Revised June 19, 2012

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Nov 5, 2013 (3 years and 8 months ago)

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Revised June 19, 2012

Nosocomial

infections

are

a

problem

faced

by

many

healthcare

facilities
.




Approximately 15% of all nosocomial
infections resulted from Surgical Site
Infections (SSIs).


Of the approximately 65 million patients
who undergo surgery every year that have
an infection, 38% have an SSI.


When a patient with a nosocomial infection
died, 77% of those were reported to be as a
result of the infection.


Studies performed demonstrate that SSIs
tend to increase a patient's hospital stay
from 7 to 10 days.

Reyes & Chang, 2011, p.234




Offsite facility to decrease incidence of
nosocomial infections


To establish wellness in all who we serve.



Encourage the development of client
centered care that focuses on service
and compassion from admission through
discharge.


Creation of an environment that fosters
education to and creativity of our health
care team.

The Mount Sinai Hospital, 2012


By applying the principles of evidence
-
based practice, reduction of nosocomial
infections will allow clients to focus on
rehabilitative practices to achieve
optimal well being.



Decrease the number of post
-
operative
infections within our clients.


Minimize the length of stay at our facility
to increase recoupment time.


Incorporate family in rehabilitative
processes to improve client outcomes.

Chief Medical
Officer

Acute
Rehabilitation

Associate
Medical Director

Physician
Assistant

Chronic
Rehabilitation

Associate
Medical Director

Physician
Assistant

Chief Nursing
Officer

Acute
Rehabilitation

Associate Nursing
Director

Nurse Manager

Staff Nurse

Unlicensed
Assistive
Personnel

Chronic
Rehabilitation

Associate Nursing
Director

Nurse Manager

Staff Nurse

Unlicensed
Assistive
Personnel

Sullivan & Decker, 2009, p. 18

Meetings will be structured as followed:


Administrative meetings


Chief Executive Officer, Chief Medical
Officer, and Chief Nursing Officer
(monthly)


Topics of Discussion


Review of facility objectives.



Mid
-
level Executive Meetings


Chief Officers and Associate Directors
(monthly)


Topics of Discussion


Compliance of protocols in accordance
to state and federal standards.


Report analysis reflecting client
outcomes and satisfaction ratings.

Departmental Meetings


Associate Director and Managers
(weekly)


Topics for Discussion


Infection control compliance in
accordance to regulatory requirements.


Innovative thoughts on improving client
centered care.

Staff Meetings


Managers and unit staff (weekly)


Topics for Discussion


Agendas to be addressed


Feedback from staff


Used to promote morale, motivation,
creativity



Rules, policies, regulations,


Disciplinary Actions


Ad hoc meetings


Employee hire/ promotion


Office activities, scheduling


Continued education


Orientation process:

Human Resources: 1 week orientation



Educational introductions


Policies and procedures


Benefits/ resources available


Tour through facility


Orientation process:

Department Specific Orientation:



6
-
7 weeks with possible extension of 1 week


upon evaluation/request


Classroom/test taking (1
st

week)


Clinical instructions/activities (4 weeks on the

floor with preceptor ; 1 to 2 weeks with


floor staff)






Off
-
site learning opportunities


Seminars once or twice a year


Education: AAS to BSN, BSN to MSN


Career growth/ staff development


Transformational Leadership Style
: ability to
commit people to actions.



3 key strategies:


-

awareness of an issue


-

analysis of knowledge


-

identification/integration of new


learning


Continued:

The objective is to increase effectiveness of
organization’s performance by:


Creativity


Highlighting


Influencing


Respecting


Supporting/Motivation



Personal Development Plan and Reflective with Regard to Leadership.
(2009).Retrieved from
http://www.ukessay.com/essay/nursing/personal
-
devepment
-
plan.php




Graphic Rating Scale
: numbering system that
indicates high and low values for evaluation



Behaviorally Anchored Rating Scale
: evaluates
quantitative and qualitative performance



Peer Review
: employees are directly involved
in the developmental and implementation
process


Yoder
-
Wise, P. S. (2007).
Leadership and Managing in Nursing
. (4
th

ed

). Mosby: Missouri (pp. 298
-
299).




Make the experience positive



Recognize staff fears



Provide the sources to reassure staff



Evaluate the roles and abilities of each staff members



Proper management roles



Utilize each employee according to our service model



Encourage communication and training





Fitzgibbons. (2008). Retrieved from
http://www.librarystudentjournal.org/index.php/lsj/article/view/63/171





Budgeting is the primary concern in business planning



Total revenue budget $9,000,000


Revenue from local services $8,000,000


Revenue from state funding $1,000,000



Pioneer Adult Rehabilitation. (2009). Retrieved from
http://www.davis.k12.ut.us/acct/bud09/parc.pdf




Total expense budget $8,000,000



$5,000,000 for salaries benefits, insurance



$500,000 for repairs and equipment



$2,500,000 for supplies, and other miscellaneous costs


Pioneer Adult Rehabilitation, 2009


Analyzing patient needs to determine how many
nursing hours are required


Calculating FTE for staff distribution


FTE = #of hours/day
x

# of days/week
x
# of weeks/year


Determining staffing mix allows for additional support


Similar centers provide average of 0.3 RN hours, 1.1 LPN
hours and 2.55 CNA hours per day per resident.








Sullivan & Decker, 2009, p. 216
-
218


Community population evaluation



Age group


-

focus on the adult and older generation because it
takes longer for them to recoup than children


Various background


-

as we are a rehabilitative facility focused on improving
clients outcomes as opposed to them staying within the
hospital, exposing them more readily to infection




Local economy status



Local competitors



Local Health Care system






Gathering data



Consult local hospital and medical facilities


Surveys


Newspapers, TV, Internet (Google, Facebook)




Improve physical mobility



Stabilize mental health



Help to activate social aspect of life


Internal forces:



Employee morale



Leadership style



Adequate staffing



Clear mission, vision and objectives



Adequate equipment and supplies



Space of facility



Financial management


External forces:


Standards and review (JCAHO)


Competition in market


Reliable suppliers


Lack of insurance


Low occupancy rates


Transportation services



Patient safety


falls, infections


Physical, Occupational, Psychological therapy


Patient and family education


Pain management


Counseling and Spiritual needs


Patient treatment and follow
-
up


Physical assessment


Pressure ulcer and wound care


Stress reduction


Restoration of function


Decrease medication errors


Increased access to information


Lower cost by saving time


Improved employee retention and satisfaction


Allow sharing of large amounts of data


Increases confidentiality and privacy


Reduces coping and storage


Reduces redundancies of entries


Faster medical alerts


Allows backtracking of medical records from
admission to discharge


Carroll, 2006, pp. 157
-
158





Scanners


Handheld communication systems


Intranet database to share information between
facilities

Purpose:

The center currently has a web presence that is outdated in
appearance and structure. An opportunity exists to re
-
engineer the
site to better reflect the mission of the rehab center and incorporate
the latest web technology.


Goal:

Continue to build identity, awareness and interest in the organization
and the services it provides.


Budget:


Time spent on completing the project


Requirement planning


Test trails


Date


Training



Politically:


Culturally sensitive


Ensure equal rights among staff and patients


Ethically:


Utilize the ANA Scope and Standards of Practice


Maintain Code of Ethics among staff



Sullivan & Decker, 2009, pp. 86
-
88

Legally:


Maintain HIPPA policy


Creating a blame free environment


Oversee that written protocols, policies, and
procedures are followed to reduce liability


Financially:


Planning the budget


Plan schedules and payrolls


Determine needs for supplies and equipments



Sullivan & Decker, 2009, pp. 86
-
88


Professionally:


Working within the scope of practice


Initiates disciplinary actions


Problem solving


Collaborates with staff in planning and executing
programs for patient care delivery


Assess learning needs and provide training


Provides feedback


Sullivan & Decker, 2009, pp. 86
-
88

Carroll, P. (2006).
Nursing Leadership and Management: A Practical Guide.
New York,
NY: Thomson Delmar Learning


Davis School District. (2009).
Pioneer adult rehabilitation center fund description.

Retrieved from
http://www.davis.k12.ut.us/acct/bud09/parc.pdf



Fitzgibbons, M. (2008, July).
Human resources management
. Retrieved from
http://www.librarystudentjournal.org/index.php/lsj/article/view/63/171



Reyes, G.E., & Chang, P.S. (2011). Prevention of Surgical Site Infections: Being a winner.
Operative Techniques in Sports Medicine, 234
-
244.


Sullivan, E. J., & Decker, P. J. (2009).
Effective Leadership and Management in Nursing.

(7
th

ed.). Upper Saddle River: Pearson Education.


The Mount Sinai Hospital. (2012).
About Mount Sinai
. Retrieved from The Mount Sinai
Hospital:
http://www.mountsinai.org/about
-
us/who
-
we
-
are/mission