National safety and quality health service standards

https://www.safetyandquality.gov.au/standards/nsqhs-standards

On my first hospital placement I encountered many IV lines. It was a surgical ward and it was essential for many patients to have bags of fluids and antibiotics running. I had limited knowledge on the importance of health care associated infections. During one of my morning shifts my buddy nurse and I were beginning the showering regime. The first patient had a bed bath although, the second preferred a shower and asked if the IV line could be disconnected whilst they did this. My nurse quickly disconnected the line and provided a shower cover for the patient’s cannula. After finishing the patient buzzed and my nurse reconnected that same IV line and bag. After seeing this happen numerous times, I asked my clinical facilitator if this was safe practice. This is when I discovered it is not to be accepted and when a line is disconnected it should be replaced with a new line and bag to prevent infection and bacteria transmission. When disconnecting and reconnecting IV lines you risk introducing pathogens into the bloodstream [ CITATION Lev95 \l 1033 ]. In Australia there were 1,493 bloodstream infections reported between 2017-18 in public hospitals (AIHW, 2019). With the tip of the giving set exposed, this

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the shift I completed baseline observations for all my patients. When I entered the room an hour later, I noticed this patients cannula had been torn out, I quickly grabbed gloves and applied pressure to the CF. But, I noticed the patient seemed a little dazed. I decided to conduct another set of observations. All of his observations had declined, I notified my buddy nurse immediately and she too noticed he had declined from his baseline. We called a MET call, as we were concerned about the patient even though he wasn’t scoring on Q-ADDS. The MET team conducted a series of examinations and as a precaution conducted a second ECG. This should extreme changes and indicated he was having a NSTEMI. This quick diagnosis saved this man’s life. I feel proud of my actions in this circumstance. Through the introduction of a tracking observation chart (Q-ADDS), early identification of deterioration is enabled allowing MET teams to facilitate quick and effective management (Smith, et al, 2006). Risks in patients can mostly be predicted through vital signs and the monitoring of patients. This may improve patient outcomes, even though some risks may be random (DeVita, et al, 2010). Furthermore, the Journal of Nursing Management states: “Serious adverse events can be prevented by recognizing and responding to early signs of clinical and physiological deterioration and depend on nurses’ clinical judgment of deterioration”. Standard 8 of the NSQHS ensures that acute deterioration in a patient is recognized and action is taken in an appropriate and prompt way (Australian Commission on Safety and Quality in Health Care, 2017). This standard aims to improve patient outcomes and decrease the interventions required to stabilize, in the case of a deteriorating patient. Both my buddy nurse had a concern for that patient and achieved the standard of care. Although, he had presented with hyperglycemia his diagnosis that day was different, I am glad we

References

AIHW. (2019). Australian Institute of Health and Welfare. Retrieved from Bloodstream infections associated with hospital care 2017–18: Australian hospital statistics: https://www.aihw.gov.au/reports/health-care-quality-performance/bloodstream-infections-hospital-care-17-18/contents/appendix-b-national-healthcare-agreement-performance-indicator-healthcare-associated-infections.

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Hansebo, G. &. (2001). Carers’ reflections about their video recorded interactions with patients suffering from severe dementia. Journal of Clinical Nursing .