HLT 313V Week 1 Implementation of Risk Management

Risk management programs benefit the hospital by avoiding financial loss and by providing methods on how to prevent hospital acquired conditions like ventilator associated pneumonia. Implementing VAP bundle protocols as a risk management program will ensure a positive outcome in patient safety and hospital finical gain.

HLT 313V Week 1 Implementation of Risk Management

Patient safety is always the allied health professionals primary goal, although this may not seem to be the case, considering “VAP is the most serious health care associated infection and is the leading cause of morbidity and mortality from device-associated infections, especially in the intensive care unit” (Parisi, 2016). This risk management proposal will explain the positive success VAP bundles have in a facility, how it will benefit an organization, and who is involved in the process of creating and implementing a new risk management program. (Grand Canyon)

The Initiative of VAP Bundles as a risk management program

Ventilator associated pneumonia is a preventable condition, meaning we don’t have to compromise the patient’s health, or use up to a whole week of an ICU bed treating a condition that could have been avoided. We just need to care a little more and that won’t happen unless we understand what the effects are and how we can stop them. If we stick to the protocol, then a significant decrease in hospital acquired conditions should result.

BioMed Central (BMC infectious disease) preformed a 3 phase case study in a neonatal ICU that initiated a VAP bundle, which is essentially a VAP prevention protocol. Although this case study was performed on neonatal patients the VAP bundle that was used showed extremely positive results and could be interchangeable with the child and adult patient population as well. “BioMed’s VAP prevention bundle, in addition to routine infection control protocol, was composed of:

  • Head-of-bed elevation 30-45 degrees.
  • Re-enforcement of hand hygiene practice.
  • Sterile suction and handling of respiratory equipment.
  • Intubation, re-intubation and endotracheal tube (ETT) suction as strictly indicated by unit protocol (document).
  • Change ventilator circuit if visibly soiled or mechanically malfunctioning (document)
  • Proper timed mouth care with normal saline and suction of oro-pharyngeal secretion.

Daily evaluation for readiness for extubation to nasal continuous airway pressure (NCPAP) at morning round, and sedation vacation for sedated patient” (Azab et al., 2015). (Grand Canyon)

Risk Management Benefits

Risk management is defined as “the process of making and carrying out decisions that will assist in the prevention of adverse consequences and minimize the adverse effects of accidental losses upon an organization” (ecfmg.org, 2012). Essentially, risk management is the process of avoiding an incident and any health care organization should take the opportunity to asses their highest risks in order to create a risk management program for each of them. When allied health professionals take the time to educate themselves and follow the risk management protocols then patients will start to benefit greatly.

When risk management programs are set in place then the organization will benefit by avoiding financial loss. The insurance companies have very strict standards when it comes to hospital acquired conditions and they will reduce hospital reimbursement by a significant percentage, which can cause the hospital to suffer a large financial loss.

Kollef et al reported in 2012 that the cost per patient increases by $40 000 when the patient has ventilator associated pneumonia.  In addition, “VAP accounts for 50% of antibiotics used in the ICU” (Klompas, 2010). When ventilator associated pneumonia is a factor, an ICU bed is occupied for up to 9 days, which also costs the hospital financially. the patient’s health is put at risk, and the hospital losses reimbursement. (Grand Canyon)

Provision of Employment Opportunities

There is a high demand for allied health care professionals and more educational programs specific to allied healthcare are being provided throughout the nation. “Students with graduate degrees in the allied health professions can look forward to well-paying and in-demand healthcare careers in a diverse field where jobs are increasing at a much faster rate than other professions” (Peterson’s Staff, 2015).

At a global standpoint, employment opportunities should be offered to new graduates to gain the experience and training they need. Senior health care professionals, supported with years of experiences and who are close to retirement can help train and teach those who are fairly new to the field. At an organizational level, health care facilities will benefit by expanding their numbers in allied health professionals and offering exceptional pay. (Grand Canyon)

Who is involved in risk management programs

A health care Risk Manager plays a very important role in the development and enforcement of a risk management program plan. The hospital administration can be one of many jobs and the risk manager is a vital one in the development of this program. They will enact the changes in clinical practice, policy and procedure necessary to fulfill that plan.

The University of Scranton writes “given that each organization faces unique challenges, there is not a one-model-fits-all risk management solution. Challenges faced by administrators that should be addressed in a risk assessment plan include but are not limited to, patient safety, mandatory federal regulations, potential medical error, existing and future policy, legislation impacting the field of healthcare” (2012).

“Joint Commission standards focus on state-of-the-art performance improvement strategies that help health care organizations continuously improve the safety and quality of care, which can reduce the risk of error or low quality care” (The Joint Commission, 2016).

Essentially, the Joint Commission’s main focus is patient safety, if an organization is not taking every method to ensure patient safety then the Joint Commission has the authority to fine or even shut down the organization. The Joint Commission is an organization to keep in mind when developing a new risk management program because now the new program will be part of the Joint Commission audits. Although risk management is essential to the joint commission, if the risk management program is not being implemented correctly then it can be shut down.

Conclusion

There is a duty to uphold as the allied health professionals to protect our patients and not only to cause them no harm, but to provide quality care and a positive healing experience. Using VAP bundles as a risk management protocol in order to prevent ventilator associated pneumonia will ensure a better and safer patient outcome while avoid a financial hardship on the organization due to insurance not reimbursing the hospital for a preventable incident.

Hospital administration will have the key responsibility in implementing, modifying and monitoring the success of the risk management program. In order for the facility to have a positive outcome, there has to be a facility wide compliance with the risk management programs. Ultimately, our goal is patient safety and satisfaction and that can be achieved by implementing and enforcing quality patient care though effective risk management programs. (Grand Canyon)

Assignment guide for (Grand Canyon) University students

References

  • Parisi, M. (2016). Use of Ventilator Bundle and Staff Education to Decrease Ventilator-Associated Pneumonia in Intensive Care Patients. Critical Care Nurse, 36(5), e1-e7. doi:10.4037/ccn2016520
  • Papadimos TJ, Hensley SJ, Duggan JM, et al. Implementation of the “FASTHUG” concept decreases the incidence of ventilator – associated pneumonia in a surgical intensive care unit. Patient Saf Surg. 2008;2(3):1-6.
  • Peterson’s Staff. 2015. Jobs in the Allied Health Profession. Retrieved from https://www.petersons.com/graduate-schools/jobs-allied-health-professions.aspx
  • Kollef MH, Hamilton CW, Ernst FR. Economic impact of ventilator-as- sociated pneumonia in a large matched cohort. Infect Control Hosp Epidemiol. 2012;33(3):250-256.
  • Klompas M. Prevention of ventilator associated pneumonia. Expert Rev Anti Infect Ther. 2010;8(7):791-800.
  • The University of Scranton. (2016). The Purpose of Risk Management in Healthcare. Retrieved December 4, 2016, from http://elearning.scranton.edu/resource/business-leadership/purpose-of-risk-management-in-healthcare

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