1 / 14

National Networking Event Critical Care Workstream RAIGMORE N.H.S TRUST

National Networking Event Critical Care Workstream RAIGMORE N.H.S TRUST. Your Aims and Programme Goals . Mortality: 15% reduction Adverse Events: 30% reduction Ventilator Associated Pneumonia: 0 or 300 days between Central Line Bloodstream Infection: 0 or 300 days between

rupali
Download Presentation

National Networking Event Critical Care Workstream RAIGMORE N.H.S TRUST

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. National Networking Event Critical Care Workstream RAIGMORE N.H.S TRUST

  2. Your Aims and Programme Goals • Mortality: 15% reduction • Adverse Events: 30% reduction • Ventilator Associated Pneumonia: 0 or 300 days between • Central Line Bloodstream Infection: 0 or 300 days between • Blood Sugars w/in Range (ITU/HDU): 80% or > w/in range • Staph Aureus Bacteraemias: 30% reduction • Crash Calls: 30% reduction • Harm from Anti-coagulation: 50% reduction in ADEs • Surgical Site Infections: 50% reduction (clean) • All process measures will be reliable at the 10-2 level (defects in the parts per 100)

  3. Scottish Patient Safety Programme Critical Care Driver Diagram Secondary Drivers Components, Activities Outcomes Primary Drivers Processes, Rules of Conduct, Structure • Reliable Process of Care: • Prevent ventilator complications • Prevent CL complications • Prevent Inf. & cross contamination • Proper Sepsis Rec. and Rx • Involve Pt./Family into Goal • Setting Process • Communications Team & Family • Clarify care wishes and EOL planning • Appropriate Infrastructure to Provide Reliable, Evidence Based Care • Improve ICU throughput • Competent staff with knowledge in QI Work • Reliable planning, communication and collaboration of a multi disciplinary team Provide reliable, timely, care using evidence-based therapies Integrate patient and family into care Improved Patient Outcomes (Reduced Mortality, Infections, & Other Adverse Events) Develop infrastructure that promotes quality care Create a collaborative team and safety culture

  4. Our Journey so far……

  5. Core Team Members

  6. INSTITUTE MULTI-DISIPLINARY ROUNDS AND ESTABLISH DAILY GOAL SHEETS • Establish a multidisciplinary round. • Who ? Consultant, registrar, junior doctors Nurse in charge, bed side nurse. pharmacist, physiotherapist, dietitian. • When? • How ? Format structured/prep sheet ? or use the observation chart as format

  7. Initial Daily Goal Sheet • Daily Goals - Date • Resp/Weaning Plan – a.m. • Venflon Review • CVS – am • Hb Target • Renal/Fluid Balance – am • G.I. Bowels • Sedation Plan (if no sedation break) • Relatives • Miscellaneous • 17.00 HR Review • Initials:

  8. Secondary Driver:Institute Multi Disciplinary Rounds /Establish Daily Goal Sheets DATA FEEDBACK TO FRONTLINE STAFF: Compliance w PVC check D S P A A P S D D S P A A P S D A P S D IMPROVE COMMUNICATION BY UNDERTAKING MULTIDISIPLINARY ROUNDS AND DAILY GOAL SHEETS Cycle 1E: ????? Cycle 1D:Failing, no 17:00 hrs review, redesign goal sheet Cycle 1C:ward rounds mon/fri 100% compliance /consider weekends Cycle 1B:Daily goal sheets testing 1-3-5 Cycle 1A:Establish who is to be on ward rounds and test on 1-3-5 patients Process Change: Testing ROUNDS AND DAILY GOAL SHEETS

  9. Second Daily Goal sheet Review times 17.00hrs and 24.00hrs

  10. GW: Percent Compliance Rounds

  11. General impact of SPSP on your unit • Better communication between disciplines • More structure • Team members playing a bigger part in care planning • Comments from questionnaire about WR Dietician “consultant values my opinion” “feel I know more about patients condition” Pharmacists “can give direct advice re medication to the whole team”

  12. Challenges • How do we bring multi disciplinary ward rounds in to the weekends. • Daily goal sheets how to move forward • Ensure nurse in charge available • Minimise Interuptions

  13. Fasting Analgesia Sedation Thromboprophylaxis Headup/Chlorhexidine Ulcer prophylaxis Glucose control/Insulin

More Related