Академический Документы
Профессиональный Документы
Культура Документы
Improvement Project
Sophie Griswold, Wendy Bertoglio, Jeremiah Palicka, Jacky Fuentes, Mack Flaherty
April 26, 2017
1
Overview of Patient Care Delivery System
VA Hospital
3N Telemetry Unit
Focus: Telemetry Monitoring Discontinuation
Protocol
2
Microsystem Model:
Leadership
Marquis, B.L. & Huston, C.J. (2015b). Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 264-
265).Lippincott Williams and Wilkins. ISBN Number: 13: 978-1-4511-9281-0.
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH: Dartmouth College. Retrieved from 4
http://dms.dartmouth.edu/cms
Microsystem Model:
Patient Focus & Staff Focus
Patient Focus
oBy and large, [we] are effective in learning about and meeting patient
needs: caring, listening, educating, and responding to special requests
and smooth service flow.
oVolunteer support staff, and ancillary support staff on unit allows for
effective completion of nursing tasks and meeting specific patient needs
Staff Focus
oNurses report feeling like they are a valued member of the
microsystem, and what [they] say matters. This is evident through
staffing, education and training, workload, and professional growth.
oNurses report 4:1 or 5:1 patient/nurse ratios, sufficient UAP staffing,
Black Belt Program
Marquis, B.L. & Huston, C.J. (2015c). Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 365-
366).Lippincott Williams and Wilkins. ISBN Number: 13: 978-1-4511-9281-0.
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH: Dartmouth College. Retrieved from 5
http://dms.dartmouth.edu/cms
Microsystem Model:
Interdependence of Care Team
Marquis, B.L. & Huston, C.J. (2015e). Leadership roles and management functions in nursing: Theory and application (8th ed., pp. 452-
456).Lippincott Williams and Wilkins. ISBN Number: 13: 978-1-4511-9281-0.
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH: Dartmouth College. Retrieved from 7
http://dms.dartmouth.edu/cms
Microsystem Model:
Process for Healthcare Delivery Improvement
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH: Dartmouth College. Retrieved from
http://dms.dartmouth.edu/cms 8
Microsystem Model:
Staff Performance Patterns
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH: Dartmouth College. Retrieved from
http://dms.dartmouth.edu/cms 9
Specific Aspect Targeted for Improvement
Cantillon, D. J., Loy, M., Burkle, A., Pengel, S., Brosovich, D., Hamilton, A., . . . Lindsay, B. D. (2016). Association between off-site central monitoring
using standardized cardiac telemetry and clinical outcomes among non-critically ill patients. Jama, 316(5), 519-524.
12
Marquis, B.L. & Huston, C.J. (2015f). Leadership roles and management functions in nursing: Theory and application (8th ed., pp.8-9). Lippincott Williams
and Wilkins.
References
Cantillon, D. J., Loy, M., Burkle, A., Pengel, S., Brosovich, D., Hamilton, A., . . .
Lindsay, B. D. (2016). Association between off-site central monitoring using
standardized cardiac telemetry and clinical outcomes among non-critically ill
patients. Jama, 316(5), 519-524.
Chambrin, M. C., Ravaux, P., Calvelo-Aros, D., Jaborska, A., Chopin, C., &
Boniface, B. (1999). Multicentric study of monitoring alarms in the adult intensive
care unit (ICU): A descriptive analysis. Intensive Care Medicine, 25(12), 1360-
1366.
Dressler, R., Dryer, M. M., Coletti, C., Mahoney, D., & Doorey, A. J. (2014).
Altering overuse of cardiac telemetry in non-intensive care unit settings by
hardwiring the use of american heart association guidelines. JAMA Internal
Medicine, 174(11), 1852-1854.
Johnson, J.K. (2003). Clinical microsystem assessment tool. 2nd ed. Lebanon, NH:
Dartmouth College. Retrieved
from http://dms.dartmouth.edu/cms
Marquis, B.L. & Huston, C.J. (2015a). Leadership roles and management functions
in nursing: Theory and application (8th ed., pp. 40-41).Lippincott Williams and
Wilkins. 13
References
Marquis, B.L. & Huston, C.J. (2015b). Leadership roles and management functions
in nursing: Theory and application (8th ed., pp. 264-265).Lippincott Williams and
Wilkins.
Marquis, B.L. & Huston, C.J. (2015c). Leadership roles and management functions
in nursing: Theory and application (8th ed., pp. 365-366).Lippincott Williams and
Wilkins.
Marquis, B.L. & Huston, C.J. (2015d). Leadership roles and management functions
in nursing: Theory and application (8th ed., pp. 321).Lippincott Williams and
Wilkins.
Marquis, B.L. & Huston, C.J. (2015e). Leadership roles and management functions
in nursing: Theory and application (8th ed., pp. 452-456).Lippincott Williams and
Wilkins.
Sendelbach, S., & Funk, M. (2013). Alarm fatigue: A patient safety concern. AACN
Advanced Critical Care, 24(4), 378-86; quiz 387-8.
Society of Hospital Medicine (2013). Continuous telemetry monitoring outside
ICU. Retrieved from http://www.choosingwisely.org/clinician-lists/society-
hospital-medicine-adult-continuous-telemetry-monitoring-outside-icu/
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