nurse-run outpatient heart failure clinic. The purpose of this clinic is to ensure that discharge education is presented to the patient in an orderly, consistent manner and complies with evidence-based practice protocols. Since these patients may be discharged from a variety of areas in the facility, having the heart failure clinic staff take ownership of the process will improve both consistency and compliance. There are cardiologists that interact with the staff and patients, but the day-to-day operations of the clinic are designed and supported by the nurses as they interact with appropriate members of the other health care team disciplines promoting the best care for the heart failure patients.
As a member of the nurse team, you have been asked to develop
one
component
of the clinic.
The hospital leadership established these objectives ...
Standards to Improve the Quality of Care - Marie Kehoe O'Sullivan, HIQAIMS Marketing
Marie Kehoe O'Sullivan, HIQA, looks at Standards to Improve the Quality of Care to patients in Ireland. This presentation was made at the Socrates National Conference, The Convention Centre, Dublin
NHS Improving Quality was invited to take part in a recently held event that celebrated the work that is being done in partnership between the Pennine Acute Hospitals NHS Trust and AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP).
Gillian Phazey, Learning and Organisational Development Manager at Pennine Acute Hospitals NHS Trust explains:
'The Learning and Organisational Development and Governance teams at the Pennine Acute Hospitals NHS Trust have been working collaboratively with AQuA to deliver a Quality Improvement Methodologies Programme (QuIMP) to support staff in developing knowledge and skills in this topic. The programme has been specifically designed to support colleagues wanting to gain an introduction to the fundamentals and concepts of quality improvement. So far, two cohorts of staff, from clinical and non-clinical areas of the Trust have completed the programme, and have completed quality improvement projects in their own work area to apply their knowledge. On 17th July a celebration event was held for cohort 2 where staff presented their work in poster or presentation form, the aim of which is to share and spread learning across the Trust. Projects were wide ranging, from introducing new processes to reduce complaints and drug errors, to improving patient experience by implementing new tools and techniques. The day was a great success with the Chief Executive and Chief Nurse in attendance. The Trust is highly supportive of this approach in equipping staff with these important techniques, and the programme supports not only our internal quality agenda and objectives, but more widely responds to the recommendations of the Berwick report. The next cohort is starting in September this year.'
Fiona Thow, Patient Safety Collaborative Delivery Lead at NHS Improving Quality delivered a keynote speech, (link to presentation slides) providing a national perspective on the plans for improving patient safety and took the opportunity to introduce the national safety collaboratives. She also highlighted the need for organisations and individuals to think differently about safety for both patients and staff.
The Health Management Techniques by Dr. KasbeAbhiram Kasbe
In health management, the role is all about ensuring that hospitals and healthcare facilities run as they should. It's about planning, organizing, and overseeing health services. Imagine being the person who decides how a hospital should be arranged so doctors and nurses can do their best work, or figuring out what kind of staff is needed and making sure they're trained right. It's a job that keeps one on their toes because healthcare is always changing, and so are the needs of the community.
When managing health, it's about being everywhere at once - supervising, inspiring, and making sure everyone's on the same page. It's about setting goals and then making sure you reach them. If something's not working, you've got to figure out why and fix it. This means constantly checking on how things are going and being ready to change plans if needed.
Managing health isn't just about managing sickness; it's about promoting wellness too. It's planning for the future, making sure that the next generation has a healthy start, and that those who are ill get the care they need. It's about having the right people with the right skills in the right place at the right time.
In health management, you could be planning a big operation, making sure the operating theatre is ready and everyone knows what they're doing. It's also about day-to-day tasks, like taking someone's blood pressure correctly or deciding what kind of machines and equipment a hospital needs.
For health managers, it's about knowing people as much as it is about knowing medicine. They have to be good with numbers to handle the money side of things, and they need to be able to make tough decisions. Communication is key because they have to talk to all kinds of people, from patients to doctors, to government officials.
In India, where family and community are so important, health managers are like the head of a large family. They need to look after everyone, make sure they're healthy, and help them live their best life. It's a role that requires a lot of care, a cool head, and a big heart.
Health management is where art meets science in healthcare. It's using creativity to solve problems and applying scientific principles to make sure everything runs smoothly. It involves everything from designing the way a hospital works to handling the staff and making sure patients are happy.
And it's not just about the present. Health management is about looking ahead, predicting what health services will need in the future, and planning for that today. It's a career that can truly be effective in people's lives.
The Nurse Leader as Knowledge Worker
H
Walden University
Transforming Nursing And Health Through Technology
NURS 6051
Nov 27, 2019
1
The Nurse Leader as Knowledge Worker
2
Purpose
Explain the concept of a knowledge worker.
Define and explain nursing informatics and highlight the role of a nurse leader as a knowledge worker.
The concept of a knowledge worker
The term “knowledge worker” was first coined by Peter Drucker. Ducker defined knowledge workers as high-level workers who apply theoretical and analytical knowledge, acquired through formal training, to develop products and services (CFI, 2019). He emphasized that due to the high level of productivity and creativity of knowledge worker, that they would be the most valuable assets in the 21st century organization. Professionals that can be referred to as knowledge worker includes engineers, pharmacists, architects, financial analysts, public accountants, physicians, scientists, design thinkers, and lawyers. Furthermore, knowledge workers have a high degree of expertise, experience, education and the primary purpose of their jobs involve the distribution, creation and application of knowledge.
3
Definition of a knowledge worker by Peter Drucker
Professional that are referred to as knowledge worker
Nursing Informatics
Nursing Informatics is a subset of informatics, specific to the nursing field and the role of the nurse in the healthcare setting. There has been several interpretation of nursing informatics. The American Nurses Association (ANA), identified nursing informatics as a specialty that integrates nursing, science, computer science, and information science to manage and communicate data, information, and knowledge in nursing practice (ANA, 2001, pg.17).
4
Nurse leader as a knowledge worker.
A nurse leader is one who inspire others to work together to achieve a common goal, for instance enhanced patient care or satisfaction. All nurses are called to nurse leadership, however there are different levels of nurse leadership. Nurse leaders are expected to help the organization to fulfill the organization’s mission, vision, values, and strategies to achieve long-range plans. Nurse leaders part take in policy setting, overseeing quality measures are carried out, accountability for overall quality of patient care delivery, staff satisfaction and organizational outcomes. For a nurse leader as a knowledge worker to be productive in an organization, the nurse leader must understand that knowledge work requires continuous learning on the part of the knowledge worker, but equally continuous teaching on the part of the knowledge worker. Having said that, a knowledge worker nurse leader will depend hugely on evidenced based practice to be productive in a healthcare organization. The use of EBP by knowledge worker nurse leader will require learning and teaching. Most healthcare organizations or hospitals rely on evidenced based practice to im.
Evidence-Based Project Update (CompleteIncomplete) ALL DOSubmi.docxturveycharlyn
Evidence-Based Project Update (Complete/Incomplete): ALL DO
Submit an update on your project. Include information on progress to date. Discuss any barriers and how you plan to overcome or have overcome. What are your plans for the completion of the project?
In your update, include how you will meet the course and EPSLO objectives (See section IV B in this syllabus- as follows)
END OF PROGRAM STUDENT LEARNING OUTCOMESCOURSE OUTCOMES1.Synthesize knowledge from nursing and the physical, behavioral, psychological and social sciences, and the humanities in the practice of professional nursing.Demonstrate an awareness of complex organizational systems including structure, mission, vision, philosophy, and values.Promote factors that create a culture of safety and caring. Demonstrate an awareness of complex relationship of safety and caring.Employ principles and participate in quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system wide practice improvements that will improve the quality of healthcare delivery for diverse populations.Use inter and intra-professional communication and collaborative skills to deliver evidence-based, patient-centered care.2.Integrate global health and health care, its relevant issues and policies as they relate to professional nursing practice.Employ principles and participate in quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system wide practice improvements that will improve the quality of healthcare delivery for diverse populations. Demonstrate basic knowledge of healthcare policy, finance, reimbursement, and regulatory environments, including local, state, national, and global healthcare trends.Examine legislative and regulatory processes relevant to the provision of healthcare.3.Evaluate research in the exploration of the spectrum of health within the framework of evidence-based practice.Participate in the development and implementation of imaginative and creative strategies to enable systems to change.
NUR 4827 LEADERSHIP IN NURSING Use inter-and intra-professional communication and collaborative skills to deliver evidence-based, patient-centered care.4.Synthesize standards of professional practice and care.Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team coordination, and the oversight and accountability for care delivery in a variety of settings.Demonstrate leadership and communication skills to effectively implement patient safety and quality improvement initiatives withinthe context of the inter-professional team.Employ principles and participate in quality improvement, healthcare policy, and cost-effectiveness to assist in the development and initiation of effective plans for the microsystem and/or system wide practiceim.
10Patient Safety Culture in hospitals.Student’s NameCoBenitoSumpter862
10
Patient Safety Culture in hospitals.
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
September 24, 2021.
Patient Safety Culture in hospitals.
Introduction.
Patient safety is an issue of global public health concern. It refers to preventing patients from harm by implementing a care system that contains errors and learns from medical errors to build a safety culture involving healthcare workers, patients, and healthcare organizations. The safety of patients is critical in care quality. Many patients worldwide have suffered injuries, disabilities, and death due to medical errors or unsafe care. Patient safety culture can be defined as healthcare organizations' values about what is essential and how to operate to protect patients. To achieve a safe culture, organizations and their members must understand the values, norms, and beliefs about essential and attitudes and behaviors related to patient safety (Ali et al., 2018).
To achieve a culture of safety, organizations should emphasize addressing disparities in the quality of care because the current challenges may worsen the efforts to narrow the gap. The key issues in establishing and providing accessible, responsive, and effective health systems are quality and safety. Poor quality and unsafe patient care increase mortality and morbidity rates throughout the world. About 75% of the healthcare delivery gaps are preventable, and approximately 10% of inpatient admission result from preventable patient harm (Amiri et al., 2018).
Patient safety cultures with strong collaboration and leadership drive and prioritize safety (Wu et al., 2019). Strong leadership and commitment from manger are essential because their attitudes and actions influence the wider workforce's behaviors, perceptions, and attitudes. The other important aspects of patient safety culture include; effective communication, mutual trust, shared views on the importance of patient safety, engaging the healthcare workforce, acknowledging mistakes, and having a system that recognizes, responds, and gives feedback on adverse events (Alquwez et al., 2018). Patient safety culture is influenced by burnouts, hospital characteristics, communication, position, work area, commitment to the patient safety program, leadership, and patient safety resources and management.
Thesis statement.
Patient safety culture focuses on safety in health care by emphasizing the prevention, reporting, and investigation of medical errors that may cause patients' adverse effects, thus reducing harm by implementing necessary measures. Several factors are affecting the culture of patient safety in hospitals. This paper highlights patient safety culture and the factors affecting patient safety culture in public hospitals.
Body.
Patient safety culture encompasses shared values and beliefs about healthcare delivery system, training and education of healthcare workers on patient safety culture, commitment from leaders and managers, ope ...
10Patient Safety Culture in hospitals.Student’s NameCoSantosConleyha
10
Patient Safety Culture in hospitals.
Student’s Name
Course
Instructor’s name.
Institutional Affiliation
September 24, 2021.
Patient Safety Culture in hospitals.
Introduction.
Patient safety is an issue of global public health concern. It refers to preventing patients from harm by implementing a care system that contains errors and learns from medical errors to build a safety culture involving healthcare workers, patients, and healthcare organizations. The safety of patients is critical in care quality. Many patients worldwide have suffered injuries, disabilities, and death due to medical errors or unsafe care. Patient safety culture can be defined as healthcare organizations' values about what is essential and how to operate to protect patients. To achieve a safe culture, organizations and their members must understand the values, norms, and beliefs about essential and attitudes and behaviors related to patient safety (Ali et al., 2018).
To achieve a culture of safety, organizations should emphasize addressing disparities in the quality of care because the current challenges may worsen the efforts to narrow the gap. The key issues in establishing and providing accessible, responsive, and effective health systems are quality and safety. Poor quality and unsafe patient care increase mortality and morbidity rates throughout the world. About 75% of the healthcare delivery gaps are preventable, and approximately 10% of inpatient admission result from preventable patient harm (Amiri et al., 2018).
Patient safety cultures with strong collaboration and leadership drive and prioritize safety (Wu et al., 2019). Strong leadership and commitment from manger are essential because their attitudes and actions influence the wider workforce's behaviors, perceptions, and attitudes. The other important aspects of patient safety culture include; effective communication, mutual trust, shared views on the importance of patient safety, engaging the healthcare workforce, acknowledging mistakes, and having a system that recognizes, responds, and gives feedback on adverse events (Alquwez et al., 2018). Patient safety culture is influenced by burnouts, hospital characteristics, communication, position, work area, commitment to the patient safety program, leadership, and patient safety resources and management.
Thesis statement.
Patient safety culture focuses on safety in health care by emphasizing the prevention, reporting, and investigation of medical errors that may cause patients' adverse effects, thus reducing harm by implementing necessary measures. Several factors are affecting the culture of patient safety in hospitals. This paper highlights patient safety culture and the factors affecting patient safety culture in public hospitals.
Body.
Patient safety culture encompasses shared values and beliefs about healthcare delivery system, training and education of healthcare workers on patient safety culture, commitment from leaders and managers, ope ...
Navigating the Health Insurance Market_ Understanding Trends and Options.pdfEnterprise Wired
From navigating policy options to staying informed about industry trends, this comprehensive guide explores everything you need to know about the health insurance market.
Global launch of the Healthy Ageing and Prevention Index 2nd wave – alongside...ILC- UK
The Healthy Ageing and Prevention Index is an online tool created by ILC that ranks countries on six metrics including, life span, health span, work span, income, environmental performance, and happiness. The Index helps us understand how well countries have adapted to longevity and inform decision makers on what must be done to maximise the economic benefits that comes with living well for longer.
Alongside the 77th World Health Assembly in Geneva on 28 May 2024, we launched the second version of our Index, allowing us to track progress and give new insights into what needs to be done to keep populations healthier for longer.
The speakers included:
Professor Orazio Schillaci, Minister of Health, Italy
Dr Hans Groth, Chairman of the Board, World Demographic & Ageing Forum
Professor Ilona Kickbusch, Founder and Chair, Global Health Centre, Geneva Graduate Institute and co-chair, World Health Summit Council
Dr Natasha Azzopardi Muscat, Director, Country Health Policies and Systems Division, World Health Organisation EURO
Dr Marta Lomazzi, Executive Manager, World Federation of Public Health Associations
Dr Shyam Bishen, Head, Centre for Health and Healthcare and Member of the Executive Committee, World Economic Forum
Dr Karin Tegmark Wisell, Director General, Public Health Agency of Sweden
Leading the Way in Nephrology: Dr. David Greene's Work with Stem Cells for Ki...Dr. David Greene Arizona
As we watch Dr. Greene's continued efforts and research in Arizona, it's clear that stem cell therapy holds a promising key to unlocking new doors in the treatment of kidney disease. With each study and trial, we step closer to a world where kidney disease is no longer a life sentence but a treatable condition, thanks to pioneers like Dr. David Greene.
Antibiotic Stewardship by Anushri Srivastava.pptxAnushriSrivastav
Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
The dimensions of healthcare quality refer to various attributes or aspects that define the standard of healthcare services. These dimensions are used to evaluate, measure, and improve the quality of care provided to patients. A comprehensive understanding of these dimensions ensures that healthcare systems can address various aspects of patient care effectively and holistically. Dimensions of Healthcare Quality and Performance of care include the following; Appropriateness, Availability, Competence, Continuity, Effectiveness, Efficiency, Efficacy, Prevention, Respect and Care, Safety as well as Timeliness.
Defecation
Normal defecation begins with movement in the left colon, moving stool toward the anus. When stool reaches the rectum, the distention causes relaxation of the internal sphincter and an awareness of the need to defecate. At the time of defecation, the external sphincter relaxes, and abdominal muscles contract, increasing intrarectal pressure and forcing the stool out
The Valsalva maneuver exerts pressure to expel faeces through a voluntary contraction of the abdominal muscles while maintaining forced expiration against a closed airway. Patients with cardiovascular disease, glaucoma, increased intracranial pressure, or a new surgical wound are at greater risk for cardiac dysrhythmias and elevated blood pressure with the Valsalva maneuver and need to avoid straining to pass the stool.
Normal defecation is painless, resulting in passage of soft, formed stool
CONSTIPATION
Constipation is a symptom, not a disease. Improper diet, reduced fluid intake, lack of exercise, and certain medications can cause constipation. For example, patients receiving opiates for pain after surgery often require a stool softener or laxative to prevent constipation. The signs of constipation include infrequent bowel movements (less than every 3 days), difficulty passing stools, excessive straining, inability to defecate at will, and hard feaces
IMPACTION
Fecal impaction results from unrelieved constipation. It is a collection of hardened feces wedged in the rectum that a person cannot expel. In cases of severe impaction the mass extends up into the sigmoid colon.
DIARRHEA
Diarrhea is an increase in the number of stools and the passage of liquid, unformed feces. It is associated with disorders affecting digestion, absorption, and secretion in the GI tract. Intestinal contents pass through the small and large intestine too quickly to allow for the usual absorption of fluid and nutrients. Irritation within the colon results in increased mucus secretion. As a result, feces become watery, and the patient is unable to control the urge to defecate. Normally an anal bag is safe and effective in long-term treatment of patients with fecal incontinence at home, in hospice, or in the hospital. Fecal incontinence is expensive and a potentially dangerous condition in terms of contamination and risk of skin ulceration
HEMORRHOIDS
Hemorrhoids are dilated, engorged veins in the lining of the rectum. They are either external or internal.
FLATULENCE
As gas accumulates in the lumen of the intestines, the bowel wall stretches and distends (flatulence). It is a common cause of abdominal fullness, pain, and cramping. Normally intestinal gas escapes through the mouth (belching) or the anus (passing of flatus)
FECAL INCONTINENCE
Fecal incontinence is the inability to control passage of feces and gas from the anus. Incontinence harms a patient’s body image
PREPARATION AND GIVING OF LAXATIVESACCORDING TO POTTER AND PERRY,
An enema is the instillation of a solution into the rectum and sig
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
CRISPR offers a powerful tool for a better future, but responsible development and addressing ethical concerns are essential. By prioritizing safety, fostering open dialogue, and ensuring equitable access, we can harness CRISPR's power for the benefit of all. (2998 characters)
2. Work culture is a collection of attitudes, beliefs and
behaviors that make up the regular atmosphere at work
environment.
Healthy workplace culture align employee behaviors and
policies with goals.
3. A safety culture is the combination of attitudes and
behaviors toward patient safety that are conveyed
when waling into a health facility.
To create sustainable improvements in safety, it is
necessary to create a culture of safety.
4. All based on our
mental processes, beliefs, knowledge, and values
What we think
Culture is learned,
not biologically inherited
What we do
What we produce
= the outcomes
Adapted from Reason
6. The factors involved in the culture of patient safety are:-
1.Leadership
Effective leaders show active engagement with patients and staff and this
has a bearing on safer patient care.
7. When all clinical and nonclinical staff
collaborate effectively, health care
teams can improve patient
outcomes, prevent medical errors,
improve efficiency and increase
patient satisfaction.
9. Communication reduces the chances of a breakdown
in continuity of care, builds relationships and
understanding.
10. Learning is a new concept to provide proper
knowledge and information to the staff related to
equipment, treatment and events.
11. 4 C's of patient-centered care
Increasing personal connection,
continuity of care,
cultural responsiveness and
community ties are critical for
enhancing the patient experience.
14. To obtain a clear view of the patient safety aspects
requiring urgent attention
To identify the strength and weaknesses of their safety
culture
To identify existing patient safety problems, and
benchmark their scores.
15. Conduct patient safety leadership walk rounds.
Create a reporting system
Designate of patient safety officer
Reenact real adverse events form your hospital
Involve patient safety initiatives
Appoint safety champion for every unit
Simulate possible adverse events
Create adverse even response team
16. Organizations with a positive safety culture are
characterized by communications founded on
mutual trust, by shared perceptions of the
importance of safety and by confidence in the
efficacy of preventive measures.”
17. Manchester Patient Safety Scales (MaPSaf)
Sexton Safety Attitudes Survey
Experience of Care Survey
SHINE Tool
18. •No time for safety or investment into
improvement
Pathological
•Safety occurs in response to an incident
Reactive
•Safety is driven by management systems and
imposed on the workforce
Bureaucratic
•There is value placed in safety with continually
improving systems
Proactive
•The ideal, where safety is an integral part of
everyday life in all staff
Generative
24. Manchester Patient Safety Framework (MaPSaF)
• Facilitate reflection on patient safety culture
• Stimulate discussion about the strengths and weaknesses
of the patient safety culture
• Reveal any differences in perceptions between staff
groups
• Help understand how a more mature safety culture might
look
• Help evaluate any specific intervention needed to change
the patient safety culture
27. Compliance with standards
• Complete
• Partial
• None
Risk Registers
• Current?
• Meaningful?
• Acted upon?
Responding to complaints
• Timely
• Remedial action
Incident reporting and Investigations
• Serious case reviews
• RCA
Measurement of quality and harm continually
• Trigger tool
• Daily measures
Measurement for improvement
• Run charts & SPC
Improvement methodology
• Small scale test of change
• PDSA (Plan do study act)
Strategic Alignment
• Driver diagrams
• Process changes
Human Factors understanding
• Communication e.g. SBAR
• Situational Awareness
NHS III
Risk management Safety 1
28. Things that
Are difficult
but go
right
Things that
go wrong
Early
completion
Excellent
innovation
Positive
surprises
Unwanted Outcome Planned Great outcome
29. Escalate
Leaders Daily Safety Brief
Overview of events of harm and
risk
Identify
Ward Bedside huddles
Nurse Doctor Patient
Mitigate
Ward Safety Huddle
Nurses, Doctors, Allied
professionals
PEWS, Watchers, family or
communication concern
The ‘huddle’ suite: Achieving situation
awareness
31. Sr. No Particulars
1 Plan
Identification of a team to administer the survey.
Decide the survey tool.
Decide if paper based or HMIS.
Set a goal of at least a 60% response rate.
Establish start/end dates.
Choose survey timing.
2
Prepare
Survey employees at all levels.
Get the list of respondents ready.
Respondents must spend 50% of the time in the unit.
Advertise the survey (Leaflets and posters)
Engage department and service leaders.
Provide respondents access to information to answer any questions.
3 Survey
Monitor response rate.
Regular update on response rates to leadership and department
heads.
Send reminders.
32. 4 Analyse
Analyse the results, use statistical tools.
Compare and benchmarks results.
5
Debrief
Present results to management first.
Debrief results by individual unit.
Emphasize survey is just a perception and NOT AN EXAM
RESULT
Debrief in the presence of a hospital leader.
Pick top positive scores and top negative scores.
6 Improve
Improvement projects can be based on common themes
identified hospital wide.
Improvement projects can be unit specific based on staff
perception.
Support in planning and delivering improvement projects.
33. 7 Sustain
Informed culture - Frequent leadership walk
rounds to create visibility.
Reporting culture - Establish non punitive
approach to error reporting.
Learning culture - Create opportunities to
learn from defects.
Just culture - Establish fair and just culture. (a
no blame culture)
Flexible culture - Facilitate adapting to
changing demands.
8 Resurvey
Share action plan and results to staff prior to
re-surveying.
Resurvey annually.
35. What did we do well?
◦ So we can replicate
Past harm
◦ Has patient care been safe in the past?
Reliability
◦ Are our clinical systems and processes reliable
Sensitivity to operations
◦ Is care safe today?
Anticipation and preparedness
◦ Will care be safe in the future?
Integration and learning
◦ Are we responding and improving?
