Patient Safety Score Improvement Plan for the Progressive Care Unit

Patient Safety Score Improvement Plan for the Progressive Care Unit

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Increased CAUTI cases have widespread financial, mortality and morbidity implications. Research shows CAUTIs are difficult to treat as they resist treatment compared to other UTIs. In this case, focusing on preventing them is critical to ensure patient safety and improve the Safety Score, which is a mark of how well a unit, a healthcare profession or a hospital has upheld patient safety standards to prevention complications associated with lack of safety. In this light, this paper seeks to design a Safety Score improvement plan for CAUTI for the PCU unit, which has experienced increased CAUTI cases that threaten patients’ life and could deny the hospital Medicare and Medicaid reimbursements.

Study of Factors

Patient Safety Issue: Catheter-associated Urinary Tract Infection (CAUTI)

Urinary tract infections make up 40% of all infections occurring in acute care hospitals. Over 80% of UTIs are catheter associated (CAUTI). Most patients in PCU receive catheters. CAUTIs may involve the entire urinary system, including the ureters, bladder, kidney and urethra (Nicolle, 2014). This increases the mortality and morbidity causing over 13,000 deaths each year. CAUTI is also contributes to secondary bloodstream infections that contribute to 10% mortality in acute care. Other complications include increased costs amounting to 0.5 billion annually, unnecessary use of antimicrobial and increased length of stay. CAUTI may also compromise immunity, as well as, complicate the primary health issue that the patient suffers from. In the PCU unit, these implications, ranging from increased morbidity to mortality have been experienced (Gould, 2014).

Nursing Leadership Influence

As in the case of driving other changes to ensure patient safety, nursing leadership has a critical role in driving changes to facilitate reduction of CAUTI incidences. Saint et al. (2010) note that nursing unit leaders are primarily important because they help cultivate clinical excellence, as a culture, develop clear visions, as well as, articulate the vision of preventing CAUTI to nurses. In addition, they serve the role of inspiring, motivating and energizing nurses based on their actions, which help them garner respect from other nurses. Nurse leaders are also solution-oriented, thus at the forefront of countering barriers to implementing changes that will prevent CAUTI. They deal with tough issues head-on, thus critical in communicating with other nurses to identify barriers to change.

Importantly, the prevention of safety issues is effectively done within a patient safety culture, where the norms, beliefs, values and practices of the organization and those involved in it are consciously aware of issues sabotaging patient safety and seek to address/prevent the issues continually. PCU nurse leader in collaboration with the head nurse conduct safety culture survey of the unit to assess conditions that may lead to CAUTI, raise awareness of the severity of CAUTI among nurses, as well as, use it to monitor effectiveness of interventions made. Nurse leaders can promote attitudes oriented towards implementing the recommendations. In building a culture of safety, nurse leaders can advocate for teamwork, a learning and just culture, patient-centeredness, evidence-based practice and communication, all which must be oriented towards implementing recommendations suggested to prevent CAUTI (Sammer & James, 2011).

Effects of Current Policies and Procedures

Patient safety is implemented within the context of organizational procedures and policies, which influence how employees act to ensure patient safety, including preventing CAUTI. They act as a framework that guide employees, including nurses, physicians and other staff members on how to act to prevent eruption of safety concerns. Healthcare institutions with effective procedures and policies on preventing CAUTI high adherence/compliance to CAUTI preventive measures, thus low incidences of CAUTI. Such organization have specific instructions, such as assessing CAUTI risk factors, reservoir/drainage back for transmission, as well as, strategies for detecting CAUTI, such as surveillance approaches. This also goes for primary and secondary prevention strategies/procedures, including assessing patient to prevent unnecessary and prolonged use of catheters, changing the drainage bag, as well as, using antibiotics. Nonetheless, Revello and Gallo (2013) note that policies must work in synergy with strong nursing leadership and a certified infection preventionist to ensure compliance and successful prevention of CA…………….………….

Patient Safety Score Improvement Plan for the Progressive Care Unit

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