Quality Compliance

Published

Specializes in ICU.

Hi, was just wanting to get someone's opinion about a bullitin board that was just set up on my unit. I work on a Neuro ICU floor of 33 beds. For this year we have been working to get our BSI, UTI, and VAP numbers down. The numbers are low but we are striveing for 0. When I mean low, we will have 1 UTI or 1 VAP for the month. Our manager and head physician have come together and developed this new bullitin board labeled Quality Compliance. On it is the name of every nurse that is employeed on our unit, along with every month of the year. I questioned what this was for and was told that they are planning on posting next to each employee how many infections they were "responible" for in that month. When I mean responisble, they research every infection. Say, if you inserted a foley and 2-3 or so days later they come down with a UTI then they pin the infection on you or, if the UTI was out of the 2-3 day window of insertion they look at when the pt was cultured positive, and they look at the nurses careing for the pt before the date of positive cultures close to that date. The same goes for the VAPs and BSIs. I understand that a no infection rate is extremely important but this is way over the top. HOW is this to boost moral? Also, being able to pin the infection exactly on one person is hard and inaccurate! Can this bullitin board be a form of slander? :confused:

Up Vote Up Vote ×
Specializes in Med/Surg, Ortho, ASC.

Wow. I don't know about slander, but that's about the most efficient morale-killer that I can think of. They ought to title the bulletin board "Wall of Shame."

Wonder if that head physician is willing to have his/her name posted up there with appropriate dings.....

"Patient XYZ suffered from hives, rash and respiratory distress following administration of drugs as ordered by Dr. Perfect."

Up Vote Up Vote ×
Specializes in ICU, ER, EP,.

While we gather this info, just about everyone does. Our info gathering focuses upon poorly drawn blood cultures, obvious contaminants... so that TEACHING on aseptic technique prevents these false positives. It is not posted, but if I contaminated a sample, it dang well will be traced back to me... and teaching occurs.

I'm troubled like you... I can insert a foley under aseptic technique with witnesses, and poor foley care, or a confused patient pulling on it causes infection and I don't own it.

Now slander? I'm assuming your from a northern state. Relax, the purpose is to identify people and correct action because medicaid/medicare, will no longer pay for nosocomial infections. So your facility, in attempts to decrease these "infections" are naming names, in attempt to shame you into "better care".

I'm not, not faulting your practice, only trying to explain the rationale why they are hostile about them.

Some facilities teach and retrain, others do what yours does. I can lament with you about a hostile work environment because you can't control the quality of care after you leave... but they are counting on peer pressure to improve the infection rates... it all comes down to $$$$$.

Honestly, although what your facility is doing stinks for morale.. and there are better ways to improve the infection statistics... if the hospital is loosing money, it threatens everyone's job. They choose the wrong path to correct it, but Slander? You'd never get, or be able to afford a lawyer to fight it, no one would take that case against the orificenal of hospital lawyers.

Choose the battle and hill you'll die on, I promise you... this isn't it...

Up Vote Up Vote ×

Shocking... but I guess everyone will be of the same mind and treat the stupid board with the disdain it deserves. We all know that bacterial growth rates are influenced by many factors and are not an exact science, so pinpointing a source within a 12 hr shift is faulty scientific reasoning, especially with multiple sets of hands involved in patient care. Management never cease to amaze... do they?

Up Vote Up Vote ×
Specializes in ICU, ER, EP,.
Shocking... but I guess everyone will be of the same mind and treat the stupid board with the disdain it deserves. We all know that bacterial growth rates are influenced by many factors and are not an exact science, so pinpointing a source within a 12 hr shift is faulty scientific reasoning, especially with multiple sets of hands involved in patient care. Management never cease to amaze... do they?

This is NOT, not board driven. This is facility driven. This is purely reimbursement, not your licensing board, your mistaken. This is about the $$$$$$ and I mean no disrespect.

Up Vote Up Vote ×
Specializes in ICU.

Zookeeper3, woh woh, never said anything about suing.... If I were to sue a hospital it would be over something bigger that this. Just wanted to know if they had the right to post something like this. I also totally agree that if they are going to make us accountable then they should make us all accountable including the MDs. Instead of spend energy on something as juvinial as this they need to focus more on other methods of prevention. Apparently what we are doing is not working. Pointing the finger is just going to make people leave and then we are stuck at the expense of training new staff.

I work on a Neuro ICU like I said before. Some of our pts are crazy, literally, so we are constanly fighting with them to not pull on things. A lot of them were found down and intubated on the field. These are the ones that allways end up with foul smelling secretions and sometimes a VAP. Also we give soo many

antibiotics virtually everyone ends up with diahrrea and, if they have a foley and

female we were are digging that &$@& out of their hoohas.

Up Vote Up Vote ×

Good Lord Zookeeper... I was referring to THE BULLETIN BOARD that is the subject of the discussion not the Board of Nursing. How could you extract that from my post? Seriously?

Up Vote Up Vote ×
This is NOT, not board driven. This is facility driven. This is purely reimbursement, not your licensing board, your mistaken. This is about the $$$$$$ and I mean no disrespect.

What board? Maybe the board in question should conveniently fall down or get wet or some other such thing.

Up Vote Up Vote ×
Specializes in Psych/CD/Medical/Emp Hlth/Staff ED.

It would seem like they would need better evidence before publicly (at least to staff) declaring that a particular nurse was responsible for an infection. Particularly since they seem to be making some assumptions that aren't as absolute as they seem to imply. It's one thing to internally address issues, but this seems unprofessional.

Up Vote Up Vote ×
Specializes in ICU.

I will keel you guys up dated. No information is posted yet, just the layout has been put up.

Up Vote Up Vote ×
Specializes in SNF.

i agree hamsterRN

Up Vote Up Vote ×
Specializes in Peds, PACU, ICU, ER, OB, MED-Surg,.

It seems unprofessional to me to have board announce to my co-workers that I might be responsible for an infection. If you need to council me do it in private. If you and your peers address this with the director I would it on these grounds.

Up Vote Up Vote ×
+ Join the Discussion