Growing a New Culture: Patient Safety

Growing a New Culture:Patient Safety Nancy Brumley Gessling, MSN, CIC Infection Prevention Copper Basin Medical Center

CBMC Demographics • Polk County – extreme Southeast corner of Tennessee • 25 Bed Critical Access, with swing beds • 3 bed Emergency Department

Infection Control History at CBMC • Old multi-tiered precaution system in place • Not evidence based • IC position frequently open or assigned to available staff nurse • Reluctance to change

Growing a Culture of Safety • Trust and confidence • Observation of IC practices • Needs assessment for education and skills • Data collection and analyses • Physician champion • Identification of stakeholders • Risk assessment for CBMC • Education of staff, physicians, administration

Evidence Based Practice • APIC membership • CDC guidelines • Journal articles for all staff categories • MDRO Surveillance • IC data to hospital PI committee and medical staff • Antibiogram every six months

Barriers to Progress • No in-house Microbiology • Short LOS • Poor attitude toward MDRO prevention • Poor compliance with barrier protection • Poor understanding of transmission based precautions • Poor physician support

Active Surveillance Cultures: or“You want to do What!?” • Based on MDRO surveillance and risk assessment • Detection of asymptomatic or subclinical state in a group of patients who are at risk but would not otherwise be identified. • Colonized patients are reservoir for MDRO transmission • Both infected & colonized pts contaminate their environment with the same relative frequency

ASC by the book • Decisions about which populations should be targeted for active surveillance should be made in the context of local determinations of the incidence and prevalence of MDRO colonization within the intervention facility as well as other facilities with whom patients are frequently exchanged CDC MDRO Guideline 2006

Stakeholder Relationships • Who is really affected by the process? • Proactive communication • Evidence based practice is essential • Track, trend, and monitor interventions • Share your success

ASC as part of a MDRO Bundle • Identify patient on admission as targeted for ASC • Obtain nasal swab on admission • Contact Precautions on admission • Barrier protection for every patient encounter • Hand hygiene in and out of room every time • A bundle is “all or nothing”

ASC Implications • Not implemented in hospitals to diagnose or treat infections • Used as a tool to provide a safer environment for reducing risk of MDRO transmission • Should be viewed as a QI measure • Prevent harm for isolated patients by providing equally attentive care to all patients

ASC Data

Growing a New Culture: Patient Safety

Growing a New Culture: Patient Safety

Presentation Transcript

Creating a Culture of Patient Safety

Nurturing a Culture of Patient Safety

Worker / Patient Safety: Steps in a Culture Change

Patient Safety New-Comers Orientation

Nurturing a Culture of Patient Safety

Medical Education Institutions: Developing a Culture of Patient Safety

ZERO INCIDENTS ACHIEVING A NEW SAFETY CULTURE

Patient Culture

NH Patient Safety Culture Survey (AHRQ) Beth Hercher , QI Specialist Patient Safety Team April 2009 Patient Safety Rest

Assessing patient safety using the Manchester Patient Safety Culture framework (MaPSaF)

Patient Safety: applying a culture assessment tool in practice

Perioperative Patient Safety Changing Safety Culture One Step at a Time

Growing A Culture of Safety

Tool for Building a Culture of Patient Safety:

Fostering A Culture of Safety: AHRQ’s Patient Safety Culture Survey

Redefining the Culture for Patient Safety

The New Patient Safety Net

Collaborative Learning from Patient Safety Organizations and International Patient Safety Culture

Patient Safety Culture Tools

CAP’s New Safety Culture

Patient Safety, Culture of Safety and Just Culture

Building a Safety Culture