Friday, August 28, 2015

 

 



Soy un nuevo usuario

Olvidé mi contraseña

Entrada usuarios

Lógica Matemáticas Astronomía y Astrofísica Física Química Ciencias de la Vida
Ciencias de la Tierra y Espacio Ciencias Agrarias Ciencias Médicas Ciencias Tecnológicas Antropología Demografía
Ciencias Económicas Geografía Historia Ciencias Jurídicas y Derecho Lingüística Pedagogía
Ciencia Política Psicología Artes y Letras Sociología Ética Filosofía


Ergonomic redesign using quality improvement for pre-hospital care of acute myocardial infarction

1) La descarga del recurso depende de la página de origen
2) Para poder descargar el recurso, es necesario ser usuario
    registrado en Universia


  Descargar recurso

Detalles del recurso

Pertenece a: Faculty of Technology ePrints Service  

Descripción: Context: Frontline emergency ambulance clinicians collaborated in a national quality improvement (QI) initiative to improve pre-hospital care for patients with acute myocardial infarction (AMI). Problem: The National Ambulance Clinical Performance Indicator (CPI) care bundle for AMI (consisting of aspirin, GTN, pain assessment and administration of analgesia) highlighted a consistent shortfall in patient pain assessment and inadequate provision of analgesia. Ineffective pain management in AMI has negative physiological and psychological effects that can be detrimental to patient outcomes. The aim is to increase the delivery of the entire AMI care bundle to 90% by March 2012 Assessment of problem and analysis of its causes: We explored barriers to effective pain management using process maps, cause-and-effect diagrams and thematic analysis of audio recordings from QI collaborative workshops and semi-structured interviews. We found that ergonomic factors (interaction between human and system factors), which included ineffective and inefficient pain assessment methods, ineffective feedback processes and poor access to analgesia were root causes for suboptimal pain management in AMI. Intervention: Through collaboration with frontline ambulance clinicians, solutions were found to overcome these root causes. These included: •Provider prompts (e.g. aide memoires and checklists) to prompt care bundle delivery. •Modified pain assessment tools (integrating Wong-baker faces, numerical verbal scores from 0 to 10 and descriptive intensity scales). •Individual clinical feedback by a clinical leader. •The introduction of small nitrous oxide canisters to increase availability and administration of analgesia earlier in the care pathway. Strategy for change: We used Plan-Do-Study-Act (PDSA) cycles to improve processes of care in AMI. Once improvements developed through PDSA cycles were identified, these were spread to county divisions and then trust-wide. Results were shared through QI workshops, face-to-face dialogue, e-forums, bulletins, newsletters and magazines locally and nationally. Measurement of improvement: Statistical Process Control (SPC) control methods were used to evaluate the effects of changes implemented. Improvements in the delivery of analgesia and the entire care bundle were achieved through initial awareness raising and implementation of system changes; e.g. provider prompts and revised pain assessment tool etc. We have already seen improvements in performance in the delivery of analgesia and also the care bundle as a whole. Effects of changes: An increase in pain assessment and the delivery of analgesia for patients experiencing AMI will help improve patient outcomes. The preliminary results of this study show improvement in the pain management in AMI. The sustainability of improvements recognised so far, and any variations that may occur as a consequence of subsequent interventions, continue to be monitored. Lessons learnt: A deeper understanding of the current system of care has been achieved by adopting a collaborative approach using QI methods focusing on ergonomics. Greater efforts earlier in the project to nurture a culture for improvement and to foster ownership and support from senior executives could have been an additional facilitator for these activities. Message for others: Systems of care can be ergonomically designed using QI methods to foster an environment that minimises opportunities for mistakes, accidental slips, lapses as well as routine (i.e. purposeful) and exceptional (i.e. unavoidable) violations in pre-hospital pain management.

Autor(es): Essam, Nadya -  Wood, Kate -  Hall, Mark -  Shaw, Deborah -  Spaight, Anne -  Baird, Andrew -  Siriwardena, A. Niroshan - 

Id.: 55212693

Versión: 1.0

Estado: Final

Tipo:  application/pdf - 

Palabras claveB990 Subjects Allied to Medicine not elsewhere classified - 

Tipo de recurso: Conference or Workshop Item  -  PeerReviewed  - 

Tipo de Interactividad: Expositivo

Nivel de Interactividad: muy bajo

Audiencia: Estudiante  -  Profesor  -  Autor  - 

Estructura: Atomic

Coste: no

Copyright: sí

Formatos:  application/pdf - 

Requerimientos técnicos:  Browser: Any - 

Relación: [References] http://eprints.lincoln.ac.uk/5087/

Fecha de contribución: 25-abr-2012

Contacto:

Localización:
* Essam, Nadya and Wood, Kate and Hall, Mark and Shaw, Deborah and Spaight, Anne and Baird, Andrew and Siriwardena, A. Niroshan (2012) Ergonomic redesign using quality improvement for pre-hospital care of acute myocardial infarction. In: International Forum on Quality and Safety in Healthcare, 17-20 April 2012, Le Palais des Congrès de Paris, France.


Otros recursos del mismo autor(es)

  1. Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model BACKGROUND: Health services research is expected to involve service users as active partners in the ...
  2. Involving older people in a multi-centre randomised trial of a complex intervention in pre-hospital emergency care: implementation of a collaborative model
  3. Patient understanding of NHS 111 service: an exploratory study of patients aged 65 and over The new NHS 111 was launched March, 2013 in addition to the 999 emergency ambulance service. There a...
  4. Overview of INEX 2014 International audience
  5. What Clinical Instructors Want: Perspectives on a New Assessment Tool for Students in the Clinical Environment Purpose: Many Canadian physical therapy education programs use the 1997 version of the Physical Ther...

Otros recursos de la misma colección

  1. Quantifying the relative roles of selective and neutral processes in defining eukaryotic microbial communities We have a limited understanding of the relative contributions of different processes that regulate m...
  2. Designing student energy interventions: a cross-cultural comparison To create successful energy interventions that motivate young people to save energy, it is crucial t...
  3. 'Close-the-loop': an iBeacon app to foster recycling through just-in-time feedback Contemporary micro-location technologies such as Bluetooth Low Energy (BLE) show promise in enabling...
  4. Effects of group performance feedback and goal-setting in an organisational energy intervention End-user energy demand (EUED) in the workplace is affected by a complex interaction between behaviou...
  5. A cost effective approach for the practical realisation of a demonstration platform for brain machine interface Over the last two decades, human brain functions have attracted a significant attention among resear...

Valoración de los usuarios

No hay ninguna valoración para este recurso.Sea el primero en valorar este recurso.
 

Busque un recurso