Elements of the Essay
**Introduction clearly identifies the population of interest and the area of concern related to quality for this population
**The rubric state must include measurement tools 20 pt
current measurement tools for this area of concern are identified and discussion includes the purpose of the tools and appropriate use according to the nursing and quality improvement
**Discuss the current process for measuring quality 20 point
Identify the steps for measurements and how improvement is identified (i.e. how do we know the intervention worked)
Includes the process for measure (PDSA,etc)
**Discuss the interdisciplinary team involvement in this quality improvement initiative (20 pt)
**Summary includes opportunities for improvements in the current process and ho the Clinical Nurse Leader impacts quality improvement (15 points)
**Includes 1-3 peer reviewed articles on quality improvmetn to support are included (5ponts)
***APA format for essay and references is correct (5points)
Im currently enrolled in school for Clinical Nurse LEader MSN degree, I attend clinical at a local community hospital name Iredell Memorial Hospital. The information I have provided below is from the Diane Collins RN BSN QI Nurse and the nurse that work directly with the unit im assigned 5 north is Linda Thompson, Director of nursing practice and quality, worked with 5 north to identify areas of focus and the unit I am assisgned is focusing on Foley Cath.
-The population of interest is Foley Catheterization Care this is the focus areas for CQI activity and monitoring for 5 north orthopedic unit
-the tracking tool that Iredell Memorial Hospital track rates for both CAUTI infection, for CAUTI infection the rate is based upon the number of infection per 1000 patient day. Iredell Memorial Hospital track Urinary Catheter Utilization rates these rates are based upon the number of device days/the number of patient day. Iredell presently trace these rates by inpatient unit and house wide The calculation of CAUTI rates and device utilization rates are standardized across the healthcare industry as evidenced through literature and NHSN and CMS reporting.
Other units that was identified the ED project will need to identify cath insertions and calculate those to identify catheter insertions and calculate those according to patients seen to establish a baseline rate and ongoing measure for that project. CAUTI infections are currently attributed to the inpatient unit where the patient is located at the time of the infection as long as the patient has been in that location for at least 24 hours. (Pam Gill, Infection Preventionist, can provide additional information on this.) Presently CAUTIs are not attributed to the ED, so device insertion rates and overall housewide CAUTI rates will be evaluated for the ED project. CAUTIs attributed to 5N will be evaluated for the 5N project.
Iredell 5North unit most frequently use PDSA within the organization. Usually a task force or improvement team is established when a quality issue is identified. That group evaluates the baseline data, reviews current processes, and develops action plans to improve the performance. Action plans are then implemented (including staff education on process changes) and then ongoing monitoring is conducted to evaluate the effectiveness of the action plan. This monitoring may include “balance” measures (e.g., if catheters are being removed earlier, can also track whether catheter re-insertions are increasing). Usually before a process is implemented housewide, it is “trialed” or tested and then evaluated on a single unit or with a single group of patients before it is spread to other units.
Five North Catheter Care Team may involve: 5N Staff RNs, 5N CNAs, Infection Prevention, Quality, Medical Staff, Materials Mgmt.
Five North Catheter Care: CAUTI Prevention efforts within the hospital have focused primarily on decreasing catheter utilization. A daily review was implemented a few years ago to decrease the number of catheter days to prevent infection. Following implementation of this practice, we saw a decrease in the incidence of CAUTI. During 2013, we have seen an increase in our CAUTI rates. We believe we need to focus our attention on ongoing catheter care to be sure staff is compliant with evidence-based care of catheters.