INTERNATIONAL PATIENT SAFETY GOALS.pptx

IPSG

1. INTERNATIONAL PATIENT SAFETY GOALS Procare Riaya Hospital PRESENTED BY: Ms. Eloisa E. Ramos Training and Education Manager Procare Riaya Hospital

2. To improve the safety and quality of care in the international community…. Mission of the Joint Commission International

3. What does this mean to you? What is Patient Safety ?

4. Patient Safety: Prevention of harm or injury to patients Identification and control of things that could cause harm to patients

5. GOAL: To be proactive- - to report - to fix -to develop -to implement systems and prevent adverse events from occurring or re-occurring International Patient Safety Goals

6. International Patient Safety Goals JCIA standards 6 th Edition addresses the updated International Patient Safety Goals; of which they are six (6 IPSG’s).

7. The purpose of the Joint Commission’s International Patient Safety Goals (IPSGs) is to promote specific improvements in patient safety in all international healthcare institutions. Purpose of IPSG – JCI

8. IPSG# 1 :Identify Patients Correctly IPSG#2 :Improve Effective Communication IPSG#3 :Improve the Safety of High-Alert Medications IPSG#4 :Ensure Correct-Site, Correct- Procedure, Correct- Patient Surgery IPSG#5 :Reduce the Risk of Health Care– Associated infections (HCAI) IPSG#6 :Reduce the Risk of Patient Harm Resulting from Falls 6 International Patient Safety Goals

9. Goal # 1:Patient Identification

10. Wrong-patient errors occur in virtually all aspects of diagnosis and treatment. Patients may be sedated, disoriented, or not fully alert; may change beds, rooms, or locations within the organization; may have sensory disabilities; or may be subject to other situations that may lead to errors in identification. The intent of this goal is twofold: First- to reliably identify the patient as the person for whom the service or treatment is intended; Second - to match the service or treatment to that individual patient.

11. The hospital develops and implements a process to improve accuracy of patients identification. Measureable Elements : 1. Patient’s are identified using TWO identifiers , NOT Including use of the patient’s room number or location. 2. Patient’s are IDENTIFIED before providing treatments and or procedures. 3. Patient’s are IDENTIFIED before any diagnostic procedures IPSG #1 Standard- APP IPSG#1 : Identify Patients Correctly

12. Purpose : 1.1. to provide guidelines for all health caregivers to ensure positive and accurate identification of patients……see complete policy IPSG 2.1 Patient Identification – is an ongoing process to accurately identify patients using at least two identifiers, none of which is the patient’s room number . Continue reading …… Our POLICY : APP : IPSG 1

13. 2 identifiers : 3.3.1 Patient’s Medical Record Number ( mandatory ) 3.3.2 Patient’s Full name ( mandatory ) 3.3.3 Patient’s date of birth ( optional ) UNKNOWN PATIENT : Maryam …please check this one …..

14. This Goal Applies to: Ambulatory Care / Outpatient Dept. (Doctors, Nurses) Hospital Laboratory (Lab technicians) Radiology Physiotherapy Patient Care Areas – Wards, ICU, NICU, L&D, OR, etc. Cardio-respiratory Care (RTs, etc.) Identification

15. Activities where Accurate Patient Identification is STRICTLY required: Blood Extractions IV insertion Medication Administration Routine Nursing Care (Vital signs, Tepid Sponge Bath, Foley Cath insertion, etc.) Surgical, Radiologic and other invasive procedures that requires consent

16. IPSG # 1 continuation …

17. Detailed…. Identification of NB

18. APP IPSG 1 – A Identification of Newborn, Infants and Mothers

19. Image of NB ID Band

20. Important Points: Ensure patients have ID bands placed on wrist/legs. Simultaneously, patient recites name, while you look into the information on the ID band then checking with the medical record. Any discrepancies between the ID band and the record must be reported to supervisor or to admitting department ASAP. Identification

21. Identification of infant and mother Baby Girl: Maria Delos Santos MRN 001122

22. Effective communication—which is timely, accurate, complete, unambiguous, and understood by the recipient— reduces errors and results in improved patient safety. Communication can be electronic, verbal, or written. The most error-prone communications are >patient care orders given verbally and those given over the telephone, when permitted under local laws or regulations. > reporting back of critical test results, such as the clinical laboratory telephoning the organization to report the results of a critical lab value. IPSG.2: Improve Effective Communication

23. Goal # 2 : Effective Communication

24. Implement a process/procedure for taking verbal or telephone orders and relay of critical test results. Improve Effective Communication

25. The hospital develops and implements a process to improve the effectiveness of the VERBAL/ and TELEPHONE communications among caregivers. MEASURABLE ELEMENTS 1. The complete VERBAL ORDER is documented and READ BACK by the receiver and CONFIRMED by the individual giving the order. IPSG 2 Standard

26. Purpose : Definitions : Open the intranet Policy IPSG # 2 and read contents For the Orientee … APP – IPSG #2 Verbal and Telephonic Orders

27. Improve Communication by: Accurate taking of Verbal and Telephone orders Implements a process for reporting of critical results of diagnostic test. Standardized approach to “handover communication”

28. 1. Accurate taking of Verbal and Telephone Orders The person receiving the information READ BACK the order and verifies accuracy of telephone and verbal orders. A 2 nd person is ideally present to attest the relay of information – both signs in chart. Physician signs ASAP – if resident available. Physician must sign the telephone order within 24 hours.

29. Standard : The hospital develops and implements a process for reporting critical results of diagnostic tests. Measurable Elements : 1. The hospital has defined the critical values for each type of diagnostic tests. 2. The hospital has identified by whom and to whom the critical results of diagnostic tests are reported. 3. The hospital has identified what information is documented in the patient record. Open intranet for Policy and Procedure.. Read for the audience ….. Examples of critical reports.. APP: IPSG 2.1 Reporting Critical Results of Diagnostic Tests

30. Reporting of Critical Values

31. Standard : The hospital develops and implements a process for handover communication . Measurable Elements : 1. Standardized clinical content is communicated between health care providers during handovers of patient care. 2. standardized forms, tools and methods support consistent and complete handover process. 3. Data from handover communication are tracked and used to improve approaches to safe handover communication . APP : IPSG # 2.2 Handover Communication

32. Open APP IPSG2.2 Policy – Handover Communication And read to Orientee …. Introduce the SBAR handover communication process. S- Situation B – Background A – Assessment R – Recommendation

33. “hand-over” – transfer of patients Can occur between: -Nurse to nurse -Nurse to doctor -doctor to doctor

34. **Standardizing a list of hospital-approved abbreviations and symbols By principle, abbreviating and short-hand writing is discouraged. Use of Hospital-approved abbreviations and symbols ONLY. Administrative Policy and Procedure (APP) List available in Clinical Areas.

35. When medications are part of the patient treatment plan, appropriate management is critical to ensuring patient safety. High-alert medications are those medications involved in a high percentage of errors and/or sentinel events, medications that carry a higher risk for adverse outcomes, as well as look-alike, sound-alike medications. Lists of high-alert medications are available. > A frequently cited medication safety issue is the unintentional administration of concentrated electrolytes (for example, potassium chloride [equal to or greater than 2 mEq / mL concentrated], potassium phosphate [equal to or greater than 3 mmol / mL ], sodium chloride [greater than 0.9% concentrated], and magnesium sulfate [equal to or greater than 50% concentrated]). Errors can occur when staff are not properly oriented to the patient care unit, when contract nurses are used and not properly oriented, or during emergencies. The most effective means to reduce or eliminate these occurrences is to develop a process for managing high-alert medications that includes removing the concentrated electrolytes from the patient care unit to the pharmacy. IPSG#3: Improve the Safety of high-Alert Medications

36. Improve the safety of Medications 1. Label all medications, medication containers (for example, syringes, medicine cups, basins), or other solutions Goal # 3 :

37. Medication labels contain: Name of drug (Brand and, preferably, with Generic) Dosage and route of administration Frequency Expiry date * Drug information visible in all drug forms

38. Standard : The hospital develops and implements a process to improve the safety of high alert medications . Measurable Elements : 1. The hospital has a lists of high alert medications, including look alike, sound alike medications, that is developed from hospital specific data. 2. The hospital implements strategies to improve the safety of high alert medications, which may include specific storage, prescribing, preparation, administration and monitoring process. 3. The location , labeling and storage of high alert medications, including look alike sound alike medications is uniform throughout the hospital . APP : IPSG #3 – Improve the Safety of High Alert Medications

39. Open policy and read to orientee .. Policy integrated with ipsg3.1 and 3.2 Show all high alert medication lists, LASA meds… APP: IPSG3 : High Alert Medication and Look – Alike , Sound – Alike Medication

40. Multi-dose Vials and irrigation solutions: Must be labeled indicating the date and time opened and expiry date. Ex. ---discard after 28 days--- - Discard if empty or if suspected to be contaminated (due to lack of label) Drug/Solution: Sterile Water for Irrigation Date/Time Opened: 20/12/2014 Expiry Date: 18/01/2015

41. Remove or improve the safety of high alert medications and look-alike-sound-alike (LASA) in all patient care areas.

42. Wrong-site, wrong-procedure, wrong-patient surgery is an alarmingly common occurrence in health care organizations . These errors are the result of ineffective or inadequate communication between members of the surgical team , lack of patient involvement in site marking, and lack of procedures for verifying the operative site. In addition, inadequate patient assessment, inadequate medical record review, a culture that does not support open communication among surgical team members, problems related to illegible handwriting, and the use of abbreviations are frequent contributing factors. IPSG#4: Ensure Correct-Site, Correct-Procedure, Correct-Patient Surgery

43. Ensure Correct-site, Correct-procedure, Correct-patient Surgery Identify patients correctly Use a checklist, including a “time-out,” before surgery Verify that documents and equipment are correct and functioning properly before surgery Mark precise site where surgery will be performed Goal # 4 :

44. Marking the surgical site involves the patient and is done with an instantly recognizable mark. The mark should be consistent throughout the organization, should be made by the person performing the procedure, should take place with the patient awake and aware , if possible, and must be visible after the patient is prepped and draped. The surgical site is marked in all cases involving laterality, multiple structures (fingers, toes, lesions), or multiple levels (spine)

45. The purpose of the preoperative verification process is to  verify the correct site, procedure, and patient;  ensure that all relevant documents, images, and studies are available, properly labeled, and displayed; and  verify any required special equipment and/or implants are present The time-out permits any unanswered questions or confusion to be resolved. The time-out is conducted in the location the procedure will be done, just before starting the procedure, and involves the entire operative team. The organization determines how the time-out process is to be documented.

46. Standard: The hospital develops and implements a process for ensuring correct site, correct procedure, and correct patient surgery . Measurable Elements 1. The hospital uses an instantly recognizable mark for invasive and surgical procedure site identification that is consistent throughout the hospital. 2. Surgical and invasive procedure site marking is done by the person performing the procedure and involves the patient in marking the site process.

47. 3 . The hospital uses a checklist or other process to document , before the procedure, that the informed consent is appropriate to the procedure, that the correct site, correct procedure, and correct patient are identified; and that all documents and medical technology are on hand, correct and functional .

48. Standard : JCI The hospital adopts and implements evidence based hand hygiene guidelines to reduce the risks of healthcare associated infections. Measurable Elements 1. The hospital adopted currently published, evidence based hygiene guidelines . 2. The hospital implements an effective hand hygiene program throughout the hospitals. 3. Handwashing and hand disinfection procedures are used in accordance with hand hygiene guidelines throughout the hospital . IPSG # 5 : Reduce the Risks of HCAI

49. Goal # 5: Reduce the Risk of Healthcare Associated Infections

50. Infection prevention and control are challenging health care–associated infections – a major concern for patients and health care practitioners. Infections common to many health care settings include 1. CAUTI - catheter-associated urinary tract infections, bloodstream infections, and pneumonia (often associated with mechanical ventilation). Central to the elimination of these and other infections is proper hand hygiene. 2. SSI – Surgical Site infections 3. VAP – Ventilator Associated Pneumonia 4. CLABSI – Central Line Associated Bloodstream Infection Goal 5: Reduce the Risk of Health Care–Associated Infections (IPSG.5)

51. Open Hand hygiene policy / Inf control Nurse APP : IPSG #5 PCI 3.1 Comply with current published and generally accepted hand hygiene guidelines

52. Do Hand Hygiene For visibly dirty, contaminated, or soiled Before eating, handling or cooking food. Patient contact Donning gloves when performing a sterile procedures

53. After: - Contact with a patient’s skin - Contact with body fluids or excretions, non intact skin, wound dressings - Removing gloves - Using the toilet - changing a diaper, tending to someone who is sick, or handling raw meat, fish, or poultry, or any other situation leading to potential contamination.

54. 5 Moments of Hand Hygiene

55. “I always make sure that I follow the 5 moments of Handwashing”

56. Goal # 6

57. Falls account for a significant portion of injuries in hospitalized patients. the organization should evaluate its patients’ risk for falls and take action to reduce the risk of falling and to reduce the risk of injury should a fall occur. The evaluation could include fall history, medications , gait and balance screening, and walking aids used by the patient. The organization establishes a fall-risk reduction program based on appropriate policies and/or procedures. The program monitors both the intended and unintended consequences of measures taken to reduce falls. IPSG#6: Reduce the Risk of Patient Harm Resulting from Falls

58. The hospital develops and implements a process to reduce the risk of patient harm resulting from falls. Measurable Elements 1. The hospital implements a process for assessing all inpatients and those outpatients whose conditions, diagnosis, situation, location identifies them as high risk for falls. 2. The hospital implements a process for the initial an ongoing assessment, re assessment, and intervention of inpatients and outpatients as risks for falls based on documented criteria. 3. Measures are implemented to reduce risk for fall for those identified patients, situations, locations assessed to be at risk. JCI Standard :

59. Reduce the Risk of Patient Harm Resulting from Falls Assess and periodically reassess each patient’s risk for falling

60. APP : IPSG #6

61. THANK YOU…. Sources: Joint Commission International 5 th edition http://www.jcrinc.com/13798/ World Health Organization PCRH APP