Chapter 22 Quality Patient Care Flashcards Preview

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Flashcards in Chapter 22 Quality Patient Care Deck (22)
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What is a primary concern for providing quality patient care?

Medication Errors


What is a sentinel event?

An unexpected occurrence involving death or loss of limb or function. Sentinel events require immediate investigation and response.


Standards of quality health care management are established by what agencies?

American Nurses Association (ANA)
The Joint Commission (TJC)
The Agency for Healthcare Research and Quality (AHRQ)


Root Cause Analysis

Process for use in investigating and categorizing the root causes of events that occur.


Core Measures

33 Core Measures divided into 4 categories.
Acute Myocardial Infarction, Heart Failure, Pneumonia, and The Surgical Care Improvement Process. The goal is to improve the quality of care by implementing national standardized performance measurement system.


What is HCAHPS?

Hospital Consumer Assessment of Health Plans Survey.
National Program for collecting and providing health care information from the consumer perspective-- results are used to improve health care services.


What is Hospital Compare?

A website is designed so consumer can compare how well (selected) hospitals serve to provide the care recommended to their patients. Allows consumers to make informed decisions about health care.


The Joint Commission

Accredits health care institutions that are funded by Medicare and Medicaid.


Patient Safety Goals. This is a summary from the Joint Commission.

Use at least two ways to identify patient.
Improve effectiveness of communication among caregivers.
Improve safety of using medications.
Improve safety of infusion pumps.
Reduce risk of health care associated infections.
Accurately and completely reconcile medications.
Reduce risk of patient harm from falls.
Encourage involvement of patients and families in patient care.
Prevent health care associated pressure ulcer.
Identify safety risks in the patient population.
Improve recognition and response to changes in patient condition.
Taking time out before procedures.


What is quality improvement (QI)?

Process or activities that are used to measure, monitor, evaluate, and control services, so that we can provide some measure of confidence to our health care consumers.


How do we monitor quality control?

Quality Improvement department receives data, analyzes trends, and recommends actions to facilitate improvement in the organization.
There is also a Continuous Quality Improvement Council as a primary decision making nursing team, as well as quality circles that function along service lines, collaborating to improve patient care.


Quality Indicator

Is an item of concern that has arisen because of a nursing practice problem. Ex.. problem with securing urethral catheters properly, or IV tubing that has not been labeled with date and time it should be changed.


Core Measures

Part of TJC accreditation standards.
Advance directives, autopsy rates, AMA rates, code-blue rates, fall rates, medication error rates, restraint use, DVT rates, surgical site infection rates


What is Performance Improvement?

Synonymous with quality improvement, and the two terms are used interchangeably. Similar to nursing process (assess, diagnose, plan, implement, and evaluate). Method that demonstrates what the standard procedures will be for nurses and others within the hospital.


Barriers to Quality Improvement

Nurses Loyalty to old practices and failure to recognize needed change.


"Work Arounds"

Pose safety threat, because working around something means getting around the problem instead of solving it. An example is the habit of borrowing medications from another patient in the interest of saving time.


Stair steps to quality health care



Six Stigma

Is a measurement standard. Reduces variation in practice through the application of DMAIC. Six Stigma means having no more than 3.4 defects per million opportunities, so if you take one million blood pressure readings there should be no fewer than 3.4 that were incorrect.





How does someone become a Certified Professional in Healthcare Quality?

By taking a certification test to determine knowledge of quality management, quality improvement, case management, and risk management. No minimum education requirement, but should have worked in quality management for a minimum of 2 years. 75% pass rate


Quality is about fire prevention not...



Key performance indicators

Reflect the things the team sees as problems like areas. Examples are time, cost, distance, # of incidents, or items. This is part of the measure phase.