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Harmonization – The Quality Choir 8 2010 NQF Safe Practices for Better Healthcare: A Consensus Report 34 Safe Practices • Criteria for Inclusion • Specificity • Benefit • Evidence of Effectiveness • Generalization • Readiness 9 Culture Consent & Disclosure Consent and Disclosure Workforce Information Management and Continuity of Care Medication Management Healthcare-Associated Infections Condition- & Site-Specific Practices 3 Culture Structures and Systems Culture Meas., FB., and Interv. Team Training and Team Interv. ID and Mitigation Risk and Hazards CHAPTER 2: Creating and Sustaining a Culture of Patient Safety (Separated into Practices] Leadership Structures and Systems Culture Measurement, Feedback, and Interventions Teamwork Training and Team Interventions Identification and Mitigation of Risks and Hazards Consent & Disclosure Consent and Informed Consent Life-Sustaining Treatment Care of Caregiver Disclosure Workforce Nursing Workforce Direct Caregivers CHAPTER 4: Workforce • Nursing Workforce • Direct Caregivers • ICU Care ICU Care Information Management and Continuity of Care Patient Care Info. Read-Back & Abbrev. Labeling Studies Discharge System CHAPTER 3: Informed Consent and Disclosure • Informed Consent • Life-Sustaining Treatment • Disclosure • Care of the Caregiver CPOE Medication Management CHAPTER 5: Information Management and Continuity of Care Patient Care Information Order Read-Back and Abbreviations Labeling Studies Discharge Systems Safe Adoption of Integrated Clinical Systems including CPOE CHAPTER 6: Medication Management Medication Reconciliation Pharmacist Leadership Role Including: High-Alert Med. and Unit-Dose Standardized Medication Labeling and Packaging Med. Recon. Pharmacist Systems Leadership: High-Alert, Std. Labeling/Pkg., and Unit-Dose Healthcare-Associated Infections Influenza Prevention Hand Hygiene Sx-Site Inf. Prevention VAP Prevention Central V. Cath. BSI Prevention MDRO Prevention UTI Prevention Condition-, Site-, and Risk-Specific Practices Wrong-site Sx Prevention Contrast Media Use Organ Donation Press. Ulcer Prevention Glycemic Control DVT/VTE Prevention Falls Prevention Anticoag. Therapy Pediatric Imaging CHAPTER 7: Hospital-Associated Infections • Hand Hygiene • Influenza Prevention • Central Venous Catheter-Related Blood Stream Infection Prevention • Surgical-Site Infection Prevention • Care of the Ventilated Patient and VAP • MDRO Prevention • UTI Prevention CHAPTER 8: • Wrong-Site, Wrong-Procedure, Wrong-Person Surgery Prevention • Pressure Ulcer Prevention • DVT/VTE Prevention • Anticoagulation Therapy • Contrast Media-Induced Renal Failure Prevention • Organ Donation • Glycemic Control • Falls Prevention • Pediatric Imaging HAI Guidelines 12 NQF CLABSI Prevention Safe Practice Specifications: 2010 Update Before insertion: • Educate healthcare personnel involved in the insertion, care, and maintenance of central venous catheters (CVCs). At insertion: • • • • • • Use a catheter checklist at the time of CVC insertion. Perform hand hygiene prior to catheter insertion or manipulation. Avoid using the femoral vein for central venous access in adult patients. Use a catheter cart or kit with components for aseptic catheter insertion. Use maximal sterile barrier precautions. Use chlorhexidine gluconate 2% and isopropyl alcohol solution as skin antiseptic preparation in patients over two months of age and allow appropriate drying time per product guidelines. After insertion: • Use a standardized protocol to disinfect catheter hubs, needleless connectors, and injection ports before accessing the ports. • Remove nonessential catheters. • Use a standardized protocol for non-tunneled CVCs in adults and adolescents for dressing care. • Perform surveillance for CLABSI and report the data on a regular basis. 13 NQF SSI Prevention Safe Practice Specifications: 2010 Update • Educate of healthcare professionals involved in surgical procedures. • Educate the patient and his or her family as appropriate about SSI • • • • • • • • prevention. Conduct periodic risk assessments for SSI. Ensure that measurement strategies follow evidence-based guidelines. Provide SSI rate data and prevention outcome measures to key stakeholders. Administer antimicrobial agents for prophylaxis. When hair removal is necessary, use clippers or depilatories. Maintain normothermia immediately following colorectal surgery. Control blood glucose during the immediate postoperative period for cardiac surgery patients. Preoperatively, use chlorhexidine gluconate 2% and isopropyl alcohol solution as skin antiseptic preparation, and allow appropriate drying time per product guidelines. 14 The Association for Professionals in Infection Control & Epidemiology • Mission To improve health and patient safety by reducing the risks of infection and related adverse outcomes. • The preeminent voice in infection prevention Over 13,000 members worldwide with responsibility for infection prevention, control and hospital epidemiology in a variety of healthcare settings. APIC Targeting Zero Initiative • Elimination Guides Evidence-based strategies to implement CDC guidelines, NQF Safe Practices and recommendations from the SHEA-APIC-IDSA Compendium – Guides to the elimination of SSIs, CR-BSIs, Mediastinitis, C. difficile, VAP and MRSA (hospital and long term care versions) help you bring science to the bedside – New guides in 2010 on A. baumannii, Hemodialysis and SSIs in orthopedics and oncology • Research 2006 MRSA & 2007 C. difficile Prevalence Studies, 2010 MRSA II Study • Education The most comprehensive program of live and online education to reduce infection, meet new and emerging regulatory requirements and understand the changing legal standard in acute, ambulatory and long term care settings Visit www.apic.org to learn more.