![]() ![]() The nurse goes through the checklist, keeping the following parameters and points of discussion in mind:ĬAUTI-Does the patient have a urinary catheter what is the indication and is it still needed? In addition, food and nutrition team members discuss dietary needs. Team members from care coordination and social work discuss family dynamics and potential barriers to discharge. We implemented the checklist in July 2017.ĭuring daily interprofessional rounds, the resident or physician assistant presents a brief patient history, medical plan of care, and an estimated day of discharge. This led us to our final acronym, CHIEF O. Recent miscommunication around oxygen requirements for discharge prompted the addition of “O” by our team-based physician assistants. After brainstorming and writing down the first initial of all of the quality and safety concerns, we landed on CHIEF. Next, we considered what word would be an easy reminder and point of reference during interprofessional rounds to lead nurses through the checklist. After a series of CAUTIs and one CLABSI in the summer of 2017, priorities included catheter management, central line care, fall prevention, and pressure injury prevention. When designing our checklist, we started with areas of safety and quality. To improve patient care, increase com munication and collaboration, monitor patient quality and safety, and ensure a smooth discharge, we established a checklist with the acronym CHIEF O. Geriatric patients tend to have extensive medical histories and complex social situations that require timely interventions from both care coordination and social work teams. Interprofessional rounds, which are used throughout the hospital, encourage interprofessional collaboration and may have a positive influence on care quality. In our 21-bed medical-surgical geriatric unit, we focus on our patients’ safety and the quality of care we deliver. As this focus on patient safety and quality continues to rise, innovative solutions from the bedside are paramount to facilitating consistent care. For example, Congress passed The Patient Safety Quality and Improvement Act of 2005, which encourages patient safety through confidential reporting of adverse events. In addition, legislation has been passed that addresses quality in healthcare. Since then, hospitals have built adverse event reporting systems, increased technology use to enhance patient safety, and modified strategies to address the alignment of financial incentives with quality indicators. In 1999, the Institute of Medicine published To Err is Human: Building a Safer Health System, the first in a series of reports focusing attention on quality and safety in healthcare. ![]() After dealing with a series of CAUTIs on a 21-bed acutecare unit for geriatric patients, we developed a nurse-driven checklist to address quality, safety, and discharge planning. Hospital-acquired conditions-such as catheter-associated urinary tract infections (CAUTI), hospital-acquired pressure injuries (HAPI), central line–associated bloodstream infections (CLABSI), and falls with injuries-are quality indicators used to measure how well a hospital delivers care. Medi – care and Medicaid reimbursement practices and the influence of quality indicators have sharpened that focus even more. Patient safety and care quality are the primary objectives for hospitals, patients, and their families. access, ejection fraction, falls, and oxygen. The checklist focuses on issues related to hospital-acquired infections, I.V.A medical-surgical geriatric unit developed a checklist to be used during interprofessional rounds and maintained by the nurse. ![]()
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