scholarly journals A Quality Improvement Project Regarding Breastfeeding Practices Among Postnatal Mother of Infants Who are Admitted in SNCU of A Selected Health Care Setting

2020 ◽  
Vol 2 (1) ◽  
pp. 49-56
Author(s):  
Papiya Bera Saha ◽  
Smritikana Mani ◽  
Govinda Chandra Das
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Family Members ◽  
Improvement Project ◽  
Team Members ◽  
The Third ◽  
Breastfeeding Practices ◽  
Pdsa Cycle ◽  
The Family ◽  
Breastfeeding Practice

Breast milk is unquestionably the best milk for the baby. From 1sthour  to first six months of life, infants should be exclusively breastfed to achieve growth & development, but most of the time this objective is not fulfilled. So to improve the practice  of breastfeeding we collected  the baseline data  from selected unit ,we observed that the breastfeeding rate of the postnatal  mothers is only 48%. Even after a lot  of effort ,we could not achieve breastfeeding practice in our SNCU before starting our project. Then we started structured and plannedprogramme in the form of PDSA cycle for 45 days. The study was adopted to increase  breastfeeding  practice rate from 48% to 80% in 6 weeks among mother in the infants of SNCU. In this  QI project  applied on 25 postnatal mother of infants who are admitted in SNCU of RG Kar Medical College & Hospital,Kolkata. Data was collected by valid feeding register and  observation checklist. For the implementation of the project, a team was formed & a meeting was carried out  among  the team members. The team found the root cause analysis by fishbone model. The team members decided to carry out PDSA cycles at the interval of 15 days for carrying out three consecutive cycles, Where the first cycle deals with motivating the health care staffs ,mothers in SNCU as well as postnatal ward, the second cycle deals with  providing IEC materials  and privacy of themother during breastfeeding and the third PDSA cycle deals with involving  the family members of the mother. After 1st PDSA cycle we have achieved an increase of  only 4% of breastfeeding practice rate  in the selected unit.After 2nd PDSA cycle we have achieved an increased rate of 14% of breastfeeding practice. The team observed even after 2nd PDSA cycle we did not achieve our goal, then after involving the family members in the third PDSA cycle ,we  have observed a dramatic increase in the breastfeeding practice rate  upto 80%. The study concluded that  simple planned QI group effort  can improve the breastfeeding practice  rate in the  any unit.   Keywords: quality improvement, breastfeeding practices, postnatal mother, PDSA, SNCU, health care settings

scholarly journals Quality improvement primer part 2: executing a quality improvement project in the emergency department

CJEM ◽  
2017 ◽  
Vol 20 (4) ◽  
pp. 532-538 ◽  
Author(s):  
Lucas B. Chartier ◽  
Antonia S. Stang ◽  
Samuel Vaillancourt ◽  
Amy H. Y. Cheng
Keyword(s):  
Health Care ◽  
Emergency Department ◽  
Emergency Medicine ◽  
Quality Improvement ◽  
Improvement Project ◽  
Emergency Department Setting ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
Final Article

ABSTRACTThe topics of quality improvement (QI) and patient safety have become important themes in health care in recent years, particularly in the emergency department setting, which is a frequent point of contact with the health care system for patients. In the first of three articles in this series meant as a QI primer for emergency medicine clinicians, we introduced the strategic planning required to develop an effective QI project using a fictional case study as an example. In this second article we continue with our example of improving time to antibiotics for patients with sepsis, and introduce the Model for Improvement. We will review what makes a good aim statement, the various categories of measures that can be tracked during a QI project, and the relative merits and challenges of potential change concepts and ideas. We will also present the Model for Improvement’s rapid-cycle change methodology, the Plan-Do-Study-Act (PDSA) cycle. The final article in this series will focus on the evaluation and sustainability of QI projects.

scholarly journals ‘CPR for Feet’ care bundle to improve foot assessment in inpatient diabetes

2018 ◽  
Vol 7 (3) ◽  
pp. e000196 ◽  
Author(s):  
Rhea O’Regan ◽  
Ross MacDonald ◽  
James G Boyle ◽  
Katherine A Hughes ◽  
Joyce McKenzie
Keyword(s):  
Quality Improvement ◽  
Nursing Staff ◽  
Quality Improvement Project ◽  
Care Bundle ◽  
Staff Education ◽  
Pressure Relief ◽  
Improvement Project ◽  
The Third ◽  
Inpatient Diabetes ◽  
Pdsa Cycle

AimsThe Scottish Inpatient Diabetes Foot Audit conducted in 2013 revealed that 57% of inpatients had not had their feet checked on admission, 60% of those at risk did not have pressure relief in place and 2.4% developed a new foot lesion. In response, the Scottish Diabetes Foot Action Group launched the ‘CPR for Feet’ campaign. The aim of this project was to raise awareness of the ‘Check, Protect and Refer’ (CPR) campaign as well as improve the assessment and management of inpatients with diabetes.MethodsA quality improvement project underpinned by Plan-Do-Study-Act (PDSA) methodology was undertaken. The first and second cycles focused on staff education and the implementation of a ‘CPR for Feet’ assessment checklist using campaign guidelines, training manuals and modules. The third and fourth cycles focused on staff feedback and the implementation of a ‘CPR for Feet’ care bundle.ResultsBaseline measurements revealed 28% of patients had evidence of foot assessment. Medical and nursing staff reported to be largely unaware of the ‘CPR for Feet’ campaign (13%). Fifty-two per cent of inpatients with diabetes had their feet assessed and managed correctly following the second PDSA cycle. After completion of the third and fourth PDSA this number improved further to 72% and all staff reported to be aware of the campaign.ConclusionsThe introduction of a ‘CPR for Feet’ care bundle improved the assessment of inpatients with diabetes.

Using Lean methodology to improve the time to antibiotics in oncology patients on chemotherapy who present to the ED with neutropenic fever.

2019 ◽  
Vol 37 (27_suppl) ◽  
pp. 31-31
Author(s):  
Brian J. Byrne ◽  
Frederick Bailey ◽  
Pat Montanaro ◽  
Patricia Anne DeFusco
Keyword(s):  
Quality Improvement ◽  
Substantial Improvement ◽  
Neutropenic Fever ◽  
Medical Emergency ◽  
Antibiotic Administration ◽  
Improvement Project ◽  
The Third ◽  
Pdsa Cycle ◽  
Time To Antibiotics ◽  
American Society

31 Background: Neutropenic fever is a medical emergency. Delays in treatment can lead to increase in morbidity, mortality, and increase length of stay. The American Society of Clinical Oncology currently recommends that antibiotics be prescribed within 60 minutes of triage. Literature review shows through a multidisciplinary effort involving the ED, lab, oncology, and pharmacy significant improvement in time to antibiotics can be achieved. Since many patients with neutropenic fever present with sepsis, these guidelines also will need to be followed. Methods: Three PDSA cycles were conducted. The first involved education of the ED staff on the importance of treating neutropenic fever and using the correct antibiotic. The second PDSA cycle involved the laboratory and the calling of critical white counts and low neutrophil counts. The third PDSA involves patient education on the importance of temperature monitoring and reporting they are on chemotherapy to ED staff. Results: Baseline data show only 33% of patients receive the correct antibiotic and the average time to administration is 3 hours and 41 minutes. Results of the quality improvement project show a substantial improvement in time to antibiotic administration to 1 hour 58 minutes and an increase in the percentage of patients who receive the correct antibiotic. The time from the specimen received in the lab until critical called also improved from 1 hour 14 minutes to 18.5 minutes. Conclusions: This quality improvement led to a significant improvement in time to correct antibiotics, but several additional steps need to be taken to meet ASCO guidelines. [Table: see text]

scholarly journals Maciej Ziemierski, Testamenty krakowskiej rodziny Królików z XVII w.

2020 ◽  
Vol 26 ◽  
pp. 11-41
Author(s):  
Maciej Ziemierski
Keyword(s):  
18Th Century ◽  
Family Members ◽  
17Th Century ◽  
16Th Century ◽  
Fourth Generation ◽  
Third Generation ◽  
The Third ◽  
The Family ◽  
The Town ◽  
Distinguished Member

17th century testaments of the Królik family from Krakow The article is dedicated to the Królik family from Krakow, who lived in the town from the late 16th century until the first years of the 18th century. The family members initially worked as tailors, later reinforcing the group of Krakow merchants in the third generation (Maciej Królik). Wojciech Królik – from the fourth generation – was a miner in Olkusz. The text omits the most distinguished member of the family, Wojciech’s oldest brother, the Krakow councillor Mikołaj Królik, whose figure has been covered in a separate work. The work shows the complicated religious relations in the family of non-Catholics, initially highly engaged in the life of the Krakow Congregation, but whose members gradually converted from Evangelism to Catholicism. As a result, Wojciech Królik and his siblings became Catholics. This work is complemented by four testaments of family members, with the first, Jakub Królik’s, being written in 1626 and the last one, Wojciech Królik’s, written in 1691.

Timely Family Feedback to Guide Family Engagement in the Intensive Care Unit

2020 ◽  
Vol 40 (6) ◽  
pp. 42-51
Author(s):  
Natalie S. McAndrew ◽  
Laura Mark ◽  
Mary Butler
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Quality Improvement ◽  
Patient Care ◽  
Care Delivery ◽  
Family Engagement ◽  
Family Satisfaction ◽  
Family Experience ◽  
Improvement Project ◽  
The Family

Background Organizations motivated to provide high-quality care in the intensive care unit are exploring strategies to engage families in patient care. Such initiatives are based on emerging evidence that family engagement improves quality and safety of care. Objective To gather family feedback to guide future nurse-led quality improvement efforts to engage families in the intensive care unit setting. Methods The Critical Care Family Satisfaction Survey, which consists of 20 items rated from 1 (very dissatisfied) to 5 (very satisfied), was paired with open-ended questions and administered to families during the intensive care unit stay from March through December 2017. Content analysis was used to identify themes regarding the family experience. Results Responses were collected from 178 family members. The mean (SD) score on the survey was 4.65 (0.33). Five themes emerged regarding the delivery of family care in the intensive care unit: family interactions with the interdisciplinary team, information sharing and effective communication, family navigation of the intensive care unit environment, family engagement in the intensive care unit, and quality of patient care. Conclusions This quality improvement project provided foundational information to guide family engagement efforts in the intensive care unit. Real-time solicitation of feedback is essential to improving the family experience and guiding family-centered care delivery in this practice environment.

scholarly journals Implementing the Patient Health Questionnaire Modified for Adolescents to improve screening for depression among adolescents in a Federally Qualified Health Centre

2020 ◽  
Vol 9 (4) ◽  
pp. e000751
Author(s):  
Mohamed Mansour ◽  
Dharshana Krishnaprasadh ◽  
Janice Lichtenberger ◽  
Jonathan Teitelbaum
Keyword(s):  
Quality Improvement ◽  
Adolescent Depression ◽  
Quality Improvement Project ◽  
Patient Health Questionnaire ◽  
Depression Symptoms ◽  
Health Questionnaire ◽  
Screening Rate ◽  
Improvement Project ◽  
Pdsa Cycle ◽  
Patient Health

BackgroundDepression, which is a serious medical illness, is prevalent worldwide and it negatively impacts the adolescent lifestyle. Adolescent depression is associated with adverse emotional and functional outcomes and suboptimal physical health. Over the last decade, it has been found that approximately 9% of teenagers meet the criteria for depression at any given time, and one in five teenagers have a history of depression during adolescence. Ninety per cent of paediatricians believe that recognition of child and adolescent depression is their responsibility; however, it has been reported that 46% lacked confidence that they could recognise depression.MethodsIn this study, adolescents between 12 and 17 years of age were screened during their well-child visits using the Patient Health Questionnaire Modified for Adolescents. A score of 10 or higher warrants a referral to a social worker and psychiatrist. The goals of this quality improvement project were to implement a standardised questionnaire and to improve the screening, diagnosis and treatment of depression in children from 12 to 17 years of age.ResultsIt was found that the adolescent depression screening rate significantly improved within 6 months of implementing this quality improvement project. The screening rate improved to 50% by mid-cycle (Plan-Do-Study-Act (PDSA) cycle 3) and up to 70% at the end of the 6-month period (PDSA cycle 5). Improvement was noted among all providers, across all age groups, and in both male and female patients by the end of the study period.ConclusionStandardised screening tests with a scoring system help providers to identify and monitor depression symptoms using a common language, especially in the outpatient clinical setting where the patient may be seen by different providers.

Sign in / Sign up

Export Citation Format

Share Document