A Central Sterile Processing and Hospital Epidemiology and Infection Control Collaboration to Ensure Safe Patient Care

AORN Journal ◽  
2020 ◽  
Vol 112 (1) ◽  
pp. 8-14 ◽  
Author(s):  
Brenda Nack ◽  
Elaine Nowakowski ◽  
Frances Nicholson
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Hospital Epidemiology ◽  
Safe Patient Care ◽  
Sterile Processing

Fire in operating theatres: DaSH-ing to the rescue

2018 ◽  
Vol 28 (7-8) ◽  
pp. 188-193
Author(s):  
Liam Wilson ◽  
Omer Farooq
Keyword(s):  
Patient Care ◽  
Fire Safety ◽  
Training Session ◽  
Operating Theatre ◽  
In Situ Simulation ◽  
Safe Patient Care ◽  
Team Interactions ◽  
Operating Theatres ◽  
Theatre Staff ◽  
Safety Officer

Operating theatres are dynamic environments that require multi professional team interactions. Effective team working is essential for efficient delivery of safe patient care. A fire in the operating theatre is a rare but potentially life threatening event for both patients and staff. A rapid and cohesive response from theatre and allied staff including porters, fire safety officer etc is paramount. We delivered a training session that utilised in situ simulation (simulation in workplace). After conducting needs analysis, learning objectives were agreed. After thorough planning, the date and location of the training session were identified. Contingency plans were put in place to ensure that patient care was not compromised at any point. To ensure success, checklists for faculty were devised and adhered to. A medium fidelity manikin with live monitoring was used. The first part of the scenario involved management of a surgical emergency by theatre staff. The second part involved management of a fire in the operating theatre while an emergency procedure was being undertaken. To achieve maximum learning potential, debriefing was provided immediately after each part of the scenario. A fire safety officer was present as a content expert. Latent errors (hidden errors in the workplace, staff knowledge etc) were identified. Malfunctioning of theatre floor windows and staff unawareness about the location of an evacuation site were some of the identified latent errors. Thorough feedback to address these issues was provided to the participants on the day. A detailed report of the training session was given to the relevant departments. This resulted in the equipment faults being rectified. The training session was a very positive experience and helped not only in improving participants’ knowledge, behaviour and confidence but also it made system and environment better equipped.

scholarly journals Infection Prevention Time Required for Construction and Design at a Large Tertiary-Care Hospital, 2019

2020 ◽  
Vol 41 (S1) ◽  
pp. s69-s70
Author(s):  
Angie Dains ◽  
Michael Edmond ◽  
Daniel Diekema ◽  
Stephanie Holley ◽  
Oluchi Abosi ◽  
...  
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Construction Projects ◽  
Small Scale ◽  
Care Hospital ◽  
Class Iii ◽  
Construction Sites ◽  
Wide Range ◽  
Time Required ◽  
Class Iv

Background: Including infection preventionists (IPs) in hospital design, construction, and renovation projects is important. According to the Joint Commission, “Infection control oversights during building design or renovations commonly result in regulatory problems, millions lost and even patient deaths.” We evaluated the number of active major construction projects at our 800-bed hospital with 6.0 IP FTEs and the IP time required for oversight. Methods: We reviewed construction records from October 2018 through October 2019. We classified projects as active if any construction occurred during the study period. We describe the types of projects: inpatient, outpatient, non–patient care, and the potential impact to patient health through infection control risk assessments (ICRA). ICRAs were classified as class I (non–patient-care area and minimal construction activity), class II (patients are not likely to be in the area and work is small scale), class III (patient care area and work requires demolition that generates dust), and class IV (any area requiring environmental precautions). We calculated the time spent visiting construction sites and in design meetings. Results: During October 2018–October 2019, there were 51 active construction projects with an average of 15 active sites per week. These sites included a wide range of projects from a new bone marrow transplant unit, labor and delivery expansion and renovation, space conversion to an inpatient unit to a project for multiple air handler replacements. All 51 projects were classified as class III or class IV. We visited, on average, 4 construction sites each week for 30 minutes per site, leaving 11 sites unobserved due to time constraints. We spent an average of 120 minutes weekly, but 450 minutes would have been required to observe all 15 sites. Yearly, the required hours to observe these active construction sites once weekly would be 390 hours. In addition to the observational hours, 124 hours were spent in design meetings alone, not considering the preparation time and follow-up required for these meetings. Conclusions: In a large academic medical center, IPs had time available to visit only a quarter of active projects on an ongoing basis. Increasing dedicated IP time in construction projects is essential to mitigating infection control risks in large hospitals.Funding: NoneDisclosures: None

scholarly journals Knowledge, Perceptions and Practices of Community Pharmacists Towards Antimicrobial Stewardship: A Systematic Scoping Review

Antibiotics ◽  
2019 ◽  
Vol 8 (4) ◽  
pp. 263 ◽  
Author(s):  
Sajal K. Saha ◽  
Chris Barton ◽  
Shukla Promite ◽  
Danielle Mazza
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Antimicrobial Stewardship ◽  
Scoping Review ◽  
Community Pharmacists ◽  
Antibiotic Use ◽  
Methodological Framework ◽  
Medical Databases ◽  
Further Development

The scope of antimicrobial stewardship (AMS) surveys on community pharmacists (CPs) is uncertain. This study examines the breadth and quality of AMS survey tools measuring the stewardship knowledge, perceptions and practices (KPP) of CPs and analyse survey outcomes. Following PRISMA-ScR checklist and Arksey and O’Malley’s methodological framework seven medical databases were searched. Two reviewers independently screened the literatures, assessed quality of surveys and KPP outcomes were analysed and described. Ten surveys were identified that assessed CPs’ AMS perceptions (n = 7) and practices (n = 8) but none that assessed AMS knowledge. Three survey tools had been formally validated. Most CPs perceived that AMS improved patient care (median 86.0%, IQR, 83.3–93.5%, n = 6), and reduced inappropriate antibiotic use (84.0%, IQR, 83–85%, n = 2). CPs collaborated with prescribers for infection control (54.7%, IQR 34.8–63.2%, n = 4) and for uncertain antibiotic treatment (77.0%, IQR 55.2–77.8%, n = 5). CPs educated patients (53.0%, IQR, 43.2–67.4%, n = 5) and screened guideline-compliance of antimicrobial prescriptions (47.5%, IQR, 25.2–58.3%, n = 3). Guidelines, training, interactions with prescribers, and reimbursement models were major barriers to CP-led AMS implementation. A limited number of validated survey tools are available to assess AMS perceptions and practices of CPs. AMS survey tools require further development to assess stewardship knowledge, stewardship targets, and implementation by CPs.

scholarly journals A qualitative positive deviance study to explore exceptionally safe care on medical wards for older people

2019 ◽  
Vol 28 (8) ◽  
pp. 618-626 ◽  
Author(s):  
Ruth Baxter ◽  
Natalie Taylor ◽  
Ian Kellar ◽  
Rebecca Lawton
Keyword(s):  
Older People ◽  
Patient Care ◽  
Social Contexts ◽  
Positive Deviance ◽  
Multidisciplinary Teams ◽  
Safe Patient Care ◽  
Working Together ◽  
Multidisciplinary Staff ◽  
Medical Wards ◽  
Safe Care

BackgroundThe positive deviance approach seeks to identify and learn from those who demonstrate exceptional performance. This study sought to explore how multidisciplinary teams deliver exceptionally safe care on medical wards for older people.MethodsA qualitative positive deviance study was conducted on four positively deviant and four slightly-above-average matched comparator wards, which had been identified using routinely collected NHS Safety Thermometer data. In total, 70 multidisciplinary staff participated in eight focus groups to explore staff perceptions about how their teams deliver safe patient care. A thematic analysis was conducted in two stages: first to identify the tools, processes, strategies, and cultural and social contexts that facilitated safety across all wards; and second to generate hypotheses about the characteristics that facilitated ‘positively deviant’ patient care.ResultsBased on identifiable qualitative differences between the positively deviant and comparison wards, 14 characteristics were hypothesised to facilitate exceptionally safe care on medical wards for older people. This paper explores five positively deviant characteristics that healthcare professionals considered to be most salient. These included the relational aspects of teamworking, specifically regarding staff knowing one another and working together in truly integrated multidisciplinary teams. The cultural and social context of positively deviant wards was perceived to influence the way in which practical tools (eg, safety briefings and bedside boards) were implemented.ConclusionThis study exemplifies that there are no ‘silver bullets’ to achieving exceptionally safe patient care on medical wards for older people. Healthcare leaders should encourage truly integrated multidisciplinary ward teams where staff know each other well and work as a team. Focusing on these underpinning characteristics may facilitate exceptional performances across a broad range of safety outcomes.

scholarly journals Correction: Assuring safe patient care in a level III NICU in anticipation of hospital closure

2020 ◽  
Vol 40 (11) ◽  
pp. 1730-1730
Author(s):  
Rachel Fleishman ◽  
Endla Anday ◽  
Vineet Bhandari
Keyword(s):  
Patient Care ◽  
Safe Patient Care ◽  
Hospital Closure

A Five-Year Study of Needlestick Injuries: Significant Reduction Associated With Communication, Education, and Convenient Placement of Sharps Containers

1992 ◽  
Vol 13 (5) ◽  
pp. 265-271 ◽  
Author(s):  
Donna J. Haiduven ◽  
Tammy M. DeMaio ◽  
David A. Stevens
Keyword(s):  
Infection Control ◽  
Patient Care ◽  
Healthcare Workers ◽  
Medical Center ◽  
Educational Programs ◽  
Needlestick Injuries ◽  
San Jose ◽  
Communication Education ◽  
Santa Clara Valley ◽  
Control Department

AbstractObjective:To decrease the numbers of needlesticks among healthcare workers.Design:All reported needlestick injuries at Santa Clara Valley Medical Center, San Jose, California, were reviewed, analyzed, and tabulated by the infection control department yearly from 1986 to 1990.Setting:A 588-bed county teaching hospital in San Jose, California, affiliated with Stanford University.Participants:All employees of Santa Clara Valley Medical Center who reported needlestick injuries on injury report forms.Interventions:From April to December 1987, more needle disposal containers were added to as many patient care areas and as close to the area of use as possible. Results of 1986, 1988, 1989, and 1990 analyses were communicated yearly to all personnel, extensive educational programs were conducted in 1987 and 1988, and educational efforts continued in 1989 and 1990.Results:In 1986, there were 259 needlestick injuries at our institution, 22% (32) from recapping. After needle disposal containers were added to all patient care areas, needlestick injuries for 1988 totalled 143, a 45% decrease in the total needlestick injuries and a 53% decrease in recapping injuries. Communication of results to all areas of the hospital and educational activities were started in 1987 and continued through the next 3 years. In 1989, there were 135 needlestick injuries, a decrease of 6% from 1988; recapping injuries decreased 40% from 1988. In 1990, there were 104 needlestick injuries, a 23% decrease since 1989, and a 33% decrease in recapping injuries. The total number of needlestick injuries from 1986 to 1990 decreased by 60%, and those injuries from recapping decreased by 81% to 89%.Conclusions:We have continued to monitor needlestick injuries, communicate findings to all personnel, and include needlestick prevention in educational programs. We contend that more convenient placement of needle disposal containers, communication of tidings, and education do decrease needlestick injuries in healthcare workers.

scholarly journals Operating room nurse residency and specialty educators: Paramount in the success of novice nurse retention

2017 ◽  
Vol 8 (5) ◽  
pp. 20 ◽  
Author(s):  
LaSandra Brown ◽  
Debbie Belgard ◽  
Nakeisha Washington ◽  
Sparkle Grueso
Keyword(s):  
Patient Care ◽  
Operating Room ◽  
Residency Program ◽  
Surgical Patients ◽  
Team Approach ◽  
Residency Programs ◽  
Nurse Residency ◽  
Safe Patient Care ◽  
Nursing Curricula ◽  
Nurse Residency Program

Perioperative service is one of the specialties of nursing in which a team approach is vital for optimal patient care. The registered nurse is responsible for coordinating and delivering safe patient care. Operating room (OR) nurses are responsible for applying fundamental applications of the nursing process while formulating plans of care unique to surgical patients. The growing shortage of nurses worldwide especially impacts highly complex areas such as the OR, where skills specialized are needed to care for patients. One of the largest challenges of a graduate nurse (GN) is becoming enculturated to new environments. Traditionally, OR nursing is a paradigm foreign in nursing curricula; this creates challenges in the GN population in applying their practical nursing skills to surgical patients. In an effort to combat ongoing knowledge deficits unique to OR nursing, Houston Methodist Hospital (HMH) created an OR nurse residency program. The literature suggests that specialty-specific nursing residency programs offer GNs essential tools for becoming successful in their transition. Additionally, research suggests reductions in nurse burnout and turnover rate among GNs with adequate training and preparation. The purpose of this article was to provide insight on the importance of introduction to the OR prior to graduating from nursing school and the importance of OR nursing specialty residency programs and specialty educators as they pertain to the ideal nursing transition, sustainability, retention, and favorable patient outcomes. A questionnaire was created to capture successful applicable practices; the questionnaire also provided an opportunity for GNs to suggest opportunities for program improvements. The questionnaire was used to explore feedback from the summer 2014 Operating Room (OR) residency program graduate nurses in an effort to capture improvements needed for future program success.

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