scholarly journals A quality improvement project to standardise decontamination procedures in a single NHS board in Scotland

2020 ◽  
Vol 21 (6) ◽  
pp. 241-246
Author(s):  
Emer Shepherd ◽  
Anne Leitch ◽  
Evonne Curran ◽  
Keyword(s):  
Quality Improvement ◽  
Healthcare Workers ◽  
Education Programme ◽  
Training Needs ◽  
Protective Equipment ◽  
Improvement Project ◽  
Know How ◽  
The Right ◽  
Training Need ◽  
Do The Right Thing

Background: A project was designed to improve decontamination procedures in our hospitals. This included: improving skills with training provided within clinical areas, simplifying procedures to reduce variation and increasing access to decontamination products. Aim: To make it easy for healthcare workers (HCWs) to do the right thing and for HCWs to be confident that they were doing the right thing. Methods: A pre-intervention survey of 120 HCWs in 10 wards on three hospital sites identified variations in the products used, variations in precautions taken and deficits in HCWs’ capabilities due to unmet training needs. Intervention: We streamlined the available products, provided an education programme and then undertook a second survey involving 133 HCWs in 12 wards. Results: Significant improvements were attained in the reported time taken to clean and disinfect ( P < 0.0001) and in HCW capability ( P < 0.0001) (reported training received); other improvements in the use of appropriate products and the use of personal protective equipment were evident. The key finding was that a large, previously unrecognised, unmet training need existed; only 44% of HCWs in the pre-intervention survey reported having received training on the topic. Conclusion: The utility of a pre-intervention survey is critical to knowing whether any change becomes improvement and to set the priorities for change. By focusing on the process rather than the outcomes, greater improvements can be attained. The assumption that all nurses know how to clean is erroneous.

scholarly journals Development of Training Needs Analysis in Organization

2017 ◽  
Vol 9 (4) ◽  
pp. 140
Author(s):  
Rachmat Hartoyo ◽  
Hady Efendy
Keyword(s):  
Human Resource Development ◽  
Descriptive Analysis ◽  
Training Needs ◽  
Training System ◽  
Continuous Training ◽  
Analysis Technique ◽  
Training Professionals ◽  
The Right ◽  
Training Need ◽  
First Time

Competition encourages the organization to always improve its performance, so as to achieve competitive advantage. One of the steps taken is to conduct extensive and continuous training and employee development. A training need assessment is a strategic step to find out the right training program for the organization and employees. In addition, to produce effective training, training professionals need to emphasize doing the right things the first time. The type of data used in this study is qualitative, and the source of data in this study is the source of literature. Data analysis technique used in this research is descriptive analysis technique to describe and describe object to be studied. The purpose of this descriptive is to make the description, description or painting systematically, factually and accurately about the facts, properties and relationships between the phenomena investigated. The study consists of evaluating the components of the training system and planning of training needs based on competence. The evaluation is aimed to find out the training system and human resource development within an organization that includes the components of the training system.

scholarly journals Extreme preterm birth in the right place: a quality improvement project

2019 ◽  
Vol 105 (4) ◽  
pp. 445-448 ◽  
Author(s):  
Katherine Edwards ◽  
Lawrence Impey
Keyword(s):  
Quality Improvement ◽  
Preterm Birth ◽  
Place Of Birth ◽  
Improvement Project ◽  
Sustained Improvement ◽  
Premature Babies ◽  
Specialist Centre ◽  
Improvement Programme ◽  
The Uk ◽  
The Right

Extreme preterm birth is a major precursor to mortality and disability. Survival is improved in babies born in specialist centres but for multiple reasons this frequently does not occur. In the Thames Valley region of the UK in 2012–2014, covering 27 000 births per annum, about 50% of extremely premature babies were born in a specialist centre. Audit showed a number of potential areas for improvement. We used regional place of birth data and compared the place of birth of extremely premature babies for 2 years before our intervention and for 4 years (2014–2018) after we started. We aimed to improve the proportion of neonates born in a specialist centre with three interventions: increasing awareness and education across the region, by improving and simplifying the referral pathway to the local specialised centre, and by developing region-wide guidelines on the principal precursors to preterm birth: preterm labour and expedited delivery for fetal growth restriction. There were 147 eligible neonates born within the network in the 2 years before the intervention and 80 (54.4%) were inborn in a specialised centre. In the 4 years of and following the intervention, there were 334 neonates of whom 255 were inborn (76.3%) (relative risk of non-transfer 0.50 (95% CI 0.39 to 0.65), p<0.001). Rates showed a sustained improvement. The proportion of extremely premature babies born in specialist centres can be significantly improved by a region-wide quality improvement programme. The interventions and lessons could be used for other areas and specialties.

scholarly journals Implementation and spread of a simple and effective way to improve the accuracy of medicines reconciliation on discharge: a hospital-based quality improvement project and success story

2019 ◽  
Vol 8 (3) ◽  
pp. e000363 ◽  
Author(s):  
Shady Botros ◽  
John Dunn
Keyword(s):  
Improve Patient Safety ◽  
Successful Implementation ◽  
Patient Harm ◽  
Success Story ◽  
Improvement Project ◽  
Medicines Reconciliation ◽  
Improvement Methodologies ◽  
The Right ◽  
Do The Right Thing ◽  
Improve Patient

BackgroundChanges are often made to medications at times of transitions in care. Inadequate reconciliation during admission, transfer and discharge causes medication errors and increases risks of patient harm. Despite well-established multidisciplinary medicines reconciliation (MR) processes at hospital admission, our MR process at discharge; however, was poor. The main errors included failure to recommence withheld medicines and lack of documentation explaining changes made to medications on discharge. Our objective was to develop an intervention that supports prescribers to follow a simple standardised MR process at discharge to reduce these errors.MethodsWorking closely as a multidisciplinary team, we used improvement methodologies to design and test a process that reliably directs prescribers in surgery to use the inpatient prescribing chart as well as the MR on admission form as sources to create accurate discharge prescriptions. The project was segmented into testing, implementation, spread and sustainability.ResultsThe tested intervention helped the accuracy of discharge prescriptions steadily and quickly improve from 45% to 96% in the pilot ward. Following the successful implementation and sustainability in two separate pilot wards, the intervention was spread to the remaining eight wards producing a similar improvement.ConclusionsTo improve patient safety, it is crucial to ensure that information about medicines is effectively communicated when care is transferred between teams. Although this can be challenging, we’ve shown that it can be done effectively and reliably if this responsibility is equally shared by healthcare professionals from all disciplines while being supported by safe systems that make it easy to do the right thing. Successfully implementing a standardised multidisciplinary MR process at discharge can also reduce the reliance on pharmacists therefore freeing them to undertake other clinical roles.

Normative Externalism

2019 ◽  
Author(s):  
Brian Weatherson
Keyword(s):  
Peer Disagreement ◽  
Circular Reasoning ◽  
Know How ◽  
Moral Uncertainty ◽  
Aggressive Action ◽  
The Right ◽  
New Treatments ◽  
Do The Right Thing ◽  
Higher Order Evidence ◽  
What Matters

Normative Externalism argues that it is not important that people live up to their own principles. What matters, in both ethics and epistemology, is that they live up to the correct principles: that they do the right thing, and that they believe rationally. This stance, that what matters are the correct principles, not one’s own principles, has implications across ethics and epistemology. In ethics, it undermines the ideas that moral uncertainty should be treated just like factual uncertainty, that moral ignorance frequently excuses moral wrongdoing, and that hypocrisy is a vice. In epistemology, it suggests we need new treatments of higher-order evidence, and of peer disagreement, and of circular reasoning, and the book suggests new approaches to each of these problems. Although the debates in ethics and in epistemology are often conducted separately, putting them in one place helps bring out themes common to both. One is that the view that one should live up to one’s own principles starts to look less attractive when you look at people with terrible principles, or at cases when doing so would lead to riskier or more aggressive action than the correct principles. Another is that asking people to live up to their principles leads to regresses in cases where it is hard to know how to live up to one’s principles.

scholarly journals Pilot Study Evaluating a Practice-Based Learning and Improvement Curriculum Focusing on the Development of System-Level Quality Improvement Skills

2011 ◽  
Vol 3 (1) ◽  
pp. 49-58 ◽  
Author(s):  
Anne M Tomolo ◽  
Renée H Lawrence ◽  
Brook Watts ◽  
Sarah Augustine ◽  
David C Aron ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Self Efficacy ◽  
Assessment Tool ◽  
Comfort Level ◽  
System Level ◽  
Improvement Project ◽  
Continuous Quality ◽  
Quasi Experimental ◽  
The Right ◽  
The Impact

Abstract Background We developed a practice-based learning and improvement (PBLI) curriculum to address important gaps in components of content and experiential learning activities through didactics and participation in systems-level quality improvement projects that focus on making changes in health care processes. Methods We evaluated the impact of our curriculum on resident PBLI knowledge, self-efficacy, and application skills. A quasi-experimental design assessed the impact of a curriculum (PBLI quality improvement systems compared with non-PBLI) on internal medicine residents' learning during a 4-week ambulatory block. We measured application skills, self-efficacy, and knowledge by using the Systems Quality Improvement Training and Assessment Tool. Exit evaluations assessed time invested and experiences related to the team projects and suggestions for improving the curriculum. Results The 2 groups showed differences in change scores. Relative to the comparison group, residents in the PBLI curriculum demonstrated a significant increase in the belief about their ability to implement a continuous quality improvement project (P  =  .020), comfort level in developing data collection plans (P  =  .010), and total knowledge scores (P &lt; .001), after adjusting for prior PBLI experience. Participants in the PBLI curriculum also demonstrated significant improvement in providing a more complete aim statement for a proposed project after adjusting for prior PBLI experience (P  =  .001). Exit evaluations were completed by 96% of PBLI curriculum participants who reported high satisfaction with team performance. Conclusion Residents in our curriculum showed gains in areas fundamental for PBLI competency. The observed improvements were related to fundamental quality improvement knowledge, with limited gain in application skills. This suggests that while heading in the right direction, we need to conceptualize and structure PBLI training in a way that integrates it throughout the residency program and fosters the application of this knowledge and these skills.

Improving Influenza Vaccination of Healthcare Workers by Means of Quality Improvement Tools

2011 ◽  
Vol 32 (6) ◽  
pp. 616-618 ◽  
Author(s):  
Jose Cadena ◽  
Teresa Prigmore ◽  
Jason Bowling ◽  
Beth Ann Ayala ◽  
Leni Kirkman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Influenza Vaccination ◽  
Healthcare Worker ◽  
Healthcare Workers ◽  
Seasonal Influenza ◽  
Vaccination Rate ◽  
Improvement Project ◽  
Vaccination Rates ◽  
Grand Rounds ◽  
Voluntary Vaccination

For a healthcare worker seasonal influenza vaccination quality improvement project, interventions included support of leadership, distribution of vaccine kits, grand rounds, an influenza website, a Screensaver, e-mails, phone messages, and audit feedback. Vaccination rates increased from 58.8% to 76.6% (P < .01). Quality improvement increased the voluntary vaccination rate but did not achieve a rate more than 80%.

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