Dr Don Berwick President & CEO, IHI Prof Bernard Crump NHS Institute for Innovation & Improvement Dr Ross Wilson Chair, Strategic Advisory Board International Forum. Local Improvement Clinic.
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Kate Cotter, Jennifer Dempsey, Cheryl Baldwin
Central Coast Health
Post-Menopausal Osteoporotic Fractures Are:
Proven therapies to reduce further fractures
Attention: All Fracture Clinic Staff
Patient with minimal trauma fracture?
The Bone Protection Project has been implemented to ensure ALL patients presenting with a minimal trauma fracture are correctly managed and investigated for underlying osteoporosis.
Please give the patient a G.P. referral letter.
Use stamp provided to record letter given to patient.
Percentage on Treatment at Discharge
Percentage of those NOT on treatment, who had treatment commenced
Central Northern Adelaide Health Service
Six Months the Use of Emergency Department Initiated Physical/Mechanical Restraint for Behaviourally Disturbed Patients.
Presentation to Emergency Department
Admission into ED
Treatment with Settling of Behaviour
Discharge, Transfer or Admission
SAAS can Request Restraint Team Standby on Arrival
If Not Behaviourally Disturbed – Possible Waiting Room/Cubicle
Patient’s Behaviour Escalates
Clerk for A9 and Old Files
If Behaviourally Disturbed – Safe Room/Resus
Nursing/Medical Staff Arrive/Present
If Affected by Drug Alcohol – Longer Waiting Time to Detox
Intervention Minimal Effect, Behaviour Escalates
Monitoring Process – Observations for Restrained Patient
AssessmentProcess To Determine Best Treatment
If Restraint – 33# Call
If De-escalation is Not Effective
And/or Seclusion Room And/or Shackles
If De-escalation is Effective
De-escalation Can Occur at Any Point
Medical Assessment Completed if Necessary
Decision to Admit, Discharge etc
Discharge from ED
Destination Can Delay discharge From ED
More Formal Psychiatric Assessment
Med & Psych May Disagree Who is Responsible for Patient
Escalation Requiring Restraint
Seclusion room location
Pre contact wait
At Level 11 of Tan Tock Seng Hospital, the peripheral iv cannula phlebitis rate will be reduced by 50% in 3 months
1. SNC Margaret Soon
2. NO Wong Siao Pin
3. SN Goh Mei ChernStaff from unit
4. AN Widarni
5. NE Prema BalanTeaching of staff
6. NE Pua Lay Hoon
7. Dr Benjamin TanDr covering L11
being a problem worth solving
Point Prevalence Phlebitis rate done on May 31 2002 is 26.3%.
Repeated point prevalence rate in the unit on 28 Nov 2002 is 25%
a. antibiotics information chartSpeed of administration & proper dilution
b. Drugs not for IV administration
c. Flushing of line according to recommendations
d. Proper restraint of restless patients
2. Audit compliance to recommendations & phlebitis rate