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I.

ABSTRACT
II. INTRODUCTION
III. PROBLEM IDENTIFICATION AND PRIORITIZATION
A. LIST OF PROBLEMS
1. Incorrect E-cart inventories or other inventories
2. Delayed BCG vaccine given to newborns
3. Hand hygiene practices are not followed
4. Delayed endorsement
5. Nurses not following sterile technique principles
6. Lack of 7S compliance
7. Lack of infection control compliance causing IV infiltration
8. Transport of patient through the canteen
9. Improper arrangement of nurses progress notes
10. Sterilium vs. sterility
B. PROBLEM OR CAUSE
LIST OF PROBLEMS
1. Incorrect E-cart inventories or other
inventories
2. Delayed BCG vaccine given to newborns
3. Hand hygiene practices are not followed
4. Delayed endorsement
5. Nurses not following sterile technique
principles
6. Lack of 7S compliance
7. Lack of infection control compliance
causing IV infiltration
8. Transport of patient through the canteen
9. Improper arrangement of nurses
progress notes
10. Sterilium vs. sterility

PROBLEM (P) OR CAUSE (C)


CAUSE
PROBLEM
CAUSE
PROBLEM
PROBLEM
PROBLEM
PROBLEM
PROBLEM
CAUSE
CAUSE

C. CONTROLLABILITY OF THE PROBLEM


LIST OF PROBLEMS

1. Delayed BCG vaccine given to newborns


2. Delayed endorsement
3. Nurses not following sterile technique
principles
4. Lack of 7S compliance
5. Lack of infection control compliance
causing IV infiltration
6. Transport of patient through the canteen

CONTROLLABILITY
(C-Controllable, U-Uncontrollable, IInterface)
C
C
C
C
C
I

D.VERIFICATION OF THE EXISTENCE OF THE PROBLEM


LIST OF CONTROLLABLE PROBLEMS
1. Delayed BCG vaccine given to newborns

2. Delayed endorsement

3. Nurses not following sterile technique


principles
4. Lack of 7S compliance

5. Lack of infection control compliance


causes IV infiltration

INITIAL DATA COLLECTED


We observed that before giving BCG
vaccine to newborns, they will wait
10 babies to be delivered first.
Generally, endorsement happens 15
minutes before the shift, however we
observed that its not being followed
due to the reason that some of the
staffs for the next shift are late.
In the OR we observed that some of
the sterile technique principles are
not followed by some nurses.
We have observed in the inpatient
units that some principles of 7s is
not strictly followed like systematic
arrangement because some of the
charts are not correctly arrange and
not in place.
We have observed that the infection
control sheets are not being updated
and the due date for changing the IV
line is not being followed. In the
inpatient units,___/12 patients had
cases of infiltration.

E. CLASSIFICATION OF PROBLEMS ACCORDING TO SIGNIFICANCE


LIST OF CONTROLLABLE
PROBLEMS
1. Delayed BCG vaccine
given to newborns

2. Delayed endorsement

INITIAL DATA COLLECTED


We observed that before
giving BCG vaccine to
newborns, they will wait 10
babies to be delivered first.
Generally, endorsement
happens 15 minutes before
the shift, however we
observed that its not being
followed due to the reason
that some of the staffs for
the next shift are
late.___/___ instances that
endorsement is delayed.

SIGNIFICAN
CE
SIGNIFICANT

ACTION
TAKEN
GO

SIGNIFICANT

GO

3. Nurses not following


sterile technique
principles
4. Lack of 7S compliance

5. Lack of infection
control compliance
causes IV infiltration

In the OR we observed that


some of the sterile
technique principles are not
followed by some nurses.
We have observed in the
inpatient units that some
principles of 7s is not strictly
followed like systematic
arrangement because some
of the charts are not
correctly arrange and not in
place.
We have observed that the
infection control sheets are
not being updated and the
due date for changing the IV
line is not being followed. In
the inpatient units, ___/12
patients had cases of
infiltration.

SIGNIFICANT

GO

SIGNIFICANT

GO

SIGNIFICANT

GO

F. PRIORITIZATION OF THE PROBLEM


LIST OF SIGNIFICANT PROBLEMS
1. Delayed BCG vaccine given to
newborns
2. Delayed endorsement
3. Nurses not following sterile
technique principles
4. Lack of 7S compliance
5. Lack of infection control compliance
causes IV infiltration

A
4.8
2.8
5
3.2
5

CRITERIA
B
C D E
3
3
2 2.6
2
4.
4
4
5

RANK

15.4

3
4

2
5

3
5

12.8
23.4

5
2

3
4.
4

5
5

5
5

20.2
24.2

3
1

CRITERIA
A MEDICAL/CLINICAL IMPORTANCE
B SOCIAL IMPORTANCE
C?
D EFFECTIVENESS OF THE CURRENT USE METHOD
E FEASIBILITY

G. PRIORITY PROBLEM:
Lack of infection control compliance causes IV infiltration
H. TENTATIVE PROBLEM STATEMENT:

TOTAL