Wound Infections in Community Health Centers

Rachel DuffyPhomolo Madome

Eva van Swaaij

“To reintegrate the traditional separation between public health and personal health

services by defining health broadly and providing preventive, environmental and

outreach services as well as medical treatment in one facility”

(Kark, S., Kark, D.)

Community Health Centers

“Open injuries have a potential for serious bacterial wound infections, including gas

gangrene and tetanus, and these in turn may lead to long term disabilities, chronic wound or

bone infection, and death”(WHO, 2012)

Wound Infection

Wound Infection Problem Analysis

Wound infections

Prevention

MaterialsProcedures

People

Nurses Knowledge nurses

Hand washing

Education

material

Dressings

Assistants Lifestyle

Time

Dressing procedure

Patients

Appointments

Relevance Hand Hygiene

One of the most important factors in cross infections.

Compliance with hand hygiene and barrier precautions remain suboptimal in all health care settings and among all types of staff, and improvement efforts frequently lack sustainability.

Despite the fact that hand hygiene and use of barrier precautions are cornerstones of infection prevention and control, they are practised with varying degrees of rigour and compliance.

Quality Improvement: PDSA

Plan: Who? – Observer, Nurse, Patients What? - Observation &

documentation Where? – Community health center(patient education)Do: The team executes planned activities for

change.(Data collection)Study: Did data collection go right? Was the

necessary education given? Were proper procedures followed?

Any problems encountered? (Analyse the data)Act: Summarize what was studied. Repeat test using suggestions given.

Plan for a new cycle if tests are successful.

Plan Do

StudyAct

Hand Hygiene Problem Analysis

MaterialsProcedures

People

Nurses

Custom

Handwash station

Availability of

alcohol

Assistants

Time

Knowledge

Patients

Hand Hygiene

Methods

Observer looking whether the nurse washes her handsRecord hand hygiene compliance and qualityPositive Negative

Very little to no bias Expensive

Counts both opportunities for hand hygiene and the action of hand hygiene.

May not be very appropriate in an understaffed setting

Can verify when hand hygiene was practiced

Compromising patient privacy

Hand hygiene quality can be assessed

Staff members can change their behaviours

Social or scientific value Scientific validity Fair participant selection Favourable risk–benefit

ratio Respect for participants Informed consent Independent review Beneficence- an

obligation to do no Harm and maximize benefits

Participants privacy will be maintained throughout the study

Informed Consent Risk /Benefit

assessments

Ethical Considerations

In undertaking our quality improvement activity, we will take into consideration and ensure all ethical components of nursing and medicine are fully met. These include ensuring our quality improvement activities has:

Discussion

EvaluationIs our study: Relevant Evidence-based Reliable Reproducible Valid Feasible

Yes! Yes! Yes! Yes! Given a similar

setting Yes! Yes! With your kind

donations

Kark, S., Kark, D. Adopted from Kotelchuck, R., Lowenstein, D., Tobin, J.N. (2011) Community Health Centers And Community Development Financial Institutions: Joining Forces To Address Determinants Of Health. Health Affairs, 30, no.11 :2090-2097.

Larson, E., & Kretzer, E. K. (1995). Compliance with handwashing and barrier precautions. Journal of Hospital Infection, 30. 88-106. Retrieved from http://dx.doi.org.dbgw.lis.curtin.edu.au/10.1016/0195-6701(95)90010-1

Lynn, J., Baily, M., & Bottrell, M., et al. (2007). The Ethics of Using Quality Improvement Methods in Health Care. Annals of Internal Medicine. 146(9. 666-673.

Meister, S (2011). QI tools, root cause analysis. Iowa department of Public Health. Retrieved from: http://www.idph.state.ia.us/mphi/common/pdf/root_cause_analysis.pdf

Orb A., Eisenhauer L., Wynaden D. Ethics in qualitative research. JOURNAL OF NURSING SCHOLARSHIP, 2000; 33:1, 93-96. ©2001 SIGMA THETA TAU INTERNATIONAL. Retrieved from: http://www.columbia.edu/~mvp19/RMC/M5/QualEthics.pdf

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

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.

Varkley, P (2010). Medical Quality and Management. Theory and practice. American College of Medical Quality. Jones and Bartlett Publishers. Sudbury, Massachusetts. Pg. 37.

WHO (2012). Prevention and management of wound infection. Department of Violence and Injury Prevention and Disability.

References

We didn’t need to look for new information, because this is an overview and summary of all the work we did before.

Search Strategy

We divided this weeks presention into two parts- Rachel worked on Ethical Theories and Flex related ethics to our quality improvement issue. Eva began working on the final presentation.

Collaboration Strategy