The Patient Care Process

The only thing in the world that is consistent is change. Healthcare is rapidly changing on so many fronts. When I started as a paramedic around 2000 the standard at the time was to give all Cardiac Arrest patients sodium bicarb. Several years into my career we were instructed to move away from this practice. Many of the ‘old timers’ were upset as a result of the many lives they had saved while using bicarb. Change is difficult. It was difficult for those medics and it is difficult in many aspects of healthcare. However, the only way to improve from where you are is to change.
This week we discussed some aspects of changing the patient care process. We evaluated what might need to be changed in order to prevent patients from not receiving their pre-op antibiotics. Patients have a pre-op checklist. Making sure this antibiotic is on that pre-op checklist is one way to help ensure this error doesn’t occur. There is also something referred to as a ‘time-out’ prior to surgery. The operating room members discuss what is being done and on what patient and verify that everything is in order before they make the first cut. If the pre-op antibiotic were a part of this ‘time-out’ and a surgery was held up when it was not administered, how many times would the nurse forget to give it? It would also be caught immediately and be able to be administered at that time.
I have witnessed medication errors with the administration of antibiotics, they are easy to do. One of the ways we attempt to reduce errors with antibiotics is to never leave the room until you see the medication dripping into the collection chamber. As simple as this seems it has helped me to catch potential errors I could have made.medication-erroe-meme



Benchmarking is how we establish where we are, where we have been and where we are going. Prior to this module I had heard the term benchmarking and had a general idea that it was a means of measuring performance. This weeks lessons, discussions and critical thinking exercises expanded my knowledge and helped me to understand how critical benchmarking is to healthcare.

Benchmarks must be measurable, but more than that they must be specific to what you are trying to accomplish overall. Setting a benchmark for decreasing infection rates and then measuring call light responsiveness isn’t going to help change infection rates. Measuring hand hygiene on the other hand may help infection rates immensely.

While benchmarks need to be specific and measurable it is also important to learn from what and how others benchmark who have the same goals as you do. Diving into the specifics of the goal, the process, the measurement (benchmark), and the outcome are all equally important when trying to set and achieve a specific benchmark.

One thing that stuck out to me specifically is watching what others use as important benchmarks in providing care. My doctor uses lab values when he wants to justify a certain type of care for me and then also incorporates symptoms when he wants to deviate from what the lab values would indicate. It has spurred me on to be much more specific in managing my own care. There was a time I would trust my care to my doctor blindly and those days are over.

Benchmarking can also be compared to effectiveness. When I am speaking with a patient I inform them of what I think is going on with their care. We discuss what the Doctor has told them, what they are feeling, what role medications and treatment may be playing in the process, and each of these can have a type of benchmark tied to it. Even if you call that benchmark “normal response” or “expected response,” even an “unexpected response” incorporates a benchmark that we are either not meeting or exceeding. This weeks lessons helped me to realize I need to be specific and factual in how I perform any task as a nurse and critically evaluate my care against a benchmark of “High Quality Care!!”

Also this week I have purchased a new computer. I utilized industry standards, or “benchmarks,” to determine what make and model would be best suited to my needs. As a result of this new make and model, it is processing my images differently than in previous weeks. I have a benchmark meme that I have “inserted” into this post, yet doesn’t seem to want to show itself…..

We’ll see how well I overcome the obstacles of this new standard of computer my benchmarking helped me pick out. It would appear that this week my performance has declined with regards to media and I will need to re-evaluate and alter my knowledge to produce better results by incorporating proper media…..