Quality Improvement/Patient Safety Carmen Gonzales -nursing
RN, has worked as a charge nurse in the cardiac surgery unit at a large urban hospital for the past 3 years. Carmen has become concerned about what seems to be an increase in infection rates of post–coronary artery bypass graft (CABG) patients’ surgical incisions. Through the hospital’s electronic health record system, Carmen is able to do a quick review of discharge summaries for cases done in the previous month and learns that during this time, three patients had incisional infections that required intravenous antibiotics and extended hospital stays. Carmen considers the seriousness of these infections in light of their effect on a patient’s overall health, as well as their financial effect on both the patient and the hospital. Carmen knows that in almost all cases, postsurgical incisional infections are preventable and decides to take action to reduce the rate of these infections in her unit.
1. What is the financial effect on the hospital of postsurgical infections?
2. What financial effect will a postsurgical infection have on the patient and his or her family?
3. Carmen would like to use the quality improvement model presented in this chapter to reduce or eliminate postsurgical infection among CABG patients. How will she go about initiating this project and answer the first three questions of the quality improvement model? What will be Carmen’s first step in initiating the plan-do-check-act (PDCA) cycle?
4. What quality improvement tool or tools would be most useful to help analyze and monitor the problem (e.g., run chart, flowchart, Pareto chart)?
5. Where can Carmen get more information about best practices or recommended guidelines related to post-CABG wound care?
6. How can Carmen share her experience in reducing the rate of postsurgical infection in her unit to help other units in the hospital? In the region, state, or nation?