A PRACTICAL GUIDE TO QUALITY IMPROVEMENT FOR BURN CARE in Low-Resourced Settings
The identification of the Problem
• Through random observation by health workers in the unit it was found that handwashing was only done: after patient procedures, after exposure to bodily fluids and after removing gloves for the sake of removing glove powder. • Ideally, every patient room should have a handwashing sink/bucket. In this unit most of them were broken and some rooms did not have sinks at all. • There was also poor/no supply of hand rub • Puts patients more at risk of nosocomial infections by cross contamination therefore can increase length of stay in hospital and have a negative impact on treatment outcomes. Through patients’ feedback in the logbook and personal experience it was highlighted that there were no screens used during burn dressing changes to separate men and women, due to lack of room and resources. This created a lack of privacy for patients.
Example where Patricia compares how it is happening in practice to how it SHOULD be happening.
Lack of privacy during burn dressing changes
Ephrem and Patricia both specify the method they used to identify their problem.
Be mindful that the problem you intend to investigate is manageable and that you have the power to change it. These QI projects focus on small steps; while the final aim may be to reduce patient mortality, this will inevitably involve multiple steps that need to be addressed one at a time.
Top Tip FOCUS ON WHAT MATTERS TO YOU AND YOUR TEAM when you start to look for improvement ideas think about the ‘things that always seem to cause problems or don’t seem to make sense.’
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