The next step in the process is to begin identifying the challenges  and impediments to implementing a quality improvement plan. In the  analysis consider the individuals affected by the change as well as the  cost of implementing the quality improvement plan.

Post a description of some of the proposed action  steps for implementing improved practice, and explain where potential  challenges might compromise your proposed improvement project. Describe  what resources are needed for your solution, and explain whether or not  those resources are cost-effective. Continue to collaborate with the  selected individuals in your practice environment as needed in the  development of the Practice Experience Project, and share this  information with your group.

Practicum week 4 Nurs4220

The goal of an effective prevention program should be a decrease in readmissions of patients in all units of the hospital. Readmissions are increasing daily due to lack of education and non-compliant patients, not only in inpatient but also in outpatient settings. Central lines are also another issue causing readmissions in addition to COPD and other disease processes. I also wanted to bring attention to central lines because they are also something that causes increased readmissions. Central venous catheters (CVCs) disrupt the integrity of the skin making patient’s very susceptible to infection with bacteria and fungi. Preventing this is a challenging process to manage. However, multiple interventions are needed to take place to improve the plan of care when health care providers are working with non-compliant patients and central venous lines.

Educating healthcare personnel to become more aware of the reason’s patients are re-admitted, and appropriate infection control measures are significant. Occasionally, healthcare providers should prove competent management of maintaining a central line and educating patients properly about their diagnosis. While performing dressing changes, maximal sterile precautions should always be used. Dressings should be changed if it becomes moist, loosened, or visibly dirty. Regardless of the way the dressing loos it should be replaced every seven days. CVC’s should be removed promptly as soon as it is no longer needed. According to Wilder, Wall, Haggard, and Epperson (2016), a line-rounding audit tool was developed to follow the number of daily central lines, reasons for dressing change recommendations and plans for central line removal. Persistent, continued education of healthcare workers, patients, and family members has been one measure used to decrease COPD exacerbations and readmissions for patients who have been discharged in the past 30 days.

Possible difficulties that can compromise these proposed improvements are the compliance of these healthcare providers. A lot of workers do not like change therefore getting them to abide by new implementations can be challenging. For example, seasoned nurses have set ways and getting them up to date on new policies and procedures can be troublesome. Another challenge is when healthcare personnel takes shortcuts to save time. A great example of something that increases the occurrences of central-line infections is when the end of the tubing is not capped off properly. Instead of finding the correct hub protector to put on it, nurses take shortcuts, loop the end of the tubing and connect it to a dirty hub. When speaking to my DON about this, she notices that nurses tend to be in a hurry and fail to realize this allows bacteria to easily contaminate the end of the tubing increasing the risk of infection, not only on central lines but also IV sites too. Sometimes we do run into issues with having the proper resources on hand, or supplies are out of stock. It is crucial to make sure all supplies are available to help prevent infection, errors, exacerbations, and readmissions. However, I believe that educating these healthcare providers with in-depth education in regards to readmissions with feedback, demonstration and verbal understanding, will positively impact facilities and result in a decrease of these patients coming back to the hospital repeatedly. These actions are in hopes to reduce the rates to as low as feasible in the hospital setting working with what is provided.

Reference:

Wilder, K. A., Wall, B., Haggard, D., & Epperson, T. (2016). CLABSI Reduction Strategy: A Systematic Central Line Quality Improvement Initiative Integrating Line-Rounding Principles and a Team Approach. Advances In Neonatal Care (Lippincott Williams & Wilkins), 16(3), 170-177. doi:10.1097/ANC.0000000000000259