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Workgroup updates
Thank you for your continued
participation in EQIC’s affinity workgroup meetings.
We adjusted the regular monthly schedule this
holiday season and the most recent updates are featured below.
Please reach out to the workgroup leads with any questions.
Sepsis
At the Dec. 5 meeting, teams
checked in and shared identified priority action steps based on
last month's assignment list. Discussion focused on accelerating
action by applying patient and family engagement and health
equity lenses. The group reviewed the Surviving Sepsis Campaign
and CDC recommendations relative to screening patients for
health-related social needs, providing education and engaging
patients and families in shared decision-making post-ICU and
during discharge planning.
Members reviewed the Institute for Healthcare
Improvement’s Psychology of Change framework and quick tips for
simplifying small tests of change. Our roadmap review highlighted
optimizing human factors and system design to develop equitable
solutions and eliminate disparities in sepsis incidence,
morbidity and mortality.
This month's sepsis roadmap team activities include
reviewing the patient and family engagement and health
equity-specific elements of the EQIC rapid-cycle improvement
program Sepsis Assessment Tool to ensure recommended practices
are in place. Throughout December and January, teams will
continue working on their priority action steps. When we return
in February, teams will report out and we'll be joined by the
Sepsis Alliance for a discussion focused on sepsis coordinator
training and education.
Pressure injuries
At the Dec. 6 PI workgroup meeting, hospitals
discussed their continuing journey to injury prevention. A
summary of the October meeting was presented, which focused on
nutritional screening, bed maintenance and improved PI rates.
Hospitals were provided time in November to conduct
an RCIP assessment to
identify opportunities to reduce patients’ pressure injury risk.
Gaps identified when conducting the assessment
include:
- the need to update hospital policies for
skin care;
- not using a valid tool to assess healing
progress;
- a turning schedule that does not allow
for uninterrupted sleep at night;
- not using the “hand test” to determine if
the sacrum is off the bed; and
- mechanisms are not available that
delineate what type of support mattress to use.
Actions taken include:
- updating current policies to reflect new
treatments and implementing timelines for skin assessments
and turning schedules;
- implementing the “maintain zero”
system-wide zero harm initiative;
- having patients share their PI stories at
the patient satisfaction committee once a month;
- educating staff on ordering specialty
mattresses;
- wearing cards around the neck with
turning visuals in critical care;
- implementing surveillance of all PI;
- conducting monthly prevalence studies and
auditing 30 PI charts; and
- creating PI education material including What I Need to Know
(or WINK),
which includes preventive sacral dressings, and SHAMBLES,
which reminds staff to assess the sacrum and heels each time
they enter the patient’s room.
A review of EQIC data showed reduction in:
- the prevalence rate of
facility-acquired pressure injuries of stage II or greater
per 100 patients;
- Agency for Healthcare Research and
Quality PSI 3: Stage III or IV pressure injuries per 1,000
discharges; and
- percentage of patients with documentation
of a pressure injury risk assessment within 24 hours of
admission.
While
we still have work to do, we congratulate
hospitals on the hard work already done to improve PI rates.
Before the next meeting, hospitals were asked to review and
update plans for decreasing PI and to be ready to discuss how to
improve rates and sustain improvements made to date.
Infections
The next workgroup meeting is scheduled for Tuesday,
Feb. 13, at 1 p.m.
Adverse drug
events/opioid prescribing
The next workgroup meeting is scheduled for
Wednesday, Feb. 14, at 1 p.m.
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