Background
The hospitalized patients and the healthcare personnel face several risks in their day-to-day activities. Therefore, risk management in healthcare is a complex issue that requires the various players, including administrators, nurses, physicians, and clients, to assess, detect, and prevent risks in patients. This issue involves a series of steps to analyze the existing risk management programs to identify any weaknesses for adequate improvement during the implementation phase. An effective risk management plan is significant for reducing the health risks and the patient’s financial losses. It also provides a framework for improving hospitalized clients’ safety (Kaya et al., 2019). This paper will focus on the risk management plan and the promotion of the safety of immobilized patients hospitalized at an intensive care clinic (ICU).
Type of Risk Management Plan and Rationale
The risk management plan addresses bedridden patients admitted to an ICU ward or found in other community settings. The reason for selecting this plan is because pressure area sores cause significant pain in geriatric patients admitted to healthcare settings (Mitchell, 2018). This complication is particularly prevalent in bedridden patients and negatively impacts diseases’ prognosis. The treatment modalities are made difficult due to the frequent infections that accompany the open sores from tissue death as a result of pressure. The combination of pressure and friction also complicates the necrosis of soft tissue cells (Mitchell, 2018). Therefore, healthcare personnel needs to institute practical actions to ensure the proper implementation of the efforts to promote the pressure areas’ integrity.
Standard Administrative Steps and Processes
The risk management plan on pressure area care needs to follow the standard guidelines accredited by the Medicare Improvements for Patients and Providers Act. The first step in this process involves analyzing the patient’s environment to identify the probable sources of injuries and illnesses. This plan utilized the standard risk assessment protocols in line with the Agency for Healthcare Research and Quality (AHRQ) regulations which MIPPA approves. The second step of the risk management plan involves assessing the nature and the seriousness of the risk occurring (Kaya et al., 2019). Several tools, including the root cause and the risk score analysis, are used to assess the problem’s etiology. This provides a vital clue in the prioritization of the nursing care of the hospitalized patient.
The third step in the risk management program involves eliminating the risk or minimizing the chances of its occurrence. According to the standard risk management guidelines approved by MIPPA, the administrators’ delegation of tasks to the nursing staff should be implemented (Kaya et al., 2019). The plan should incorporate mitigation, contingency, and transfer plans. The mitigation strategies enable the lowering of the probability of the risk occurring. Contingency techniques provide for the steps to take to minimize the extent of the hazards. Finally, the fourth step involves evaluating the risk control strategies for their effectiveness. The administrators should institute further plans to ensure that the risk is sufficiently controlled. The risk management plan’s continued review is vital in promoting positive outcomes (Kaya et al., 2019). It is a continuous process that encompasses the initial goals’ refinement to address any newly identified risks.
Hospitals are a place where numerous health risks to patients occur, impacting their quality of life negatively. Therefore, healthcare providers need to incorporate the principles of total quality management in patient care. This strategy involves tailoring the treatment modalities according to patients’ individual wants to improve on their satisfaction. It also requires employee’s involvement in generating risk prevention plans. In the identified risk management plan, the initial stages involved assessing the priority risk in the immobilized patients (Allen-Duck et al., 2017). High rates of pressure area ulcers are reported yearly among the sick individuals admitted to the ICU; hence it was recognized as a high priority area. A risk management plan in pressure area care is needed to improve the prevention of this problem.
Key Agencies and Organizations
Several agencies are in place for promoting the safety of patients. First, AHRQ aims to encourage patients’ safety and quality of life by facilitating accessible, affordable, and high-quality care. Second, the National Committee for Quality Assurance (NCQA) ensures that healthcare organization countrywide meets patient care standards by issuing certification licenses (Allen-Duck et al., 2017). Third, the Joint Commission on Accreditation of Health Care Organizations (JCAHO) is a non-profit organization that enables hospitals to improve the quality of care provided to patients and the risk management capacities (Allen-Duck et al., 2017). Furthermore, the Division of Healthcare Quality Promotion (DHQP) ensures patients’ protection by reviewing and validating data on antibiotic resistance, immunizations, and hospital-acquired infections. Therefore, these agencies provide that there is a provision of high-quality care to lower healthcare risks.
Evaluation of the Compliance
The risk management plan on pressure area care adheres to the regulatory agencies on patient and workers safety. This plan ensures the protection of the patient’s well-being in line with the provisions of the DHQP. The Medicare MIPPA advocates for improving the care after the elderly during their stay in ICU and nursing homes. Ensuring optimum pressure area care is integral in promoting geriatrics care that is often immobilized due to numerous age-related conditions (Lam et al., 2018). This risk management plan also emphasizes educating the healthcare providers and other patient assistants on lowering the chances of infections and bleeding of the bedridden patients from impaired skin integrity. Additionally, healthcare providers are sensitized on applying standard infection prevention methods, including donning gloves during pressure area care to ensure safety. They are also educated on utilizing the standard procedures when changing a patient’s position to reduce the risk of low back pains. In conformity with the national and local patient safety regulations, this plan focused on preventing the risk of injury and worsening hospitalized patients’ prognosis.
Recommendations
Several recommendations exist which are in line with the JCAHO guidelines on patient safety. First, the immobilized patient’s two-hourly turning with adequate documentation on turning charts promotes effective pressure area care. Positional changes in patients unable to move are vital for improving the blood circulation in the pressure areas for adequate tissue perfusion. Furthermore, turning patients promotes the redistribution of pressure and reduces the sheer mechanical forces necessary for bedsores’ development. Second, ensuring that the patient is dry and continent at all times promotes skin integrity. Research shows that the skin, which is wet and soiled with urine and feces, is prone to pressure ulcers (Mitchell, 2018). Nurses ensured that the patient received daily bathing with adequate drying of the skin to remove any physical materials that may cause the skin’s tearing. Pressure area care requires the effective implementation of evidence-based strategies for maintaining tissue integrity.
Furthermore, the nurses adequately implemented the techniques to promote the comfort of the patient’s bed surface. The care providers issued a highly specified foam mattress to provide support and comfort required to prevent pressure area sores. Placing additional pillows under the patient’s pressure areas prone to ulcers, including at the sacral region, below the neck, under the knees, and below the heels, promotes pressure care. Moreover, the caregivers practiced the ongoing assessment of the patient’s skin for the early signs of damage, including reddened skin, presence of blisters, and swelling of the skin (Mitchell, 2018). The practical assessment of the skin is crucial for prompt management of pressure injuries to prevent complications.
References
Allen-Duck, A., Robinson, J. C., & Stewart, M. W. (2017). Healthcare quality: A concept analysis. Nursing Forum, 52(4), 377–386. Web.
Kaya, G. K., Ward, J. R., & Clarkson, P. J. (2019). A framework to support risk assessment in hospitals. International Journal for Quality in Health Care: Journal of the International Society for Quality in Health Care, 31(5), 393–401. Web.
Lam, M. B., Figueroa, J. F., Feyman, Y., Reimold, K. E., Orav, E. J., & Jha, A. K. (2018). Association between patient outcomes and accreditation in US hospitals: Observational study. BMJ, 363, k4011. Web.
Mitchell, A. (2018). Adult pressure area care: Preventing pressure ulcers. British Journal of Nursing, 27(18), 1050-1052. Web.