Articles - OB Neonatal Study Guide

Challenges Involved with Quality and Safety Implementation and Sustainability

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When integrating change into practice, it’s important to understand the challenges involved with quality and safety implementation and sustainability. This will allow for adequate planning and preparation. This is the second article in a series describing challenges encountered in this area, and it highlights lack of upper-level support, project fatigue, inadequate personnel, and competing priorities. …

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Common Barriers Encountered in Quality and Safety Implementation

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When integrating change into practice, it’s important to understand the common barriers encountered in quality and safety implementation. This will allow for adequate planning and preparation. Some of the challenges include a lack of team integrity and disruptive and hierarchical behavior. Unfortunately, these factors can contribute to medical errors and patient harm. Historically disruptive and …

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Data Monitoring Using Control Charts

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In order to continuously improve quality and safety within healthcare, processes must be monitored before and after changes are implemented to determine if improvement has been made. There are various ways to track progress with data including run charts and control charts. Run charts are useful in providing a quick analysis and visual review of …

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Dashboards as Performance Monitoring Systems

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As part of the quality improvement process, data is needed to identify a baseline current state, determine gaps, and track progress towards a target rate. Dashboards are one way to display these components and enable a picture of current performance. Think of dashboards as performance monitoring systems, similar to an automobile dashboard that provides real-time …

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Experience with the NCC Exam Process

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If you are reading this, I’m assuming you are preparing for and planning to take the National Corporation Certification (NCC) exam for Obstetric and Neonatal Quality and Safety at some point in the near future. If you have any angst about this, take a few minutes to read this article. This is my experience with …

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Tracking Change with Quality Improvement Efforts

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Tracking change with quality improvement efforts requires establishing clear data definitions, using a standardized method of data collection, and displaying the data in a manner that generates meaningful information. To begin, in order to determine if improvement has been made, one must establish that a change has occurred and that it has led to improvement. …

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Cognitive Biases as Contributing Factors to Medical Errors

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“The human brain is a complex organ with the wonderful power of enabling man to find reasons for continuing to believe whatever it is that he wants to believe. – Voltaire” (O’Sullivan & Schofield, 2018) Cognitive Biases Defined Cognitive biases, defined as “flaws or distortions in judgment and decision-making” (Joint Commission, 2016, p.1), have been …

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Selecting Key Quality Metrics

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The scope of quality improvement (QI) work is broad, and narrowing this down involves thoughtful consideration to selecting key quality metrics. This can be based on evaluating the importance to different stakeholders, financial implications, and prioritization to areas of opportunity identified through benchmarking of data against like size facilities/units. Let’s use, for example, a quality …

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Requirements around Patient Identification

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The Joint Commission’s requirements around patient identification is that two patient identifiers are used to correctly associate an individual with the intended service or treatment. These can include the patient’s name, medical record or identification number, telephone number or date of birth. The goal is to ensure accurate identification of a person and matching of …

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Medication Errors and Strategies to Improve Medication Safety

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Case Scenario A 32-year-old G2 P1 undergoes an elective induction of labor at 39 weeks. She is admitted at 6 AM. The night nurse works quickly to complete her admission and get the induction process started. Oxytocin is ordered along with a mainline intravenous (IV) of D5LR running at 125 ml/hr. On this unit, it …

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