Running head: TASK 1 1 Task 1 Western Governors University
TASK 1 2 Task 1 Issue and Explanation With the advent of the Patient Protection and Affordable Care Act (ACA), the focus of healthcare organizations and medical providers has become quality of care and value. In an effort to foster better health of Americans, the ACA includes provisions aimed at preventing illness, improving patient safety and outcomes through evidence-based practice, and reducing healthcare costs (Agency for Healthcare Research and Quality [AHRQ], n.d.). As a certified participant in Medicare and Medicaid through Det Norske Veritas (DNV), our organization makes quality care a priority. The Centers for Medicare and Medicaid Services (CMS), America’s largest health care payer, has implemented national health care quality reporting policies, payment incentives for improvements in quality metrics, and reimbursement adjustments based on patient outcomes for all participating healthcare entities (Centers for Medicare and Medicaid Services [CMS], n.d.). One major quality measure that our Surgical Services department traces is surgical site infections (SSIs), which are considered by CMS (n.d.) to be hospital associated conditions that negatively affect patient outcomes and hospital reimbursement. In compliance with the CMS Conditions of Participation (n.d.), our department utilizes evidence-based practice guidelines from the Association of periOperative Registered Nurses (AORN) to inform our practices in the operating room (OR), including those related to infection prevention. According to Spruce and Wood (2014), preventing SSIs begins with maintaining a clean OR environment for every patient. With that in mind, the issue I have identified is staff noncompliance with a change in our room cleaning practice to meet regulatory requirements.
TASK 1 3 Investigation and Evidence Immediately after our latest DNV accreditation survey, the bristle brooms and dustpans that we used to remove gross debris from the floor before mopping between procedures had to be removed from the OR. Because these items can disperse contaminated particles from the floor into the air and cannot be easily disinfected, they are not acceptable for use in the surgical department (Wood, 2014). In the first week following the change, I noticed increased instances of both biological and contaminated non-biological debris left on the floor after the room had been cleaned along with growing accumulations of debris in the OR’s main corridors and room doorways throughout the day during patient care. Foot traffic and the passage of beds and stretchers through the dirty hallways further dispersed the contaminated debris into other areas of the department where patient care is provided. Transport of this debris on equipment to other areas of the hospital increases the potential for contamination of other items and increases the risk of infection (Armellino et al., 2018).
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- Spring '17
- Task 1, Centers for Medicare and Medicaid Services, ECOLAB, leadership experience, Broom, improvement project, C493