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Reducing In-Patient Health Care Infections

Info: 1825 words (7 pages) Essay
Published: 18th Sep 2017 in Nursing

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Kathryn Moultrie

According to a task force for “Ventilator Acquired Pneumonia (VAP), (2007), conducted by the Chairman, Department of Internal Medicine Alejandro Arroliga, MD; Chief Medical Officer, Robert Pryor, MD; and representatives from nursing, respiratory therapy and patient safety in Temple , Texas, VAP is the most common infection in hospital intensive care units (ICU). Established criteria are for early diagnosing, including; patients’ at risk, visual inspection measures, that determine Ventilator Acquired Pneumonia (VAP) onset (Case study on Ventilator Acquired Pneumonia task force initiative, 2016).

Part 1: The Members of the and Task of the Team

The team members consisted of the Chairman, Department of Internal Medicine Alejandro Arroliga, MD; Chief Medical Officer, Robert Pryor, MD; and representatives from nursing, respiratory therapy and patient safety. The task for the team was to analyze collected data and established criteria for diagnosing patients with VAP and prevention measures, through the close monitoring patients, which would serve as the foundation for identifying prevention measures and subsequently reduce incidences of common “Ventilator Acquired Pneumonia (VAP), within the organization. Success also included decreases in patients’ length of stay in the ICU on mechanical ventilation (Flower, M. D. M., 2011 and Case study on Ventilator Acquired Pneumonia task force initiative, 2016 and Curtain, L. (2011).

Part 2: Who may have been accountable for each task on the team?

The accountability of the team for each task on the team is based on establishing a set of ground rules for working with one another, to understand their respective roles on the team and acknowledge, expect and value conflict. It is important that all members contribute high quality collective work in order for the team to complete all tasks related to the implementation and enforcement of the criteria, to reduce VAP rates at Scott & White Healthcare (Scott & White 2016 and Grigsby (n. d.).

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No one individual, each (all) individual member are accountable for each task on the team, there must be a common purpose and agreement to the performance goal, and approach for which everyone on the task force is mutually accountable. Accountability moves from member to member based on the topics or task assigned and the members’ skill and knowledge (Scott & White 2016 and Grigsby n. d.).

Part 3: Identify one issue that could arise with this task force, how the member could remedy the issue using the information from Crucial Accountability.

One issue that could arise with this task force, and how the member could remedy the issue using the information from Crucial Accountability is, “commitment” of each member. According to Rachel, M. M. (2012), article Accountability: A concept worth revisiting, without willingness, intent, ownership, and being emotionally compelled (commitment) of the entire task force, there is no accountability (Rachel 2012). These elements are all needed to enhance the chance of success of the task force. The member could remedy the issue using the 5 affirmative statements from Crucial Accountability which are; crucial elements, commitment and consequences of accountability (Rachel 2012, Accountability: A concept worth revisiting).

Part 4: How I am held accountable to the healthcare team?

First, I am held accountable to the healthcare team (my) by the Code of Ethics for nurses, primarily “do no harm”, to me this means that in everything I do, I will take full responsibility for myself, second I am willing to take responsibility for my mistakes, my decisions my action and learn from corrective feedback. Last but not least it is important accountability to the healthcare team means we, as a team or department, must remain committed to doing our best to serve both internal and external customers and all partners in the process. Accountability is at the heart of nursing, weaving its way through nursing practice in all settings and at all levels (Care and Safety Standards, Competence, and Nurse Accountability, (n. d.) and Patterson, K., (2013), et al p. 5).

Part 5: Who addresses lack of accountability, are they effective and why or why not?

The individuals who are responsible for addressing lack of accountability rest in the hands of many in our Organization; Chairman Phil Roe, M.D, introduced the VA Accountability First Act of 2017 and David Shulkin who is the is the current secretary of the Veterans Affairs Department are the leaders addressing lack of accountability and our local chief medical officer (Cape Coral, Florida) and COO and a regional director as well. Though a bill (the VA Accountability First Act of 2017), would provide the VA Secretary increased flexibility to remove, demote, or suspend any VA employee, including Senior Executive Service employees, for performance or misconduct. According to colleagues, Veterans and even some department’s heads, the process is not effective (Accountability: The VA Accountability First Act of 2017, 2017)

In conclusion, there are fragments, bits and pieces, and leftovers of lack of accountability in our system, and no one addresses, which includes Patient Aligned Care Team (PACT), which includes MD /ARNP, RN, LPN, Case manager, Pharmacist, and Social worker as well as Veteran scheduling staff. Colleagues and Veterans/families feel that this goes unchecked because members of the hierarchy, often choose to remain quiet and nothing is ever addressed.. Example Kathryn calls for an appointment with PCP – gets an appointment 5 days later when her doctor returns from vacation (lack of accountability), or Kathryn’s doctor is out, but she gets a same-day appointment (or as rule stands) with another doctor in the group (accountable). It took civilian nurses, hired by the Veteran Health Administration (whistle blower), to bring attention to those, responsible for addressing lack of accountability (Accountability: The VA Accountability First Act of 2017, 2017).

Part 6 Affirmative Statements

Provide a brief (1-2 sentences) example of a clinical action that demonstrates your accountability

An example of clinical actions that demonstrates accountability is my part in the MyHealtheVet online program, ensuring traveling Veterans remain connected to health care while traveling; 4. We, as a team or department, commit to doing our best to serve both internal and external customers and all partners in the process.

A traveling Veteran traveling from Up State New York, forgot his medications, I collaborated and communicated with our pharmacist and VA Facility’s travel nurse coordinator to solve the issue, which provides him (the Veteran) with a supply of the medication to last until he could return home. Crucial accountability lays out not only the need for holding others to their word, but also practical steps on how to do so. People who say they believe in accountability and execution, but struggle with how to do it, should have this book on their desk. It goes beyond conceptual ‘solutions’ and provides simple techniques and approaches that anyone can use.” (Rachel, M. M., (2012), Accountability: A concept worth revisiting)

References

Accountability: The VA Accountability First Act of 2017, (2017), Retrieved from Web, March 19, 2017,

https://veterans.house.gov/accountability

American Nurses Association, (2011), Provision 4: Code of ethics for nurses with interpretive statements, Retrieved from, http://www.nursesbooks.org/ebooks/download/CodeofEthics.pdf

Care and Safety Standards, Competence, and Nurse Accountability, Video, (2015), Retrieved from NU 414 Interprofessional Teams, On-line Course, Reading Topic and Outcomes, Saint Joseph’s College Maine, March 19, 2017,

https://www.youtube.com/watch?v=lJdNo1dpSJM

Case study on Ventilator Acquired Pneumonia task force initiative, (2016), Retrieved from NU 414 Interprofessional Teams, On-line Course, Reading Topic and Outcomes, Saint Joseph’s College Maine, March 19, 2017,

http://www.accountablecarestories.org/case_studies/best-practices-at-scott-white-healthcare-reduces-incidence-of-common-icu-infection-1

Care and Safety Standards, Competence, and Nurse Accountability, (n. d.) Retrieved from, YouTube, March 19 2017,

https://youtu.be/lJdNo1dpSJM

Curtain, L. (2011), Preventing ventilator-associated pneumonia: A nursing-intervention, Retrieved from Web, March19, 2017, https://www.americannursetoday.com/preventing-ventilator-associated-pneumonia-a-nursing-intervention-bundle/

Flower, M. D. M., (2011), American Nurses Association, Provision 4: Code of ethics for nurses with interpretive statements, Retrieved from NU 414 Interprofessional Teams, On-line Course, Reading Topic and Outcomes, Saint Joseph’s College Maine, March 19, 2017,

http://www.nursesbooks.org/ebooks/download/CodeofEthics.pdf

Rachel, M. M., (2012), Accountability: A concept worth revisiting

American Nurses Association (ANA), Retrieved from Web, March 19, 2017,

https://www.americannursetoday.com/accountability-a-concept-worth-revisiting/

Saloojee, H., (2017), et al, The health professional’s role in preventing nosocomial infections, Postgraduate Medical Journal, Retrieved from Web, March 19, 2017,

http://pmj.bmj.com/content/77/903/16

 

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