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oPPoRTUNiTiES FoR iMPRoVEMENT performanCe measurement and improvement update PERFORMANCE IMPROVEMENT Several areas of performance improvement are still above our threshold. Key focus areas that will be addressed include medication errors and “do not returns” for clinical procedure and unprofessional behavior. medication errors Medication errors continue to be a huge concern due to the high incidence of medication errors noted throughout the United States. Medication errors can result in harmful effects or death, increase hospital length of stay, and add tremendous cost to healthcare. Medication errors continue to be a cause of concern for maxim <strong>Staffing</strong> Solutions as evidenced by our performance improvement data. There are many ways you can take steps to minimize this risk: make certain to follow the 6 rights of medication administration: 4Right Medication. Check the physician order and check it against the medication label. 4Right Dose. Check the physician order and the medication label. Look up the medication if you are unfamiliar with it. 4Right Time. Check the order and check the medication label. Check the time. Give the medication at the time prescribed. 4Right Route. Check the MD order and check the medication label to determine that the medication will be given by the right route. 4Right Patient. Check the MD order and check the medication label. Check the patient and check the patient’s allergies prior to medication administration. 4Right Documentation of Medication. Properly document the medication given, dose, time, route, and patient response to medication. take steps to stay current on medications: Many new medications come into the market each year. Take steps to become familiar with medication so you have a full understanding of medication administration, dosage, side effects, and proper storage. Consider taking continuing education courses to better understand medication administration and prevent medication errors. MedCom is a CEU vendor that Maxim uses that offers a course on medication administration. Please contact your Maxim representative for more information. do not returns A “Do Not Return” (or DNR) occurs when a facility notifies Maxim that they do not wish for a particular staff member to return. Facilities have the right to do this, and Maxim must honor their request. DNRs usually occur due to two reasons: unprofessional behavior and for clinical reasons. do not return for Clinical procedure Prior to performing any procedure, make certain to follow the facility policy and procedure manual. If, at any time, you are unsure about any type of treatment, medication, or procedure, STOP and ASK FOR HELP! This will ensure that the patient gets the proper treatment. do not return for unprofessional Behavior Did you know that Maxim has to report all cases of unprofessional behavior that result in a DNR to The Joint Commission? Unprofessional behavior is disrespectful and disruptive to staff and patients. In some cases, facilities have reported these types of behaviors to the state licensing boards. Please take a moment to consider your behavior when working in facilities. Make certain to maintain professionalism at all times. JoiNT CoMMiSSioN continued new! tHe Joint Commission Center for transforming HealtHCare Established in 2009, The Joint Commission Center for Transforming Healthcare aims to solve healthcare’s most critical safety and quality problems. The Center’s participants – the nation’s leading hospitals and health systems – use a systematic approach to analyze specific breakdowns in care and discover their underlying causes to develop targeted solutions that solve these complex problems. In keeping with its objective to transform healthcare into a high reliability industry, The Joint Commission will share these proven effective solutions with the more than 18,000 health care organizations it accredits and certifies. Hospitals have made significant advances in quality – even better results are now achievable. Hospitals and The Joint Commission are working together to improve systems and processes of care. More information can be found here: http:// www.centerfortransforminghealthcare.org/ Source: http://www.centerfortransforminghealthcare.org/ about/about.aspx w w w . t r a v m a x . c o m 4
pi Corner Ask Deb tHis edition’s question to our readers: As healthcare providers, we are experiencing a continual issue of medication errors. This quarter, we would like to hear opinions from our readers related to this issue. Your opinions are very important to us. This information will be used to work with our clients and hopefully alleviate, or at least lessen, the occurrence of medication errors. Our goal is to assist the client, employee, and patient in hopes of ensuring safe healthcare. Ask Deb wants to know: What do you think is the most appropriate way to properly handle a personality conflict with your supervisor? Please send your responses to askdeb@maximstaffing.com. previous question: Why do you think that medication errors are taking place when nurses go into a facility and work shifts? Winning Response: I have been an agency nurse for 4 years. Though I have not had any medical errors, I have had a few near misses. In my experience, the top two reasons that set up agency nurses for potential medication errors are: 1. Inadequate training • This last year, one of the six hospitals I worked at gave me a full patient load and expected me to complete an orientation checklist within the same shift. Additionally, the person tasked with orienting me was also given a full patient work load. Another hospital did not provide any training at all. I had to hit the floor running. • Alternatively, one facility, not only provided me a 2 hour orientation separate from my work shift, but they also gave me a handout so I would not forget the information. That reference material was well used! 2. Poorly communicated shift expectations. The expectations are not only different between health care facilities, but they are different between work areas. For example: At one hospital it is the night RN's responsibility to provide sliding scale insulin coverage for high blood glucose levels, yet in the same hospital on a different unit the coverage is expected to be provided by the day shift RN. I suppose reason number two could also be attributed to inconsistent expectations throughout facilities. What helps me prevent errors: 1. I take notes when given information. If the facility allows, I save a file for each unit in a password protected personal computer document folder. That way, I can cue up the expectations specific to each unit (prevents me from needing to ask the same questions each time). I recently took advantage of this approach to fill in on a unit I had not worked on in a year. It made for a successful and safe shift. 2. I write down all the important phone numbers that I will need to do my job properly (inpatient pharmacy, transportation/escort, discharge pharmacy, etc) and place that list in my ID badge holder. Prevents me from needing to run to the nurse's station to reference the phone list. Saves time! 3. I make checklists for each patient to remind me when medications are due. Congratulations to last week's winner, Dana Schanrfenberg! Enjoy your $100 gift card! About Dana Schanrfenberg... I earned a BSN and a BA in Biology with a minor in chemistry at Seattle Pacific University in 2001. For the majority of my career as a nurse, I have worked primarily in oncology and medical-surgical settings. In 2009, I completed a master of nursing degree at the University of Washington with a focus on education. For the past five years, I have worked part time as a medical-surgical instructor in the clinical setting and as an agency nurse for almost the same amount of time. Currently, I am employed with Maxim <strong>Staffing</strong> Solutions and teach at North Seattle Community College in Seattle, Washington. It is my joy to work with nursing students and care for patients in vulnerable life transitions. Exposure to so many different settings has strengthened my skills as a nurse and helped me to more fully appreciate the "art" in the "art and science" of nursing. Working as an agency RN has allowed me to balance my efforts to serve the community I live in, continue to teach, and be there for my husband and two children when needed. w w w . t r a v m a x . c o m 5
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