Collaborate to Extubate. Clinical Safety & Effectiveness Cohort 19: Team # 7
|
|
|
- Ambrose Garrett
- 5 years ago
- Views:
Transcription
1 Collaborate to Extubate Clinical Safety & Effectiveness Cohort 19: Team # 7
2 The Team Division CS&E Participant: Marivel Garcia, BSRC, RRT- NPS CS&E Participant: Crisostomo Cabagay, BSN, RN, CCRN CS&E Participant: Veronica Armijo-Garcia, MD CS&E Participant: Dorinda Escamilla-Padilla, DNP, RN, PNP-AC/PC Team Member: Ronald Estrella, MSN, RN, CCRN Facilitator: Edna Cruz, M.Sc., RN, CPHQ, CPPS Sponsor Department: James Barker, M.D. V.P. Clinical Services, UHS
3 AIM Statement Decrease unplanned extubation (UPE) by 50% (1.1 UPEs/100 ventilator days to 0.5 UPEs/100 ventilator days) by December 31, 2016 in the Medical ICU at University Hospital. The team used the PDSA model for Improvement
4 Definition UPE includes self-extubation and accidental extubation. Frequent during mechanical ventilation in critically ill patients Associated with increased morbidity and mortality Bhattacharya, P., Chakraborty,A., Agarwal, P., (2007)
5 Background: Incidence Multiple Studies on UPE Most recent articles in adult ICUs report: 1 22% of intubated patients have an UPE 18-91% of UPE are self-extubations Reintubation rates are also wide: % Bhattacharya, P., Chakraborty,A., Agarwal, P., (2007)
6 Background: At What Cost? Increased morbidity: Increase ventilator days and associated risks Pneumonia DVT Increase LOS Increased mortality Bhattacharya, P., Chakraborty,A., Agarwal, P., (2007).
7 Study: Baseline Data Medical Intensive Care Unit January thru July intubated patients 24 UPEs 16% of all intubated patients Data on 22 patients only 1.1 UPEs/100 ventilator days All were self-extubations 17 (70%) occurred between Day 0-3
8 Extubation Flow Diagram Scope changes from last project review
9 Cause and Effect Diagram
10 Unplanned Extubation
11 Real Issue: Flow Position at UPE
12 Causes for UPE
13 Sedation Utilized
14 Baseline Process Control Chart Patients
15 Baseline Process Control Chart UPE per 100 Ventilator Days
16 Action Plan Action Plan Aim Statement: To reduce UPE in the Medical ICU by 12/31/2016 Action Strength Action Driver Action Who? Why? Start Date Strong Inadequate sedation Target RASS Day 0-3 of Mechanical Ventilation. Nursing Staff/MD Standardize Simplify 11/1/16 Intermediate Inadequate sedation Patient Room Sign: Sedation Day 0-3 of Mechanical Ventilation Charge Nurse Standardize Simiplify 11/1/16 Intermediate Subjective implementation of sedation protocol Develop weekly process report to Marivel/Cris create awareness about compliance to new sedation target Standardize Simiplify 11/1/16 Intermediate Subjective implementation of sedation protocol Use of Huddle & Process Report to Nursing Staff hardwire the sedation protocol Standardize Simiplify 11/1/16
17 Compliance Intervention: Target RASS of -3 on vent days 0-3 Goal: 80% intervention adherence Compliance November 56% December 73%
18 Post-Intervention * Excluding toxic ingestions, pre & post interventions UPE were 0.9 vs. 0.46
19 Financial Return on Investment Every UPE extends MV days and LOS by 6.8 days and 11 days, respectively and costs $35,520 per UPE. Expected UPE over intervention time = 1.1/100 vent days = 3.9 UPEs Actual UPE over intervention time = 2 ROI = (3.9-2) x $35,520 = $67,488 (amount saved over 2 month period) Based on cost of UPE within literature Conservative ROI based on intensive care charges at UHS Ventilator and room - $53, 863 amount saved Ebstein, Krivopal, De Lassence
20 Conclusions Sedation intervention has trended towards decreased UPE. Positive ROI Additional time needed to confirm success of intervention 20
21 Thank you for your time! Questions? 21
22 References Bhattacharya, P., Chakraborty,A., Agarwal, P., (2007). Comparison of outcome of selfextubation and accidental extubation in ICU. Indian Journal of Critical Care Medicine, pg McNett. M., & Kerber, K.(2015). Unplanned Exubations in the ICU: Risk Factors and Strategies for Reducing Adverse Events. Journal of science communication, p Epstein S, Nevins M, & Chung J. (2000). American Journal of Respiratory and Critical Care Medicine, 161: Krivopal M., Shlobin O., & Schwartzstein R. (2003). Utility of daily routine portable chest radiographs in mechanically ventilated patients in the medical ICU. Chest, 123: De Lassence A., Alberti C., Azoulay E., et al. (2002). Impact of unplanned extubation and reintubation after weaning on nosocomial pneumonia risk in the intensive care unit. Anesthesiology, 97:
Unplanned Extubation In Intensive Care Units (ICU) CMC Experience. Presented by: Fadwa Jabboury, RN, MSN
Unplanned Extubation In Intensive Care Units (ICU) CMC Experience Presented by: Fadwa Jabboury, RN, MSN Introduction Basic Definitions: 1. Endotracheal intubation: A life saving procedure for critically
FHA Call to Action: Eliminating Infection-Related Ventilator-Associated Complications IVAC Bi-Monthly Webinar #2 May 3, 2018
FHA Call to Action: Eliminating Infection-Related Ventilator-Associated Complications IVAC Bi-Monthly Webinar #2 May 3, 2018 Agenda FHA MTC Call to Action for IVAC Data Review HRET HIIN Hospital Peer Sharing
A Resident-led PICU Morbidity and Mortality Conference
A Resident-led PICU Morbidity and Mortality Conference James Moses, MD, MPH Associate Program Director Boston Combined Residency Program Director of Patient Safety and Quality Department of Pediatrics
Reducing Unplanned Extubations in the NICU Following Implementation of a Standardized Approach
Reducing Unplanned Extubations in the NICU Following Implementation of a Standardized Approach Kevin L Crezeé RRT-NPS, Robert J DiGeronimo MD, Marilyn J Rigby DNP NNP-BC, Rick C Carter RRT-NPS, and Shrena
Rita Hunsucker, DNP, Nicole Cornell, MS, Gerald Hobbs, PhD, Jorge Con, MD & Alison Wilson, MD WVU Medicine, J.W. Ruby Memorial Hospital
Rita Hunsucker, DNP, Nicole Cornell, MS, Gerald Hobbs, PhD, Jorge Con, MD & Alison Wilson, MD WVU Medicine, J.W. Ruby Memorial Hospital The authors have nothing to disclose. Post extubation dysphagia (PED)
Cohort 20 Team 7. Improving Care Of The Pediatric Patient With A Tracheostomy
Cohort 20 Team 7 Improving Care Of The Pediatric Patient With A Tracheostomy Team Members & Participants Marisa Earley, MD / Medical Resource Carlos Montano / Respiratory Resource Nelia Acuna / Nursing
Can We Identify Patients at High Risk for Unplanned Extubation? A Large-Scale Multidisciplinary Survey
Can We Identify Patients at High Risk for Unplanned Extubation? A Large-Scale Multidisciplinary Survey Maged A Tanios MD MPH, Scott K Epstein MD, Jeanette Livelo RN MBA, and Daniel Teres MD BACKGROUND:
Improving Outcomes for High Risk and Critically Ill Patients
Improving Outcomes for High Risk and Critically Ill Patients KP Woodland Hills Medical Center Presented by: Sharon M. Kent RN BSN, CCRN Lynne M. Agocs-Scott RN MN, CCRN CCNS Introduction of the IHI The
Policies and Procedures. I.D. Number: 1145
Policies and Procedures Title: VENTILATION CHRONIC- CARE OF MECHANICALLY VENTILATED ADULT PERSON RNSP: RN Clinical Protocol: Advanced RN Intervention LPN Additional Competency: Care of Chronically Mechanically
Patients Being Weaned From the Ventilator: Positive Effects of Guided Imagery. Authors McVay, Frank; Spiva, Elizabeth; Hart, Patricia L.
The Henderson Repository is a free resource of the Honor Society of Nursing, Sigma Theta Tau International. It is dedicated to the dissemination of nursing research, researchrelated, and evidence-based
Clinical and Financial Successes at Advocate Health Care Utilizing our
Clinical and Financial Successes at Advocate Health Care Utilizing our Tele-ICU Program June 2, 2016 Cindy Welsh, RN, MBA, FACHE VP for Critical Care and Medical Professional Affairs Advocate Health Care
ABCDEF Bundle Implementation
ABCDEF Bundle Implementation Anne Putzer, MS, RN, ACNS-BC, CCRN Cat Zyniecki, BSN, RN, CCRN Columbia St. Mary s Wisconsin Association of Clinical Nurse Specialists CNO/CNS/Shared Governance Breakfast September
PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation
PREVENTION OF POSTOPERATIVE PULMONARY COMPLICATIONS: Reducing Postoperative Mechanical Ventilation Rowena Chona O. Sano, MSN, RN, CNL, CPHQ Memorial Hermann Greater Heights Hospital Houston, TX Nothing
Clinical and Financial Successes at Advocate Health Care Utilizing our Tele-ICU Program
Clinical and Financial Successes at Advocate Health Care Utilizing our Tele-ICU Program April 30, 2016 Michael Ries, MD, MBA, FCCM, FCCP, FACP Medical Director Adult Critical Care and eicu Advocate Health
CLINICAL PREDICTORS OF DURATION OF MECHANICAL VENTILATION IN THE ICU. Jessica Spence, BMR(OT), BSc(Med), MD PGY2 Anesthesia
CLINICAL PREDICTORS OF DURATION OF MECHANICAL VENTILATION IN THE ICU Jessica Spence, BMR(OT), BSc(Med), MD PGY2 Anesthesia OBJECTIVES To discuss some of the factors that may predict duration of invasive
VAE PROJECT MASTER ACTION PLAN. Note: Please be aware that these areas overlap to reduce duplication and optimize the synergies
VAE PROJECT MASTER ACTION PLAN Note: Please be aware that these areas overlap to reduce duplication and optimize the synergies Practice NHSN Surveillance Data Collection Is VAE NHSN Surveillance data collection
Reducing Ventilator Associated Pneumonia (V.A.P) System and Patient Tracer
Reducing V.A.P.: SYSTEM Tracer Begin with Large Group General Questions: 1. Describe your surgical and then medical process related to the prevention of V.A.P. 2. The Team Leader will create questions
Benefits of Tele-ICU Management of ICU Boarders in the Emergency Department
Benefits of Tele-ICU Management of ICU Boarders in the Emergency Department Session #309, February 22, 2017 Michael Ries, MD, MBA, FCCM, FCCP, FACP Medical Director Adult Critical Care and eicu Advocate
Copyright Scottsdale Institute All Rights Reserved.
Copyright Scottsdale Institute 2018. All Rights Reserved. No part of this document may be reproduced or shared with anyone outside of your organization without prior written consent from the author(s).
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers
Using People, Process and Technology to Enhance Outcomes for Patients and Their Caregivers Melissa A. Fitzpatrick, RN, MSN, FAAN VP & Chief Clinical Officer, Hill-Rom Trends Driving Our Industry Aging
Policies and Procedures. ID Number: 1138
Policies and Procedures Title: VENTILATION Acute-Care of Mechanically Ventilated Patient - Adult RN Specialty Practice: RN Clinical Protocol: Advanced RN Intervention ID Number: 1138 Authorization: [X]
Difficult Airways: All Airways are NOT Created Equal July 23, 2018
Difficult Airways: All Airways are NOT Created Equal July 23, 2018 ACS Quality and Safety Conference Lisa Failace, MSN, RN, CCRN-K Donna Swartz, MAS, RN, CPHQ, CPPS Hackensack University Medical Center
Unplanned Exubations in the ICU: Risk Factors and Strategies for Reducing Adverse Events
Unplanned Exubations in the ICU: Risk Factors and Strategies for Reducing Adverse Events Molly McNett, PhD, RN, CNRN, and Kathleen Kerber, MSN, RN, ACNS-BC, CNRN Abstract Objective: To describe risk factors
VAP Prevention in the CTICU
The University of San Francisco USF Scholarship: a digital repository @ Gleeson Library Geschke Center Master's Projects and Capstones Theses, Dissertations, Capstones and Projects Spring 5-22-2015 VAP
Beyond the Bundle. Improving Ventilator Related Outcomes through Multidisciplinary Collaboration
Beyond the Bundle Improving Ventilator Related Outcomes through Multidisciplinary Collaboration Definitions VAE Ventilator associated event global term for NHSN reporting criteria VAC: Ventilator Associated
Solution Title: Multidisciplinary Approach to Reduce Delirium in the ICU
Solution Title: Multidisciplinary Approach to Reduce Delirium in the ICU Program/Project Description, including Goals What was the problem to be solved? How was it identified? Delirium leads to a three-fold
Challenges of Sustaining Momentum in Quality Improvement: Lessons from a Multidisciplinary Postoperative Pulmonary Care Program
Challenges of Sustaining Momentum in Quality Improvement: Lessons from a Multidisciplinary Postoperative Pulmonary Care Program Michael R Cassidy, MD Pamela Rosenkranz, RN, BSN, MEd, and David McAneny
Continuous Lateral Rotation Therapy (CLRT): Development and Implementation of an Effective Protocol for the ICU
Continuous Lateral Rotation Therapy (CLRT): Development and Implementation of an Effective Protocol for the ICU Submitted by: Leslie Swadener-Culpepper, RN, MSN, CCRN, CCNS Clinical Nurse Specialist for
Micro-Preemies.Macro Outcomes Keywords: Background: Global AIM: Secondary Aims: Golden Hour Charter (Focus on thermoregulation): Respiratory Charter
Micro-Preemies.Macro Outcomes Carey Gaede, NNP-BC; Mary Jane Zonfrilli, NNP-BC; Stephanie King, RRT; Sara Dalbey, NNP-BC; Lisa Davis, NNP-BC; William Stratton, MD Primary: Carey Gaede, NNP-BC; e-mail:
Collaboration and Coordination in the MRICU: An Interprofessional Approach to Implementation of a Daily Review of Sedation Strategy, Liberation
Collaboration and Coordination in the MRICU: An Interprofessional Approach to Implementation of a Daily Review of Sedation Strategy, Liberation Potential and Mobility Plan Amy Dean, MS, RN, CCRN Kristin
The Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications
The Use of Patient Audits and Nurse Feedback to Decrease Postoperative Pulmonary Complications Christine M. Schleider, RN, BSN Adam P. Johnson, MD, MPH Kathleen M. Shindle, RN, BSN Scott W. Cowan, MD,
Best Practices for Prevention of Ventilator Associated Pneumonia. Marti Shaver, RN, CIC Derreck Wallace, RRT Ruth Sidor, MSN APRN
Best Practices for Prevention of Ventilator Associated Pneumonia Marti Shaver, RN, CIC Derreck Wallace, RRT Ruth Sidor, MSN APRN North Decatur Hillandale Downtown Decatur DeKalb Regional Health System
Exemplary Professional Practice: Patient Care Delivery Model(s)
Exemplary Professional Practice: Patient Care Delivery Model(s) EP7EO Nurses systematically evaluate professional organizations standards of practice, incorporating them into the organization s professional
Seattle Nursing Research Consortium Abstract Style and Reference Guide
Seattle Nursing Research Consortium Abstract Style and Reference Guide Page 1 SNRC Revised 7/2015 Table of Contents Content Page How to classify your Project. 3 Research Abstract Guidelines 4 Research
Regenstrief Center for Healthcare Engineering
Purdue University Purdue e-pubs RCHE Publications Regenstrief Center for Healthcare Engineering 3-31-2007 All Bundled Out - Application of Lean Six Sigma techniques to reduce workload impact during implementation
ASCO s Quality Training Program
ASCO s Quality Training Program Project Title: Treatment of febrile neutropenia at the University of Virginia Presenter s Name: Tri Le, MD, Tanya Thomas, RN, Michael Keng, MD Institution: University of
SOLUTION TITLE: Can Critical Care Become A Restraint Free Environment?
ORGANIZATION: ST AGNES MEDICAL CENTER SOLUTION TITLE: Can Critical Care Become A Restraint Free Environment? PROGRAM/PROJECT DESCRIPTION INCLUDING GOALS: The critical care environment is perhaps the last
Early Mobility in the Intensive Care Unit
Early Mobility in the Intensive Care Unit Marianne Munson, PT, DPT University of Rochester Strong Memorial Hospital Physical Medicine and Rehabilitation Objectives Summarize the benefits of early mobility
A Healthy Work Environment Endeavor Postoperative Handover from the OR to CTICU
A Healthy Work Environment Endeavor Postoperative Handover from the OR to CTICU Anna Dermenchyan RN, BSN, CCRN-CSC Clinical Nurse III, Cardiothoracic ICU Ronald Reagan UCLA Medical Center adermenchyan@mednet.ucla.edu
Owning and Developing Your Practice Through Alignment
Owning and Developing Your Practice Through Alignment David Mantz Director, Respiratory Care, Sleep Disorders Center and The Tammy Walker Cancer Center Salina Regional Health Center Salina Kansas Alignment
Successful and Sustained VAP Prevention Patti DeJuilio, MS, RRT-NPS, Manager, Respiratory Care Services, Central DuPage Hospital, Winfield, IL
Successful and Sustained VAP Prevention Patti DeJuilio, MS, RRT-NPS, Manager, Respiratory Care Services, Central DuPage Hospital, Winfield, IL Objectives & About Us Central DuPage Hospital is a large community
Our Sepsis Improvement Journey
A25 Our Sepsis Improvement Journey Driving Value through Collaboration December 6, 2016 9:30 10:45 am #IHIFORUM Session Objectives P2 To describe how our organization reduced sepsis mortality, saved lives
The Digital ICU: Return On Innovation
The Digital ICU: Return On Innovation Cheryl Hiddleson, MSN, RN, CCRN-E Director, Emory eicu Center May, 2017 The Digital ICU: Return on Innovation Cheryl Hiddleson MSN, RN, CCRN-E Director, Emory eicu
Impacting quality outcomes: Utilizing an innovative unit-based nursing role. Kaitlin Lindner, BSN, RN, CCRN Stacey Trotman, MSN, RN, CMSRN, RN-BC
Impacting quality outcomes: Utilizing an innovative unit-based nursing role Kaitlin Lindner, BSN, RN, CCRN Stacey Trotman, MSN, RN, CMSRN, RN-BC Outcomes Identify opportunities for improving quality outcomes
Use of TeleMedicine to Improve Clinical and Financial Outcomes
Use of TeleMedicine to Improve Clinical and Financial Outcomes Michael Ries, MD, MBA, FCCM, FCCP, FACP Medical Director, Critical Care and eicu Advocate Health Care November 12, 2015 Use of TeleMedicine
Actionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP)
Executive Summary Checklist Actionable Patient Safety Solution (APSS) #2D: VENTILATOR-ASSOCIATED PNEUMONIA (VAP) In order to establish a program to reduce ventilator-associated pneumonia (VAP) the following
Stopping Sepsis in Virginia Hospitals and Nursing Homes Hospital Webinar #2 - Tuesday, March 21, 2017
Stopping Sepsis in Virginia Hospitals and Nursing Homes Hospital Webinar #2 - Tuesday, March 21, 2017 Welcome and Introductions Today s objectives: Introduce Sepsis Practice Collaborative Model Tier 1
A New, National Approach to Surveillance for Ventilator-associated Events; Challenges and Opportunities
A New, National Approach to Surveillance for Ventilator-associated Events; Challenges and Opportunities Linda R.Greene,RN,MPS,CIC Manager of Infection Prevention Highland Hospital Rochester, NY Affiliate
Passage to Excellence Our Sepsis Journey
Passage to Excellence Our Sepsis Journey St. Catherine of Siena Medical Center October/November 2017 St. Catherine of Siena Medical Center 311 bed community hospital Voluntary medical staff leadership
Critical Care, Critical Choices: The Case for Tele-ICUs in Intensive Care
Critical Care, Critical Choices: The Case for Tele-ICUs in Intensive Care April 29, 2011 Waltham, MA Presented by Lisa Payne Simon, MPH Cheryl H. Dunnington, RN, MS 1 FAST Initiative Overview 2004-2010
JOGNN I N F OCUS. Unplanned extubations (UE) in the neonatal. Unplanned Extubation in the NICU Jessica A. Barber
JOGNN I N F OCUS Unplanned Extubation in the NICU Jessica A. Barber Correspondence Jessica A. Barber MSN, CRNP, NNP-BC, RNC, Children s Hospital of Philadelphia, Neonatal/Infant Intensive Care Unit, 34th
Communication with Surrogate Decision Makers. Shannon S. Carson, MD Associate Professor University of North Carolina
Communication with Surrogate Decision Makers Shannon S. Carson, MD Associate Professor University of North Carolina Role of Communication with Families in the ICU Sharing information about illness and
The Impact of a Daily Goals Tool in the ICU: More than a Checklist
S Y S T E M The Impact of a Daily Goals Tool in the ICU: More than a Checklist May 24, 2016 Our Vision To be the Nation's leading public academic health care system. Leading. Teaching. Caring. Acknowledgements
Louise Rose RN, BN, ICU Cert, Adult Ed Cert, MN, PhD
Louise Rose RN, BN, ICU Cert, Adult Ed Cert, MN, PhD TD Nursing Professor in Critical Care Research, Sunnybrook Health Sciences Centre Associate Professor, LSBFON, University of Toronto CIHR New Investigator
19th Annual. Challenges. in Critical Care
19th Annual Challenges in Critical Care A Multidisciplinary Approach Friday August 22, 2014 The Hotel Hershey 100 Hotel Road Hershey, Pennsylvania 17033 A continuing education service of Penn State College
Implementation of a Multidisciplinary Ventilator-Weaning and Sedation Protocol in a Community Intensive Care Unit
Research DIMENSION Implementation of a Multidisciplinary Ventilator-Weaning and Sedation Protocol in a Community Intensive Care Unit Amanda L. Rumpke, RN, MSN, ACNP, CCRN; Beth A. Zimmerman, RN, BSN Prolongation
SAHS Critical Care Residency Program
SAHS Critical Care Residency Program Sherry Parks BSN, MS, NEA-BC VP &CNO Teri Woychick BSN, RN Director of Critical Care Cindy Malinowski RN, MN, CCRN, Nurse Educator Perfect Storm High CC turnover Lack
SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL DEPARTMENT POLICY TITLE: OXYGEN ADMINISTRATION (INCLUDING Job Title of Reviewer: EFFECTIVE DATE: REVISED DATE: POLICY TYPE: Director, Respiratory Care Services (Resp)
CRITICAL CARE CLINICIANS KNOWLEDGE GUIDELINES FOR PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA OF EVIDENCE-BASED. C E 1.0 Hour. Pulmonary Critical Care
Pulmonary Critical Care CRITICAL CARE CLINICIANS KNOWLEDGE OF EVIDENCE-BASED GUIDELINES FOR PREVENTING VENTILATOR-ASSOCIATED PNEUMONIA By Mohamad F. El-Khatib, MB, PhD, Salah Zeineldine, MD, Chakib Ayoub,
Clinical Safety & Effectiveness Cohort # 8
Clinical Safety & Effectiveness Cohort # 8 1 IMPROVING THE TIMELINESS OF PARACENTESIS: IMPACT OF A PROCEDURE TEAM DATE Educating for Quality Improvement & Patient Safety FINANCIAL DISCLOSURE Patricia Wathen,
@ncepod #tracheostomy
@ncepod #tracheostomy 1 Introduction Tracheostomy: Remedy upper airway obstruction Avoid complications of prolonged intubation Protection & maintenance of airway The number of temporary tracheostomies
Improving family experiences in ICU. Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU
Improving family experiences in ICU Pamela Scott Senior Charge Nurse Forth Valley Royal Hospital ICU Family Burden in icu:- Incidence of anxiety symptoms range from 21% to 60.4% (median 40%) from ICU admission
Session Number 211 LET S BE THE DRIVER OF THIS BUS: NURSE DRIVEN PROTOCOLS IN ACUTE CARE
Content Description Session Number 211 LET S BE THE DRIVER OF THIS BUS: NURSE DRIVEN PROTOCOLS IN ACUTE CARE Donna Barto, DNP RN CCRN Advanced Nurse Clinician Virtua Health Marlton, New Jersey This presentation
SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY
PS1006 SARASOTA MEMORIAL HOSPITAL NURSING DEPARTMENT POLICY TITLE: TRACHEOSTOMY SPEAKING VALVE EFFECTIVE DATE: REVISED DATE: POLICY TYPE: 135.008 (Respiratory Therapy) (Patient Care) 134.900 (Rehab) 10/93
Objective Measures CMS TRANSPLANT PROGRAM QUALITY WEBINAR SERIES
CMS TRANSPLANT PROGRAM QUALITY WEBINAR SERIES Objective Measures James Ballard, MBA, CPHQ, CPPS, HACP Eileen Willey, MSN, BSN, RN, CPHQ, HACP QAPI Specialist/ Quality Surveyor Educators (QSE s)/ Transplant
Implementing Rapid Response Teams Audio Conferences
Upcoming Distance Learning Opportunity from the Idaho Hospital Association Implementing Rapid Response Teams Audio Conferences Thursday, April 19, 2007 Saving Lives with Rapid Response Teams Thursday,
9/8/14. Re-hospitalizations among patients in the Medicare Fee-for-service Program
Rachael Ali-Permell, BS, RT, RRT-NPS, ACCS, AE-C Manager Respiratory Therapy Department Bayhealth Milford Memorial Hospital, Delaware Faculty Quinones Healthcare Seminars, LLC Hospital Readmission Reduction
Health Literacy Mara McDermott RN, BSN Elizabeth Blazek RN, BSN
Health Literacy Mara McDermott RN, BSN Elizabeth Blazek RN, BSN Kathy J. Morris, DNP, APRN-NP, FNP-C, FAANP Sue Barnason PhD, RN, APRN-CNS Judy Jesz, DNP, MBA, RN Jana Uryasz, MSN, RN The Problem In a
Selecting Measures. Presented by: Rebecca Lash, PhD, RN Collaborative Outcomes Council July 2016
Selecting Measures Presented by: Rebecca Lash, PhD, RN Collaborative Outcomes Council July 2016 Content adapted from Robert Martin, PsyD, Performance Excellence & Dr. Moira Inkelas Methods for Improvement
THE NEED FOR CLEAR team communication
QUALITY CORNER Improving Communication in the ICU Using Daily Goals Peter Pronovost, Sean Berenholtz, Todd Dorman, Pam A. Lipsett, Terri Simmonds, and Carol Haraden OBJECTIVES The specific aims of this
Developing a Trauma Center
Developing a Trauma Center Amy Koestner, RN, BSN, MSN Trauma Program Manager Spectrum Health Medical Center Carol Spinweber, MS, RN Trauma Program Manager St. Joseph Mercy Oakland Objectives: Describe
NURSING GUIDELINES TO PROCEDURAL SEDATION Finalized 1/18/2012 Procedural Sedation Task Force
Intention (responsiveness) Responds normally to commands Responds purposefully to verbal commands/or light touch DEEP Responds to pain Reflex withdrawal No response Anticipated Outcomes (Airway, Cardiovascular)
Patients with Rib Fractures How We Decreased Unplanned Transfers to the ICU. Lillian Aguirre, DNP, CNS, CCRN, CCNS Orlando Regional Medical Center
Patients with Rib Fractures How We Decreased Unplanned Transfers to the ICU Lillian Aguirre, DNP, CNS, CCRN, CCNS Orlando Regional Medical Center Disclosures I do not have any disclosures Background Struggling
Can nurses Compliance to Ventilator Care Bundle Help to Prevent Ventilator Associated Pneumonia in ICU? Mok Chi Man, RN (SP) ICU, PYNEH, HKEC
Can nurses Compliance to Ventilator Care Bundle Help to Prevent Ventilator Associated Pneumonia in ICU? Mok Chi Man, RN (SP) ICU, PYNEH, HKEC 1 Introduction Ventilator-associated pneumonia (VAP): Lung
Preventing ICU Complications. Lee-lynn Chen, MD Assistant Clinical Professor UCSF Department of Anesthesia and Perioperative Care
Preventing ICU Complications Lee-lynn Chen, MD Assistant Clinical Professor UCSF Department of Anesthesia and Perioperative Care Overview Catheter related bloodstream infection Ventilator associated pneumonia
Healthcare 9/15/2017. Learning Outcomes. Transforming Clinical and Fiscal Outcomes through Staff Nurse Driven Change
Transforming Clinical and Fiscal Outcomes through Staff Nurse Driven Change Marian Altman RN, MS, CNS-BC, CCRN-K,ANP American Association of Critical Care Nurses Clinical Practice Specialist Learning Outcomes
a Canadian Critical Care Knowledge Translation Network ac 3 KTion Net
a Canadian Critical Care Knowledge Translation Network ac 3 KTion Net 1 Learning Objectives To understand the need for knowledge translation (KT) in Critical Care To review the need for measurement as
Progressive Mobility in the ICU: Improving the Patient Experience. Rachel Lewis-Bayliss BSN, RN Theresa M. Davis PhD, RN, NE-BC
Progressive Mobility in the ICU: Improving the Patient Experience Rachel Lewis-Bayliss BSN, RN Theresa M. Davis PhD, RN, NE-BC Early Progressive Mobility Team Jason Vourlekis MD, MBA: Medical Director
Effective Floor and ICU Rounding
Effective Floor and ICU Rounding Scott C. Gardner, MMSc, PA-C Physician Assistant, Intermountain Medical Center, Intermountain Healthcare; Salt Lake City, Utah Objectives: Identify the elements of effective
Reducing opioid-related harm and building quality improvement capability in New Zealand: a national formative collaborative
Session Code: M3 The presenters have nothing to disclose Reducing opioid-related harm and building quality improvement capability in New Zealand: a national formative collaborative John Kristiansen Prem
Clinical Safety & Effectiveness Cohort # 18 Follow up and tracking of EMR virology and microbiology test results in a Pediatric university-based
Clinical Safety & Effectiveness Cohort # 18 Follow up and tracking of EMR virology and microbiology test results in a Pediatric university-based ambulatory teaching clinic 1 Division Lizette Gomez, M.
Patient safety incidents associated with airway devices in critical care: a review of reports to the UK National Patient Safety Agency
Anaesthesia, 2009, 64, pages 358 365 doi:10.1111/j.1365-2044.2008.05784.x Patient safety incidents associated with airway devices in critical care: a review of reports to the UK National Patient Safety
NCEPOD On the Right Trach?
NCEPOD On the Right Trach? Hospital Number Tracheostomy insertion (1) Consent and WHO type (surgical) checklists should be adopted and used prior to tracheostomy insertion, wherever it is performed. Q8.
COPD & Pneumonia Readmission Reduction Program. October 25, 2017
COPD & Pneumonia Readmission Reduction Program October 25, 2017 Susan J. Bowers, MBA, BSN, RN Chief Quality Officer Mercy Health - Lorain 2 Locations Mercy Health Lorain Hospital Lorain, Ohio 250 bed community
Nurse Driven Foley Removal Protocol. Cathy Moore, MSN, ACNS-BC, CCRN 2009
Nurse Driven Foley Removal Protocol Cathy Moore, MSN, ACNS-BC, CCRN 2009 Abstract Text Nosocomial urinary tract infections (UTI) are common and costly occurrences for hospitalized patients. Patients may
Analysis of Unplanned Extubation Risk Factors in Intensive Care Units
10 Analysis of Unplanned Extubation Risk Factors in Intensive Care Units Yuan-Chia Cheng 1, Liang-Chi Kuo 1, Wei-Che Lee 1, Chao-Wen Chen 1, Jiun-Nong Lin 2, Yen-Ko Lin 1, Tsung-Ying Lin 1 Background:
Final scope for the systematic review of the clinical and cost effectiveness evidence for the prevention of ventilator-associated pneumonia (VAP)
Final scope for the systematic review of the clinical and cost effectiveness evidence for the prevention of ventilator-associated pneumonia (VAP) Contents 1. AIM...2 2. BACKGROUND...2 3. INTERVENTIONS...3
Failure to Maintain: Missed Care and Hospital-Acquired Pneumonia
Failure to Maintain: Missed Care and Hospital-Acquired Pneumonia STTI INDIANAPOLIS, OCTOBER 2017 DIAN BAKER, PHD, RN PROFESSOR, SCHOOL OF NURSING DIBAKER@CSUS.EDU CALIFORNIA STATE UNIVERSITY, SACRAMENTO
VENTILATOR ASSOCIATED PNEUMONIA (VAP) SOP VAP SK-V1
VENTILATOR ASSOCIATED PNEUMONIA (VAP) SOP Version Number V1 Date of Issue February 2018 Reference Number Review Interval Approved By Name: Fionnuala O Neill Title: Nurse Practice Coordinator Authorised
Feedback from Anesthesia clinicians. 2.1 Intubate Patient Workflow
Feedback from Anesthesia clinicians 2.1 Intubate Patient Workflow The following section describes the workflow as derived from the Intubate Patient use case analysis. Intubate Patient (Process) This process
General OR-Stanford-CA-1 revised: Tuesday, February 02, 2016
Stanford University Anesthesiology Residency Program Rotation specific goals and objectives for residents Core Curriculum for PGY 1 Surgery Residents on the Anesthesia Rotation Description: The General
Clinical Research Proposal To the Jersey City Medical Center Institutional Review Board
1 Clinical Research Proposal To the Jersey City Medical Center Institutional Review Board Principle Investigators: Erin Salmond BSN RN and Joanie Knuth RN BSN RN Date of Submission: Type of Proposal: Descriptive
Improving Quality of Care for Mechanically Ventilated Patients in Long Term Care Through Full Compliance with the Ventilator Bundle Protocol
Walden University ScholarWorks Walden Dissertations and Doctoral Studies Walden Dissertations and Doctoral Studies Collection 2016 Improving Quality of Care for Mechanically Ventilated Patients in Long
Discharge Information
Discharge Information Yes, patients were given information about what to do during their recovery Vikki Choate, MSN, RN, CCM, RN-BC, CPHQ Nashville, TN May 14-15, 2013 Learning Objectives At the end of
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence
Risk Factor Analysis for Postoperative Unplanned Intubation and Ventilator Dependence Adam P. Johnson MD, MPH, Anisha Kshetrapal MD, Harold Hsu MD, Randi Altmark RN, BSN, Herbert E Cohn MD, FACS, Scott
Conflict of Interest Disclaimer. The Affordable Care Act. The Affordable Care Act. Caring for the Critically Ill. The Affordable Care Act
Conflict of Interest Disclaimer Reducing Risks of Harmful Events in the Critically Ill I have no financial interests or conflicts of interest related to this talk Alfred F. Connors, Jr., MD Chief Medical
4/28/17. New Jersey Antimicrobial Stewardship Learning Action Collaborative. Antimicrobial Stewardship Efforts in New Jersey. Update May 10, 2017
New Jersey Antimicrobial Stewardship Learning Action Collaborative Update May 10, 2017 Antimicrobial Stewardship Efforts in New Jersey Acute Care Hospitals Outpatient Settings (ED, physician practices)
Clinical Pathway: TICKER Short Stay (Expected LOS 5 days) For Patients not eligible for other TICKER Clinical Pathways
Project TICKER Teamwork to Improve Cardiac Kids End Results Clinical Pathway: TICKER Short Stay (Expected LOS 5 days) For Patients not eligible for other TICKER Clinical Pathways Notes: (1) This pathway
2017 Participant Packet
The Virginia Society for Respiratory Care is proud to present The 40 th Annual May 22nd thru May 24th, 2017 Opportunity to earn18 AARC CRCEs 2017 Participant Packet Host Hotel Hilton Virginia Beach Oceanfront
Mary Baum President & CEO BA&T September 18, 2015
Mary Baum President & CEO BA&T September 18, 2015 Objective Why patient safety is so difficult to solve? The problem remains Advances in clinical workflow A collaborative approach Metrics matter Just start.