scholarly journals A quality improvement project for the cost‐effective management of maternal anaemia

Author(s):  
Katherine S. Colman ◽  
Sue Pavord ◽  
Noémi Roy
2021 ◽  
Vol 50 (Supplement_1) ◽  
pp. i12-i42
Author(s):  
L Hickson ◽  
A K L Liu ◽  
G Bailey ◽  
S Bruce ◽  
K Kawafi ◽  
...  

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.


2016 ◽  
Vol 24 (4) ◽  
pp. 327-334
Author(s):  
Yvonne Ufitinema ◽  
Rex Wong ◽  
Eva Adomako ◽  
Léonard Kanyamarere ◽  
Egide Kayonga Ntagungira ◽  
...  

Purpose The purpose of this paper is to describe the quality improvement project to increase the medical record documentation completion rate in a district hospital in Rwanda. Despite the importance of medical records to support high quality and efficient care, incomplete documentation is common in many hospitals. Design/methodology/approach The pre- and post-intervention record completion rate in the maternity unit was assessed. Intervention included assigned nurse to specific patients, developed guideline, provided trainings and supervisions. Findings The documentation completion rate significantly increased from 25 per cent pre-intervention to 67 per cent post-intervention, p < 0.001. The completeness of seven out of the ten elements of medical records also significantly increased. Practical implications The quality improvement project created a cost-effective intervention that successfully improved the documentation completion rate. Ongoing monitoring should be continued to learn sustainability. Originality/value The results are useful for hospitals with similar settings to improve completion of nursing documentation and increase nursing accountability on patient care.


2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S343-S343 ◽  
Author(s):  
Alpa Desai ◽  
Steven Burdette

Abstract Background Metronidazole (MTZ) is an imidazole that is used to treat parasites and anaerobic infections. The traditional dose of 500 mg every 6 to 8 hours achieves adequate serum concentration to treat most anaerobic infections. MTZ has a concentration dependent bactericidal activity with a long half-life of 8 hours and also exhibits post-antibiotic effect. The literature lacks clinical data in regards to a once daily higher dose of IV MTZ. Methods A retrospective quality improvement project via electronic medical record review of 88 adults who received MTZ 1 gm IV daily at a single tertiary medical center, from April 2014 to October 2016. Inclusion criteria were patients &gt;/=18 years who received MTZ 1 gm IV every daily for &gt;/= 48 hours. Results Of the 88 patients who received 1 gm of MTZ, 66 met inclusion criteria. Mean age was 58 years (range 24 to 90 years). Indications for use are shown in Figure 1. Mean duration of therapy was 10 days (range 2 to 42 days). Twenty-nine (43.9%) received &lt;/= 6 days and 37 (56.1%) received &gt;/= 7 days. Fourteen (21%) were discharged home on MTZ 1 gm IV daily for 4–6 weeks duration. One patient had a documented adverse reaction (severe nausea) while the other 65 tolerated well. No documented treatment failure was reported. Conclusion MTZ has been used in combination with other antimicrobial agents to treat polymicrobial infections. It is generally well tolerated when administered in dosages of &lt;2gm per day. Pharmacodynamic studies have demonstrated activity for 12 to 24 hours after administration of 1 gm of MTZ. Our study showed no safety concerns with 1 gm daily dosing and no reported treatment failure. The limitation of our study includes lack of comparative cohort. The potential advantages of once daily dosing include optimized bacterial killing, minimization of drug administration, and reduction of the cost of antibiotics as well as the cost of administration. Our safety and quality improvement project support that MTZ 1 gm IV daily dose is potentially a safe, efficacious and cost effective alternative to three times dosing especially in hospitalized patients and may have role in OPAT. Disclosures All authors: No reported disclosures.


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