scholarly journals 78 A Quality Improvement Project on Oxygen Administration Within the Geriatrics COVID-19 Cohort Ward

2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Hickson ◽  
A K L Liu ◽  
G Bailey ◽  
S Bruce ◽  
K Kawafi ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Flow Rate ◽  
Cost Effective ◽  
Quality Improvement Project ◽  
Education Session ◽  
Improvement Project ◽  
Oxygen Administration ◽  
Number Of Patients ◽  
Oxygen Requirements

Abstract Introduction Due to the COVID-19 pandemic, many medical and surgical wards were reassigned as COVID-19 cohort wards to accommodate the number of patients admitted with the virus. Nurses and healthcare assistants (HCAs) from various departments and backgrounds were redeployed to these areas. Within the geriatrics population, patients with severe COVID-19 often have high oxygen requirements and can rapidly deteriorate. Therefore, we conducted a quality improvement project within the geriatrics COVID-19 ward focused on improving patient safety by improving oxygen administration to patients. We also aimed to enhance the knowledge and confidence levels of nurses and HCAs in regards to oxygen administration. Method From April–July 2020, we compared the oxygen that was administered to COVID-19 patients against the oxygen therapy that was documented on observation charts. This included whether the correct type of device, flow rate and target oxygenation saturations were used. We carried out multiple Plan-Do-Study-Act (PDSA) cycles including a staff education session on oxygen administration, placed an oxygen guidelines poster on each patient’s bedside, administered a short quiz and distributed reminder lanyard cards. We also conducted a staff survey comparing knowledge and confidence on oxygen administration before and after an education session. Results Overall there has been an improvement in oxygen charting and administration after 4 PDSA cycles. There is 100% correct use of oxygen device and correct setting of oxygen flow rate after the 2nd and 3rd PDSA cycles. After the teaching session, all staff reported feeling more confident in oxygen management. Based on the audit data and quiz results, there was an improvement in knowledge of oxygen administration. Conclusions We have demonstrated that by using simple time-efficient and cost-effective interventions, improvements can be made in oxygen administration and subsequently patient safety. This has the potential to influence prognostic outcomes among the geriatrics population with COVID-19.

scholarly journals Physical Therapist–Established Intensive Care Unit Early Mobilization Program: Quality Improvement Project for Critical Care at the University of California San Francisco Medical Center

2013 ◽  
Vol 93 (7) ◽  
pp. 975-985 ◽  
Author(s):  
Heidi J. Engel ◽  
Shintaro Tatebe ◽  
Philip B. Alonzo ◽  
Rebecca L. Mustille ◽  
Monica J. Rivera
Keyword(s):  
Quality Improvement ◽  
Physical Therapy ◽  
San Francisco ◽  
Physical Therapist ◽  
Medical Center ◽  
Early Mobilization ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Icu Admission ◽  
Number Of Patients

Background Long-term weakness and disability are common after an intensive care unit (ICU) stay. Usual care in the ICU prevents most patients from receiving preventative early mobilization. Objective The study objective was to describe a quality improvement project established by a physical therapist at the University of California San Francisco Medical Center from 2009 to 2011. The goal of the program was to reduce patients' ICU length of stay by increasing the number of patients in the ICU receiving physical therapy and decreasing the time from ICU admission to physical therapy initiation. Design This study was a 9-month retrospective analysis of a quality improvement project. Methods An interprofessional ICU Early Mobilization Group established and promoted guidelines for mobilizing patients in the ICU. A physical therapist was dedicated to a 16-bed medical-surgical ICU to provide physical therapy to selected patients within 48 hours of ICU admission. Patients receiving early physical therapy intervention in the ICU in 2010 were compared with patients receiving physical therapy under usual care practice in the same ICU in 2009. Results From 2009 to 2010, the number of patients receiving physical therapy in the ICU increased from 179 to 294. The median times (interquartile ranges) from ICU admission to physical therapy evaluation were 3 days (9 days) in 2009 and 1 day (2 days) in 2010. The ICU length of stay decreased by 2 days, on average, and the percentage of ambulatory patients discharged to home increased from 55% to 77%. Limitations This study relied upon the retrospective analysis of data from 6 collectors, and the intervention lacked physical therapy coverage for 7 days per week. Conclusions The improvements in outcomes demonstrated the value and feasibility of a physical therapist–led early mobilization program.

A quality improvement project focused on assessment of risk level of outpatient psychiatry patients

2017 ◽  
Vol 41 (S1) ◽  
pp. s898-s898
Author(s):  
T. Tuvia ◽  
M. Kats ◽  
C. Aloezos ◽  
M. To ◽  
A. Ozdoba ◽  
...  
Keyword(s):  
Patient Safety ◽  
Quality Improvement ◽  
Residency Training ◽  
Psychiatry Residency ◽  
Care Quality ◽  
Quality Improvement Project ◽  
Risk Level ◽  
List Type ◽  
Psychiatry Residency Training ◽  
Improvement Project

Since the implementation of the Clinical Learning Environment Review by the Accreditation Council for Graduate Medical Education, there has been an emphasis on training residents in health care quality as well as patient safety. As such, psychiatry residency training programs have had to incorporate quality improvement (QI) projects into their training. We developed a QI curriculum, which not only included resident and faculty participation, but also encouraged other staff in our department to focus on patient safety as well as improving their performance and the quality of care provided to the patients.In this poster, we present the development of our curriculum and will include a successful QI project to highlight this. This project focused on creating an algorithm to help assign patient risk level, which is based on evidence based risk factors. This project was created due to a survey conducted in our clinic which demonstrated that clinicians, and in residency training in particular, identifying and managing high risk patients can be anxiety provoking for trainees. We will present the specifics of this QI project, and additionally outline the steps that were taken to develop and integrate the QI project into clinical practice.Objectives(1) Learn how to successfully incorporate a QI project and curriculum into a psychiatry residency training program.(2) Understand both resident and faculty perspectives on what resources facilitated participation in QI.(3) Present the development of a quality improvement project focused on risk assessment of outpatient psychiatric patients.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals 63 Quality Improvement Project: Should We be Doing More or Less Ct Head Scans in the Health Care of Older People Department?

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i18-i20
Author(s):  
M Munir ◽  
T Shouter ◽  
H S Tay
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Older People ◽  
Management Plan ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Number Of Patients ◽  
New Findings ◽  
New Finding ◽  
Ct Head

Abstract Introduction Older people are likely to have more CT head scans given their multiple co- morbidities, being on anticoagulants, and increased falls. The aims of this quality improvement project (QIP) were to identify the number of patients who had CT head scan, the reason/indication of it, the number of patients who had new finding/s on it, actions taken on new findings, and whether the management plan was altered because of the CT scan. Methods Medical notes and CT head scan reports of all patients admitted to the Health Care of Older People department from April to September 2018 were reviewed to evaluate the indications of CT head scans, new findings, and management plans following the findings. Results 461 (10.7%) out of the 4323 patients discharged from the healthcare of older people department during April to September 2018 had CT head scans during admission. Frequent indications for CT head scans included delirium, falls and head injury. Only 46 (9.9%) patients had new finding/s on the CT head scan, and action was taken on 26 (56.5%) of these patients. The CT head scan changed the management plan of only 17 (3.6%) patients. Please see Table for more details. Conclusions By using our clinical judgement, following NICE guidelines on head injuries, educating our colleagues on the criteria for requesting a CT head scan, taking collateral histories about patients’ cognition and ascertaining the mechanism of fall, we can lessen the financial burden on the NHS and minimise the radiation exposure to our patients.

Use and costs of inhaled nitric oxide and inhaled epoprostenol in adult critically ill patients: A quality improvement project

2019 ◽  
Vol 76 (18) ◽  
pp. 1413-1419 ◽  
Author(s):  
Stephanie L Davis ◽  
Jessica R Crow ◽  
John R Fan ◽  
Katie Mattare ◽  
Glenn Whitman ◽  
...  
Keyword(s):  
Nitric Oxide ◽  
Quality Improvement ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Academic Medical Center ◽  
Tertiary Care ◽  
Inhaled Nitric Oxide ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Number Of Patients

Abstract Purpose Inhaled epoprostenol and inhaled nitric oxide are pulmonary vasodilators commonly used in the management of acute respiratory distress syndrome and right ventricular failure; however, they have vastly different cost profiles. The purpose of the project was to transition from nitric oxide to epoprostenol as the inhaled pulmonary vasodilator (IPV) of choice in adult critically ill patients and evaluate the effect of the transition on associated usage and costs. Methods A single-center, prospective, before and after quality improvement project including adult patients receiving inhaled nitric oxide, inhaled epoprostenol, or both was conducted in 7 adult intensive care units, operating rooms, and postanesthesia care units of a tertiary care academic medical center. The total number of patients, hours of therapy, and costs for each agent were compared between stages of protocol implementation and annually. Results Seven hundred twenty-nine patients received inhaled nitric oxide, inhaled epoprostenol, or both during the study period. The monthly inhaled nitric oxide use in number of patients, hours, and cost decreased during all stages of the project (p < 0.01). The monthly inhaled epoprostenol use in number of patients, hours, and cost increased during all stages (p < 0.01). Overall, total IPV use increased during the study. However, despite this increase in usage, there was a 47% reduction in total IPV cost. Conclusion Implementation of a staged protocol to introduce and expand inhaled epoprostenol use in adult critically ill patients resulted in decreased use and cost of inhaled nitric oxide. The total cost of all IPV was decreased by 47% despite increased IPV use.

A Brief Education of PCPs Can Help Reduce the Number of Patients Unscreened for HCV: A Quality Improvement Project

2015 ◽  
Vol 110 ◽  
pp. S983
Author(s):  
Harleen K. Chela ◽  
Nizaar Talaat ◽  
Sameer Siddique ◽  
Imran Ashraf ◽  
Bhupinder Romana ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Number Of Patients
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