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Infection Control and Quality
   Improvement Theories
          Rachel Duffy
         Eva van Swaaij
      Phomolo Flex Madome
FADE and wound infections
                    • F: Focus on wound
                      infections
                    • A: See what can be done
      Focus           to prevent wound
                      infections
Execute   Analyse   • D: Develop a plan that
                      can be implemented in
                      your setting
     Develop        • E: Implement your plan
                     Evaluate and start
                    again, focussing on new
                    areas
PDSA
• This quality improvement approach is widely
  used for process improvement.
• It has been used in hand hygiene
  improvement projects
• In cost-effectiveness of pressure ulcer quality
  collaborative research
• Have also been used in infection control
  projects and improvements
• It will engage those give/given the care
• It initiates change in a simple approach
• Implementation of quality improvement
  interventions can be complicated if the PDCA
  cycle is not utilized (Robichaud, 2004).
• Quality improvement projects utilizing the PDCA
  in long-term care setting offers knowledge gained
  from these projects and may help increase the
  understanding of implementing effective change
  (Robichaud, 2004).
• Used to conduct small-scale tests of change
• Then small PDSA cycles can be linked for
  broader implementation
PDSA
       Plan
•   Will wound culturing be easy for
    staff, will staff give necessary
    education and comply with new
    procedures, who is going to do
    what?
         Do                                  Plan    Do
•   The team do planned activities for
    change
           Study
•   Did culturing go right, necessary        Act    Study
    education given, proper procedures
    followed, any suggestions?
•   Act
•   Repeat test using suggestions
    given, Plan for the cycle if tests are
    successful
TQM- Principles
• 1.Customer focused-Organizations depend on their customers
  and therefore should understand current and future customer
  needs, should meet customer requirements and strive to exceed
  customer expectations
• 2. Leadership- Leaders establish unity of purpose and direction.
  They should create and maintain the internal environment in
  which people can become fully involved in achieving the
  organization's objectives
• 3.Involvement of people- People at all levels are the essence of
  an organization and their full involvement enables their abilities
  to be used for the organization's benefit.
• 4.Process approach-A desired result is achieved more efficiently
  when activities and related resources are managed as a process.
• 5.System approach to management- Identifying, understanding
  and managing a system of interrelated processes as a system
  contributes to the organization’s effectiveness and efficiency in
  achieving its objectives.
• 6.Continual improvement- Continual improvement of the
  organization's overall performance should be a permanent
  objective of the organization.
• 7.Factual approach to decision making- Effective decisions are
  based on the analysis of data and information.
• 8.Mutually beneficial supplier relationships- An organization and
  its suppliers are interdependent and a mutually beneficial
  relationship enhances the ability of both to create value
Behavioural Theories in Infection
                control
Lowbury Lecture
Cognitive determinants of human behaviour
• knowledge
• motivation
• intention
• perception of threat
• Outcome expectancy/attitude
• Perceived behavioural control/self efficacy
• Social pressure
References
•   Department of Community and Family Medicine, Duke University Medical Center (2005)
    Patient Safety – Quality Improvement. What is Quality Improvement? Retrieved on the 19th
    of April 2012 from: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html

•   Robichaud, T,. G. (2004). AN INNOVATIVE PROJECT TO TRANSFORM THE ACQUISITION AND
    DISTRIBUTION OF INVENTORY SUPPLY IN AN EFFORT TO LOWER PROCUREMENT COSTS.
    COLLEGE OF NURSING. The University of Arizona

•   Patient Safety Curriculum Guide. Topic 7 Using quality-improvement methods to improve
    care. Retrieved from
    http://www.who.int/patientsafety/education/curriculum/PSP_mpc_topic-07.pdf

•   Pitteta, D. (2004). The Lowbury lecture: behaviour in infection control. Journal of Hospital
    Infection, 58 (1), 1–13. DOI:
    http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1016/j.jhin.2004.06.002

•   Patel, G. (2010).Total Quality Management in Healthcare. Retrieved from
    http://www.biomedicalprojects.com/files/TQM%20in%20Healthcare.pdf
Search strategy

• Eva: I used the references from last time I
  worked on the FADE model. I also searched in
  pubmed to find specific articles where the
  FADE model had been implemented in wound
  care, but I didn´t find anything. So I thought of
  an example for myself and used that as an
  example in the presentation.
• Phomolo: Used Google scholar with key words
  PDSA CYCLE and WOUND CARE.
Collaboration strategy

• We decided all of us would work on a QI model
  and give an example with it. We agreed to meet
  two hours before the presentation to put all our
  parts together. Unfortunately only one team
  member showed up and the others did not send
  around their presentation parts. When after an
  hour another team member showed up, the
  presentation could be put together a bit. The last
  team member agreed to work on the
  presentation during the lecture, because he/she
  was late.

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Community h centers theories

  • 1. Infection Control and Quality Improvement Theories Rachel Duffy Eva van Swaaij Phomolo Flex Madome
  • 2. FADE and wound infections • F: Focus on wound infections • A: See what can be done Focus to prevent wound infections Execute Analyse • D: Develop a plan that can be implemented in your setting Develop • E: Implement your plan  Evaluate and start again, focussing on new areas
  • 3. PDSA • This quality improvement approach is widely used for process improvement. • It has been used in hand hygiene improvement projects • In cost-effectiveness of pressure ulcer quality collaborative research • Have also been used in infection control projects and improvements
  • 4. • It will engage those give/given the care • It initiates change in a simple approach • Implementation of quality improvement interventions can be complicated if the PDCA cycle is not utilized (Robichaud, 2004). • Quality improvement projects utilizing the PDCA in long-term care setting offers knowledge gained from these projects and may help increase the understanding of implementing effective change (Robichaud, 2004).
  • 5. • Used to conduct small-scale tests of change • Then small PDSA cycles can be linked for broader implementation
  • 6. PDSA Plan • Will wound culturing be easy for staff, will staff give necessary education and comply with new procedures, who is going to do what? Do Plan Do • The team do planned activities for change Study • Did culturing go right, necessary Act Study education given, proper procedures followed, any suggestions? • Act • Repeat test using suggestions given, Plan for the cycle if tests are successful
  • 7. TQM- Principles • 1.Customer focused-Organizations depend on their customers and therefore should understand current and future customer needs, should meet customer requirements and strive to exceed customer expectations • 2. Leadership- Leaders establish unity of purpose and direction. They should create and maintain the internal environment in which people can become fully involved in achieving the organization's objectives • 3.Involvement of people- People at all levels are the essence of an organization and their full involvement enables their abilities to be used for the organization's benefit. • 4.Process approach-A desired result is achieved more efficiently when activities and related resources are managed as a process.
  • 8. • 5.System approach to management- Identifying, understanding and managing a system of interrelated processes as a system contributes to the organization’s effectiveness and efficiency in achieving its objectives. • 6.Continual improvement- Continual improvement of the organization's overall performance should be a permanent objective of the organization. • 7.Factual approach to decision making- Effective decisions are based on the analysis of data and information. • 8.Mutually beneficial supplier relationships- An organization and its suppliers are interdependent and a mutually beneficial relationship enhances the ability of both to create value
  • 9. Behavioural Theories in Infection control Lowbury Lecture Cognitive determinants of human behaviour • knowledge • motivation • intention • perception of threat • Outcome expectancy/attitude • Perceived behavioural control/self efficacy • Social pressure
  • 10. References • Department of Community and Family Medicine, Duke University Medical Center (2005) Patient Safety – Quality Improvement. What is Quality Improvement? Retrieved on the 19th of April 2012 from: http://patientsafetyed.duhs.duke.edu/module_a/module_overview.html • Robichaud, T,. G. (2004). AN INNOVATIVE PROJECT TO TRANSFORM THE ACQUISITION AND DISTRIBUTION OF INVENTORY SUPPLY IN AN EFFORT TO LOWER PROCUREMENT COSTS. COLLEGE OF NURSING. The University of Arizona • Patient Safety Curriculum Guide. Topic 7 Using quality-improvement methods to improve care. Retrieved from http://www.who.int/patientsafety/education/curriculum/PSP_mpc_topic-07.pdf • Pitteta, D. (2004). The Lowbury lecture: behaviour in infection control. Journal of Hospital Infection, 58 (1), 1–13. DOI: http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1016/j.jhin.2004.06.002 • Patel, G. (2010).Total Quality Management in Healthcare. Retrieved from http://www.biomedicalprojects.com/files/TQM%20in%20Healthcare.pdf
  • 11. Search strategy • Eva: I used the references from last time I worked on the FADE model. I also searched in pubmed to find specific articles where the FADE model had been implemented in wound care, but I didn´t find anything. So I thought of an example for myself and used that as an example in the presentation. • Phomolo: Used Google scholar with key words PDSA CYCLE and WOUND CARE.
  • 12. Collaboration strategy • We decided all of us would work on a QI model and give an example with it. We agreed to meet two hours before the presentation to put all our parts together. Unfortunately only one team member showed up and the others did not send around their presentation parts. When after an hour another team member showed up, the presentation could be put together a bit. The last team member agreed to work on the presentation during the lecture, because he/she was late.

Hinweis der Redaktion

  1. We chose to look at he FADE model because it was developed by the department of community and family medicine by a university, so we though it could apply very well to our setting of community health centers
  2. For slide 5 : Patient Safety Curriculum Guide. Topic 7 Using quality-improvement methods to improve care. Retrieved from http://www.who.int/patientsafety/education/curriculum/PSP_mpc_topic-07.pdf
  3. PlanWill wound culturing be an easy task for staff?Is there enough staff to do the culturing?Will staff comply?Can staff be able to give necessary education?Who is going to do whatDoThe team will do the planned activities for changeStudyDid the culturing go right?Challenges encountered?Is staff able to give education?Were proper procedures followed?Now what are the suggestionsActNow that there suggestions on the improvement of the test, the test is repeated with taking the suggestions into considerationPlan for next step if tests are successful is done here
  4. Patel, G. (2010).Total Quality Management in Healthcare. Retrieved from http://www.biomedicalprojects.com/files/TQM%20in%20Healthcare.pdf
  5. Patel, G. (2010).Total Quality Management in Healthcare. Retrieved from http://www.biomedicalprojects.com/files/TQM%20in%20Healthcare.pdf
  6. Pitteta, D. (2004). The Lowbury lecture: behaviour in infection control. Journal of Hospital Infection, 58 (1),1–13. DOI: http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1016/j.jhin.2004.06.002