Question

A case study.

Question; suzanne joes 76 year old patient with COPD is admitted to the ICU. Mrs jones is placed on mechanical ventilation to assist with her breathing. after two days on the ventilation, mrs jones is extubation with then transferred to a medical surgery unit. the medication regimen is adjusted during the hospitalization. mrs jones is discharged home fter 6 days. she and her family are please with the care she receive in the hospital (learning objective 3 and 6) 1. Describe the quality performance tool that may be used to demonstrate that the care and treatment rendered are both cost efficient and of high quality. 2. Describe the quality performance that may be used to demonstrate that the nursing care utilized evidence - based care and high quality, resulting in patient satisfaction and good patient outcomes

Answer 1

The mission and vision of every healthcare institution is to provide a quality care so as to achieve total patient satisfaction. In order to evaluate the quality of care, there are various indicators which are used by the healthcare settings. These are the quality performance tool for hospital also known as PATH. This tool supports the hospitals to assess their performance, question their results and evaluate if their is need for improvement. The various performance indicators are

• Clinical effectiveness evaluate through the mortality rates, rate of readmission, return to ICU, appropriate use of antibiotics, timely administering medication, doctors responsiveness to nurses call.
• Safety evaluated through incident of patient fall, ensure right patient and right procedure, safe use of high alert medication, preventing harm due to equipment malfunctioning, maintaining privacy and confidentiality.
• Efficiency evaluated through adequate staffing, competent staffs, short length of stay.
• Patient centeredness evaluated through score on patient perception and patient satisfaction survey, opportunity to patient to participate in decision making for his treatment, use of informed consents.
• Responsive goverance evaluated through care rounds, care calls, follow up visits and rehabilitative services.
• Staff orientation evaluated through adequate inservice education, budget for staff health improvement, healthy and safe working environment, staff incentives, staff excessive weekly working hours.

The role of nursing care in gaining patient satisfaction is crucial. The patient gives a positive feedback when they receive high quality nursing care. For achieving this target of patient satisfaction and good patient outcome, nursing faculty uses evidenced based care which is to be delivered through a highly skilled and competent staffs. For a COPD patient certain evidenced based care provided are:

• First thing to provide advanced care is adequate staffing pattern without heavy workload. A safe working environment for nurses to work and make decisions for patient care is necessary. This has been proved with evidence how the positive working environment and conditions lead to a positive patient outcome.
• Use of skilled and competent staff: This is important because the patients with COPD at times appear to be stable but may become critical to handle in no time. Therefore those staff who have complete knowledge about the disease condition and is skilled enough to manage a emergency situation should be assigned to the patient.
• Oxygenation is a crucial step for COPD patient. This is to prevent hypoxia and organ damage. The use of oxygen is correct treatment for COPD which is proven with evidence to improve the quality of life.
• Appropriate use of antibiotics to treat the underlying infections and use of steroids to control inflammation of airways is applied that will result in improved health status.
• Health education to identify and prevent various allergans which may trigger an episode of COPD. Education on certain lifestyle modifications and activity planning is also important.
• Informed consents for the procedure and adequate explaination of the treatment regimen to make patients participate in their treatment and decision making will foster positive outcome.
• Patients feedback is the tool to evaluate any quality performance. This will also help to understand the drawback and pave a way for making improvements.