Patient active involvement in care and healthcare-associated infection prevention

Encourage Patients Active Involvement in Their Own Care as a Patient Safety Strategy

The objective of this work is to examine the importance of encouraging patients to be actively involved in their own health care as a method of ensuring a safety strategy for the patient. Health-care associated infections (HAIs) have created a growing concern in the healthcare community worldwide. Toward this end "infection preventionists are on the front line in the battle against HAIs. As such, they are charged with understanding and interpreting the goals pertaining to HAIs and leading efforts to achieve those requirements within the mandated timeframe." (Stoessel, 2009)

ENCOURAGE PATIENTS ACTIVE INVOLVEMNET in THEIR OWN CARE as a PATIENT SAFETY STRATEGY

Objective

The objective of this work is to examine the importance of encouraging patients to be actively involved in their own health care as a method of ensuring a safety strategy for the patient.

II. Statement of the Joint Commission

The Joint Commission is stated to have issues the following goals and requirements toward promotion of specific improvement in safety of patients on the part of healthcare provider organizations:

Joint Commission 2009 NPSGs, Hospital

Goal 1: Improve the accuracy of patient identification.

Goal 2: Improve the effectiveness of communication among caregivers.

Goal 3: Improve the safety of using medications.

Goal 7: Reduce the risk of healthcare-associated infections.

Goal 8: Accurately and completely reconcile medications across the continuum of care.

Goal 9: Reduce the risk of patient harm resulting from falls.

Goal 13: Encourage the patients' active involvement in their own care as a patient safety strategy.

Goal 15: Identify safety risks inherent in an organization's patient population.

Goal 16: Improve recognition and response to changes in a patient's condition.

Joint Commission 2009 NPSGs, Ambulatory Health Care

Goal 1: Improve the accuracy of patient identification.

Goal 2: Improve the effectiveness of communication among caregivers.

Goal 3: Improve the safety of using medications.

Goal 7: Reduce the risk of healthcare-associated infections.

Goal 8: Accurately and completely reconcile medications across the continuum of care.

Goal 11: Reduce the risk of surgical fires.

Goal 13: Encourage patients' active involvement in their own care.

III. Changes to Goals and Requirements

It is stated in the 2007 Hospital/Critical Access Hospital National Patient Safety Goals that the following changes have been made to the goals and requirements set out by the Joint Commission:

(1) 8b has been added to as follows: "The complete list of medications is also provided to the patient on discharge from the facility."

(2) Goals 13 states patients should be encouraged to become actively involved in their own care as a patient safety strategy.

(3) Goal 13A states that the means for patients and their families should be defined and communicated in regards to reporting of concerning about safety and that encouragement should be provided for them to follow through on this.

(4) Goal 15 states that the organization "identifies safety risks inherent in its patient population; and (5) 15A states "The organization identifies patients at risk for suicide. [Applicable to psychiatric hospitals and patients being treated for emotional or behavioral disorders in general hospitals -- NOT APPLICABLE to CRITICAL ACCESS HOSPITALS] (the Joint Commission, 2009)

Stated as the only change to the 2007 Disease-Specific Care National Patient Safety Goal is the noted change to 8B which adds that the complete list of medications is provided to the patient upon discharge from the health care facility. (the Joint Commission, 2009)

The work of Cooper (2009) entitled: "NYC Hospital to Educate Patients Using Opinionmeter Survey Kiosks, Tablets" states that the company Opinionmeter International is a manufacturer of survey kiosks and consumer survey technology and that this company has made an announcement of its partnership with the Metropolitan Hospital in New York City and for the purpose of deploying Opinionmeter's touchscreen tablets and kiosks. Specifically stated is as follows:

"The purpose of the Joint Commission's National Patient Safety Goals is to promote improvements in patient safety, which would include improving the accuracy of patient identification, the effectiveness of communication among caregivers and the safety of using medications. In addition, they seek to reduce the risk of healthcare-associated infections, encourage patients' active involvement in their own care as a patient safety strategy and improve recognition and response to changes in (a) patient's condition." (Cooper, 2009)

The director of patient safety and cultural competency for the Metropolitan Hospital in New York City is noted as having stated that the survey capabilities of Opinionmeter will assist healthcare providers in promoting involvement of patients in their own care and that it is believed that this is a critical aspect of the experience of the patient in receipt of healthcare provision. (Cooper, 2009, paraphrased)

Discussion of the Issue

Optimal health care delivery is highly supported by patient involvement in their own care and for the purpose of avoiding infections and specifically HAIs as well as for the purpose of correctly taking medications and treatment prescribed by health care providers. There have been formal supports put into place by the Joint Commission that, if followed and adhered to carefully by health care providers should serve patients well in their recovery and attainment of good health following receiving health care in hospitals, clinics, and other facilities of health care providers throughout the nation. The work of Powell (2009) entitled; 'Can the Ambulatory Care Setting Learn Lessons from other High Risk Domains?" reports that errors in communication "are routinely cited in over 70% of all root cause analyses of serious patients injuries or avoidable patient deaths while in the healthcare system. " (Powell, 2009) Powell states that the values of 'High Reliability Teams' within ambulatory care teams are those as follows: (1) Sensitivity to operations; (2) commitment to resilience; (3) Deference to Expertise; (4) Reluctance to simplify; and (5) preoccupation with failure. ( )