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Supporting Quality Care

Supporting Quality Care. NURS 274 Nursing Leadership Darlene LoPresto, BSN, RN,C Graduate Student FSU. Standards of Care. Structural Process/Performance Outcome. Nursing Specific Standards.

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Supporting Quality Care

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  1. Supporting Quality Care NURS 274 Nursing Leadership Darlene LoPresto, BSN, RN,C Graduate Student FSU

  2. Standards of Care Structural Process/Performance Outcome

  3. Nursing Specific Standards

  4. MICHIGAN LEGISLATURE  95th Legislature Regular Session Michigan Compiled Laws Complete Through PA 169 and includes 172-184 and 204 of 2010 PUBLIC HEALTH CODE (EXCERPT)Act 368 of 1978 Part 172 NURSING Section 333.17201SectionDefinitions; principles of construction. Section 333.17208SectionLicensed practical nurse; health profession subfield. Section 333.17209SectionRenewal of license to practice as trained attendant; eligibility; “practice as a trained attendant” defined; original license prohibited; licensed psychiatric attendant nurse considered licensed practical nurse. Section 333.17210SectionRegistered professional nurse; issuance of specialty certification; qualifications. Section 333.17211SectionPractice of nursing or as licensed practical nurse; license or authorization required; use of words, titles, or letters. Section 333.17212SectionRegistered professional nurse; ordering, receiving, or dispensing complimentary starter dose drugs. Section 333.17213SectionLicensure as registered professional nurse; graduate of nurse education program located outside of United States; requirements. Section 333.17221SectionMichigan board of nursing; creation; number and qualifications of members; terms. Section 333.17224, 333.17225SectionRepealed. 1989, Act 201, Imd. Eff. Oct. 23, 1989. Section 333.17231SectionHonorary license; "advanced illness" defined; name of section. Section 333.17241SectionNursing education program; application to conduct; evidence required; evaluation; inspection; report; approval; continuation of existing programs; accreditation by national board or organization; education program for psychiatric attendant nurses or trained attendants prohibited. Section 333.17242SectionInspection of approved nursing education program; report; notice of deficiency; removal from list of approved programs; hearing.

  5. Accrediting Agency Standards

  6. committed to improving health care safety continuously improve quality of care accreditation of health care organizations accreditation is a risk-reduction activity reduce the risk of adverse outcomes

  7. HFAP determines a facility’s ability to deliver high quality patient care by using our CARE methodology. This process includes an in-depth review of both open and closed patient records as well as direct observation of care provided.

  8. http:www.ahrq.gov Clinical Information • Clinical Practice GuidelinesCurrent and archived Clinical Practice Guidelines — beta blockers practice advisory — treating tobacco use and dependence • Tobacco CessationU.S. Public Health Service Clinical Practice Guideline: Pathfinder page links to materials that help tobacco users quit.Surgeon General Reports: The latest information to help people quit smoking, and to help health care professionals treat tobacco use and dependence.

  9. Public Transparency • Broad scale quality initiative • Consumers compare facilities • Informed choices • Better public information

  10. Public Transparency • www.healthgrades.com • www.mihospitalinform.org • www.hospitalcompare.hhs.gov • www.hospitalconnect.com • www.wedmd.com

  11. Public Transparency http://www.healthgrades.com/hospital-directory/michigan-mi/patient-safety-HGSTA7662386230092

  12. TheConsumer Assessment of Healthcare Providers and Systems (CAHPS): Health care organizations use CAHPS results to: Assess the patient-centeredness of care; Compare and report on performance Improve quality of care. standardized surveys of patients' experiences http://www.hospitalcompare.hhs.gov/hospital-compare.aspx?hid=230037&lat=41.8933451&lng=-84.6269824&stype=GENERAL&&stateSearched=MI

  13. Quality Improvement

  14. Benchmarking • A benchmark is a specific quantitative standard for an outcome with which you compare your own institution. (Ellis & Hartley, 2009)

  15. Sources of Date Key Indicators QA (Incident Reports) Audits Surveys

  16. QI/PI Process

  17. Sentinel Event

  18. Risk Management Policies, procedures, & practices involved in identification, analysis, assessment, control, and avoidance, minimization, or elimination of unacceptable risks. (www.businessdictionary.com)

  19. RM Focus • Studies QA findings and trends • Think ahead about defense strategies • Proactive identification and elimination of risk areas institution wide • Patient and family are informed

  20. Incident Report Process Root Cause Analysis: Goal = Answer: What happened? Why did it happen? What do you do to prevent if from happening again?

  21. Incident Report Process: Five Why’s Technique Example: Problem Statement: You are on your way home from work and your car stops in the middle of the road. • Why did your car stop?   - Because it ran out of gas. • 2. Why did it run out of gas?   - Because I didn't buy any gas on my way to work. • 3. Why didn't you buy any gas this morning?   - Because I didn't have any money. • 4. Why didn't you have any money?   - Because I lost it all last night in a poker game. • 5. Why did you lose your money in last night's poker game?   - Because I'm not very good at "bluffing" when I don't have a good hand.

  22. Incident Report Process: Systems Focus • Not one person’s fault • Involves people and/ or processes • System failure results in error

  23. Never Events: • Effective October 1, 2008 • No reimbursement • Must note if ‘Present on • Admission” • Requirements of ‘Never Event’ • occurs: • -Report event • -Root cause analysis • -Waive costs • -Apology

  24. Recognition of nursing excellence 14 Forces of Magnetism Goals Benefits Magnet Status

  25. Michigan Magnet Status • Beaumont Hospital Troy MI  2009 • Bronson Methodist Hospital Kalamazoo MI  2009  • Children's Hospital of Michigan Detroit MI  2008  • DMC Huron Valley Sinai Hospital Commerce Township MI  2009  • Detroit Receiving Hospital and University Health Center Detroit MI  2009  • Holland Community Hospital Holland MI  2007  • Munson Medical Center Traverse City MI  2006  • Oaklawn Hospital Marshall MI  2009  • Sparrow Hospital Lansing MI  2009  • Spectrum Health-Blodgett Hospital Grand Rapids MI  2009  • Spectrum Health-Butterworth Hospital Grand Rapids MI  2009  • Spectrum Health-Helen DeVos Children's Hospital Grand Rapids MI  2009  • William Beaumont Hospital Royal Oak MI  2004 

  26. Questions? As the professional nurse You make the difference!

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