Becker's Clinical Quality & Infection Control

September 2014 Becker's Clinical Quality & Infection Control

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Infection Control & Clinical Quality September/October 2014 • Vol. 2014 No. 4 INDEX Table of Contents p. 4 Preventing HAIs p. 6 Executive Briefing: Infection Prevention p. 8 Product Showcase p. 13 Executive Briefing: Eradicating HAIs p. 14 Expert- Recommended Hand Hygiene Practices 10 must-know tips p. 6 Hospital Elevator Buttons or Bathrooms? Which is hurting your infection control efforts more? p. 7 Readmission Reduction Lessons From the Ritz-Carlton What the luxury hotel chain can teach us about being patient-centered p. 19 Patient Safety & Quality Improvement Toolbox 20 patient safety tools p. 18 How Much Critical Information is Missed During Patient Handovers? Probably more than you think p. 14 Inside the One C. Diff Vaccine Focusing on Prevention, Not Treatment By Akanksha Jayanthi The collective mindset of the healthcare industry in the U.S. is shifting from treating conditions to preventing them. In a nutshell, providers are trying to keep patients healthy so they don't come to the hospital. Following this philosophy is Swiftwater, Pa.-based Sanofi Pasteur's vaccine, the only candidate in phase III trials fo- cused on Clostridium difficile infection prevention instead of treatment. The vaccine uses a technique common in preventive vaccines called toxoiding, where the C. diff toxins responsible for infec- tion are extracted, de-activated and then reintroduced so the body can generate an immune response. Toxoiding is also the Are You Misusing The Term 'Population Health?' By Molly Gamble Based on the latest study findings, there are plenty of ways to mistakenly use the term "population health." While the words are perhaps two of the most-spoken among healthcare leaders in the past year, the exact meaning of the phrase is unclear. For instance, back in 2003, David Kindig, MD, PhD, a population health thought leader, wrote that the term was being more widely used "but often without clarification of its meaning and definition," accord- ing to the study. He said increased use of "population health" without a precise meaning could "render the term more confusing than helpful." In 2010, inspired by statistics from Robert Wood Johnson Foundation, Winston-Salem, N.C.-based Novant Health leaders decided to investi- gate the amount of time the system's nurses were actually spending at the bedside during their 12-hour shifts. "We discovered that we weren't that different from the rest of health- care organizations," says Sallye Liner, RN, Novant's chief clinical officer. "They were spending two- and-a-half to three hours on direct care. They're working hard. They're just engaged in activities that didn't have them performing at the top of their license. " Novant's leaders brought together a group of nurses from across the health system's then-13 hospitals to further investigate the issue and come up with a solution. Ms. Liner says the nurses identified four ma- jor types of activities that accounted for most of their time away from the patient: hunting for and gathering supplies (such as IV poles), retriev- ing medications, care planning and the process of admitting the patient (including the necessary paperwork concerning patient history, medica- tions and other documentation). Ms. Liner says Novant Health then decided to set an ambitious goal: having nurses spend 70 percent of their time in a patient's room. "Over the course of the last three years fol- lowing that, we've worked on care team models that included having the nurse define what the top of their license performance would look like," she says. "It was clear that we would need a team of people wrapped around nurses to make sure all of the needs of the patient were met." In line with that discovery, Novant brought in certified nursing assis- tants and had them take over many of the activities that were keeping nurses away from the bedside. Fur- thermore, the implementation of an continued on page 5 continued on page 5 continued on page 6 Bringing Nurses Back to the Bedside: How Novant Health Tripled Direct Patient Care Time By Helen Adamopoulos

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