Simple steps to prevent hospital-acquired pneumonia in non-intubated patients: a quality improvement project

2021 ◽  
Vol 30 (2) ◽  
pp. 110-115
Author(s):  
Alice Wilkinson ◽  
Anousha Singal ◽  
Ghada Ramadan
Keyword(s):  
Quality Improvement ◽  
Elderly Care ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Allied Health Professionals ◽  
Improvement Project ◽  
Life Saving ◽  
Adult Feeding ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Background: Hospital-acquired pneumonia (HAP) affects approximately 1.5% of UK inpatients. As well as leading to significant morbidity and mortality, HAP increases burden on hospitals by lengthening hospital stay. At a district general hospital in Kent, a quality improvement project (QIP) was designed that introduced simple preventive measures that could be implemented by ward nurses and allied health professionals. Methods: Three audit cycles studying a total of 222 inpatients on elderly care wards were undertaken over a 6-month period to assess staff compliance at various stages of the project, with interventions between each cycle. Actions included raising bedheads to 30°, sitting patients out of bed for meals, discouraging use of drinking straws, and regular mouth care. Results: Overall, improvements were seen in three of the measures. Considering the percentage of patients, there was a 23% increase in patients with bedheads >30°, 21% increase in use of adult feeding cups rather than straws, and 26% rise in patients sitting out of bed for meals. Conclusion: The main objective of this QIP was to show that these simple yet potentially life-saving interventions are easy to implement on a busy ward, and the results have shown this to be true.

Lessons learned in establishing a quality improvement project to reduce hospital acquired infections in the neonatology ward at a referral hospital in Rwanda

2016 ◽  
Vol 24 (4) ◽  
pp. 341-348 ◽  
Author(s):  
Naasson Gafirimbi ◽  
Rex Wong ◽  
Eva Adomako ◽  
Jeanne Kagwiza
Keyword(s):  
Quality Improvement ◽  
Lessons Learned ◽  
Referral Hospital ◽  
Quality Improvement Project ◽  
Injection Technique ◽  
Improve Quality ◽  
Improvement Project ◽  
Content Type ◽  
Hospital Acquired

Purpose Improving healthcare quality has become a worldwide effort. Strategic problem solving (SPS) is one approach to improve quality in healthcare settings. This case study aims to illustrate the process of applying the SPS approach in implementing a quality improvement project in a referral hospital. Design/methodology/approach A project team was formed to reduce the hospital-acquired infection (HAI) rate in the neonatology unit. A new injection policy was implemented according to the root cause identified. Findings The HAI rate decreased from 6.4 per cent pre-intervention to 4.2 per cent post-intervention. The compliance of performing the aseptic injection technique significantly improved by 60 per cent. Practical implications This case study illustrated the detailed application of the SPS approach in establishing a quality improvement project to address HAI and injection technique compliance, cost-effectively. Other departments or hospitals can apply the same approach to improve quality of care. Originality/value This study helps inform other hospitals in similar settings, the steps to create a quality improvement project using the SPS approach.

Please reconcile, not wait a while

2019 ◽  
Vol 105 (2) ◽  
pp. 122-126
Author(s):  
Ashifa Trivedi ◽  
Sadhna Sharma ◽  
Richa Ajitsaria ◽  
Nicola J Davey
Keyword(s):  
Quality Improvement ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Acute Setting ◽  
Paediatric Department ◽  
Medicines Reconciliation ◽  
The Mean ◽  
Patient Safety Incidents ◽  
Main Factor

A quality improvement project to increase the rate of paediatric medicines reconciliation was carried out in a district general hospital between April and July 2018. Baseline data collected from our paediatric ward shows that medicines reconciliation by doctors is only accurately completed 50% of the time. Evidence shows that medicines-related patient safety incidents are more likely when medicines reconciliation happens more than 24 hours after a person is admitted to an acute setting. The aim of this quality improvement project was therefore to ensure that 100% of paediatric patients have their regular medications prescribed by mid-day the day after admission. The paediatric pharmacy team reviewed all paediatric inpatient drug charts from Monday to Friday for 12 weeks. The number of regular medications and the number of medicines reconciled was recorded each day. The effectiveness of various interventions were reviewed using Plan–Do–Study–Act cycles. On average, 40 patients were reviewed each week. The mean reconciliation rate was 79%, and the worst rate was 0%. 100% reconciliation was achieved on 34 occasions and was achieved continuously for the last 3 weeks of data collection. A repeat audit carried out in September 2018 found the reconciliation rate was maintained at 100%. Multiple interventions occurred during this quality improvement project: teaching sessions for doctors, posters to raise awareness and questionnaires for parents/children to complete about their regular medications. The main factor for success in this project has been involving all members of the paediatric department including children and their parents.

A Clinical Nurse Specialist–Led Interprofessional Quality Improvement Project to Reduce Hospital-Acquired Pressure Ulcers

2016 ◽  
Vol 30 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Christina Fabbruzzo-Cota ◽  
Monica Frecea ◽  
Kathryn Kozell ◽  
Katalin Pere ◽  
Tamara Thompson ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pressure Ulcers ◽  
Clinical Nurse Specialist ◽  
Quality Improvement Project ◽  
Nurse Specialist ◽  
Improvement Project ◽  
Clinical Nurse ◽  
Hospital Acquired

14 Rational Prescribing in the Frail Elderly Population: A Quality Improvement Project to Reduce Inappropriate Prescribing Using STOPP-Frail Criteria

2020 ◽  
Vol 49 (Supplement_1) ◽  
pp. i1-i8
Author(s):  
J Brooke ◽  
R Darnell ◽  
M Boltova ◽  
N Hashemi
Keyword(s):  
Quality Improvement ◽  
Elderly Care ◽  
Inappropriate Prescribing ◽  
Drug Effects ◽  
The Elderly ◽  
Quality Improvement Project ◽  
University Hospital ◽  
Lipid Lowering ◽  
Adverse Drug Effects ◽  
Improvement Project

Abstract Introduction 2.5 million people in the UK are aged over 80 and up to 50% can be considered frail. Complex co-morbidities and polypharmacy are linked with adverse drug effects and negative outcomes. NICE recommends a medication review yearly, and a hospital admission provides an opportunity for this. STOPP-Frail is a screening tool designed to highlight medications that could be reduced/stopped with a view to improving quality of life. We conducted a quality improvement project to quantify levels of inappropriate prescribing at Croydon University Hospital (CUH), with a view to de-prescribing and reducing adverse drug effects. Methods A retrospective analysis was carried out on the Elderly Care wards at CUH. Data was collected from 60 consecutive patients discharged from 1st November 2018, utilising electronic Cerner records. Recorded medication on admission and discharge, noting any amendments in accordance with the STOPP-Frail criteria. Results Data collected from 60 patients; one exclusion for not meeting STOPP-Frail criteria (n=59). Median age 86 years (69 to 103 years). Mean number of medications on admission 7.42 (1 to 15). 93.2% patients had polypharmacy (defined as ≥ 4 medications). Mean number of medications on discharge 8.22; an increase of 0.8/patient. 19.4% admission medications met STOPP-Frail criteria for inappropriate prescriptions. Only 18.8% of these were reduced or stopped during admission. Gastrointestinal and cardiovascular medications were most commonly inappropriately prescribed (n=27 and 24 respectively). Most common medications not amended were lipid-lowering therapies (n=21) and proton-pump inhibitors (n= 20). Conclusions The opportunity to rationalise medication in the frailest patients admitted to CUH is missed in over 80% of cases. STOPP-Frail provides clear guidance to aid clinicians in reducing inappropriate prescribing. An educational programme is in place to highlight medication rationalisation and guide clinicians in the use of the STOPP-Frail tool. This includes doctors’ induction, departmental teaching, posters and computer flash cards.

scholarly journals 1473 Urology Consent Forms at a District General Hospital – a Quality Improvement Project

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
D Bernstein ◽  
A West ◽  
E Preston ◽  
P Premakumaran ◽  
N Suleyman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Data Collection ◽  
General Hospital ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Consent Form ◽  
National Guidelines ◽  
Improvement Project ◽  
Consent Forms ◽  
Carbon Copy

Abstract Aim Consent is a core component of interaction between patients and healthcare professionals. Prior to surgery, forms are completed to record patient consent. As well as containing risks and benefits of the procedure, the consent form, as per guidelines1,2, must be legible and suitable to a patient’s capacity. To evaluate compliance with local and national guidelines, a quality improvement project was undertaken at a district general hospital. Method Over a three-week period 30 urology consent forms were selected to assess adherence to local and national guidelines. The appropriateness of consent form, patient signature, legibility, acronym use and whether the patient was offered a carbon copy were assessed. After initial data collection, all urology staff consenting patients were notified of the findings and how best to improve guideline adherence. A further three-week data collection was undertaken, though the sample set was small due to Coronavirus and Christmas. Results The results confirmed that patients had appropriate consent forms filled out and were signed appropriately. After intervention, there was clear improvement in legibility, with no low legibility consent forms, and 100% vs 83% high or moderate legibility between data sets. Intervention also resulted in significant reduction of acronym use; 33% vs 60%. More patients were also offered to retain a carbon copy; 89% vs 40%. Conclusions Through this intervention of highlighting local and national guidance as compared to current practice, compliance drastically improved. As the pandemic subsides, we hope regular emails to surgical teams will improve consent form completion to better patient care.

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