Managing Acute Respiratory Failure in Small, Rural, and Critical Access Hospitals: Non-Invasive Ventilation & High-Flow Nasal Cannula

IPRO HQIC

Due to medical-surgical nurses’ limited exposure to managing acute respiratory failure, nurses in rural and critical access hospitals do not always have a comfort level with non-invasive ventilation (NIV) equipment and/or High-Flow Nasal Cannula (HFNC). Managing this situation on medical-surgical floors within these smaller hospitals created a void, especially without access to specialty staff who have advanced clinical respiratory experience, lack of critical care beds, and/or the lack of respiratory therapy resources. This is especially true in rural and critical access hospitals, possibly exacerbating adverse events and potentially increasing health disparities (due to access of specialty care issues). This electronic tool provides digestible information to support the front-line in CPAP, BiPAP, and HFNC management.

Eliminating Disparities to Advance Health Equity and Improve Quality

MHA Keystone Center

The MHA Keystone Center encourages organizations to use this guide to assess the current level of hospital implementation around key strategies aimed at reducing disparities to achieve equity and improving quality. This resource will guide organizations to prioritize and act on identified gaps so that deliberate and purposeful action is taken to ensure that the outcomes across all patient populations are equitable. Sections of the guide include:

Section 1: Understanding Key Terms

Section 2: Why Equity in Care Matters

Section 3: Strategic Pillars on the Journey Toward Equity

Section 4: Recommendations for Action

Section 5: Levels of Implementation

Section 6: The MHA Keystone Center’s Dedication to

Achieving Health Equity

Section 7: Resource Compendium

Preventing Hospital-Associated Venous Thromboembolism: A Guide for Effective Quality Improvement

Agency for Healthcare Research and Quality (AHRQ)

Pulmonary embolism resulting from deep vein thrombosis—collectively referred to as venous thromboembolism—is the most common preventable cause of hospital death. Pharmacologic methods to prevent venous thromboembolism are safe, effective, cost-effective, and advocated by authoritative guidelines, yet large prospective studies continue to demonstrate that these preventive methods are significantly underused. Based on quality improvement initiatives undertaken at the University of California, San Diego Medical Center and Emory University Hospitals, this guide assists quality improvement practitioners in leading an effort to improve prevention of one of the most important problems facing hospitalized patients, hospital-acquired venous thromboembolism.

Anticoagulation FORUM: Numerous Resources and Expert Guidance

Anticoagulation FORUM

  • Education & Guidance
  • Webinars and Events
  • Centers of Excellence
  • Anticoagulation Stewardship

Established more than 25 years ago, the Anticoagulation Forum is the largest organization of its kind helping practitioners improve patient care by providing current and relevant information on best practices. The flagship program, the Anticoagulation Centers of Excellence, embodies our commitment to the clinical application of evidence-based practices and improved patient outcomes. Expert Guidance is provided by the Board of Directors, who are regularly relied upon for their expert opinion. Their contributions to research and guideline development have influenced all aspects of anticoagulation therapy.

Managing the Risks of Direct Oral Anticoagulants

The Joint Commission: Sentinel Event Alert

While DOACs offer ease of use to patients, stopping bleeding events in patients on DOACs is more complicated, requiring different strategies than those for patients on warfarin (Coumadin®) and heparin. Unlike the more widely available reversal agents for warfarin and heparin, reversal agents for DOACs are lesser known and may not be available in every care setting. Also, some DOACs have no FDA-approved reversal agent at this time. Therefore, bleeding complications can be severe if these patients are not assessed according to guidelines on the management of DOACs. Intracranial hemorrhage is the most serious emergent bleeding risk.

In response to an increase in adverse events related to these widely prescribed medications, this alert provides guidance on the safe use and management of DOACs to all medical practitioners and health care organization leaders, particularly chief medical officers, pharmacists, emergency department clinicians, and quality and safety officers.

VTE & VTE/COVID-19 Resources

North American Thrombosis Forum (NATF)

The North American Thrombosis Forum is dedicated to saving lives through education and prevention. A major part of this is helping healthcare professionals stay up to date on the latest research in the rapidly changing field of thrombosis. Through educational events and informative articles geared specifically towards clinicians, NATF provides clinicians with the information they need to best treat their patients. Topics covered include thrombosis, stroke prevention, atrial fibrillation, diabetes, cardiovascular-related illnesses, and more. Check back regularly for important updates on everything from the development of new medications to the release of novel research.

Partnering with Patients and Families During the COVID-19 Pandemic

American Institutes for Research (AIR) and IPRO Hospital Quality Improvement Contractor (HQIC)

The American Institutes for Research (AIR) and the IPRO HQIC hosted the March 2021 Patient and Family Engagement (PFE) webinar, titled Partnering with Patients and Families During the COVID-19 Pandemic.

During this 45-minute interactive event, the AIR team provided an overview of five PFE best practices and described how engaging patient and families can help both patients and clinical staff address the emergency. The event featured real-world examples of how hospitals are partnering with patients and families during the COVID-19 pandemic.

Webinar Materials:

March 30: Partnering with Patients and Families During the COVID-19 Pandemic IPRO QIN-QIO

Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guidelines )

European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance

(Updated 05/21/24) In 2019, a full set of Clinical Practice Guidelines were developed, by the European Pressure Ulcer Advisory Panel, National Pressure Injury Advisory Panel and Pan Pacific Pressure Injury Alliance. Prevention and Treatment of Pressure Ulcers/Injuries: Clinical Practice Guidelines, The International Guideline and can be purchased for a fee. In addition, a Quick Reference Guide (QRG), which provides a summary of the recommended guidelines can be downloaded for no charge.

Pressure Injury- Learning and Action Network (LAN) – May 24th, 2021

IPRO & Telligen Hospital Quality Improvement Contractors (HQICs)

The LAN included:

  • A presentation of aggregated results from the IPRO & Telligen HQIC Hospital Baseline Assessment specific to pressure injury
  • An interactive discussion with quality and performance improvement subject matter experts on pressure injury identification, prevention, and management.

Attendees had the opportunity to discuss:

  • Pressure injury challenges in small rural and critical access hospitals (in general and with COVID-19)
  • Approaches to overcome these challenges, including patient and family engagement and health equity strategies.

Hospitals left “in action” with a variety of strategies and 17 salient resources for the front-line to further efforts in All-Cause Harm (Pressure Injury) prevention and management.

Building a Team to Reduce CLABSI and CAUTI

Prepared by the HAP Quality Initiatives Department
Healthcare Associated Infection Prevention Managers
September 2019 for IPRO HQIC

The purpose of this tool kit is to teach you the key elements that are essential in building a successful team to reduce central line associated bloodstream infections (CLABSI) and catheter associated urinary tract infections (CAUTI) on your unit. The tool kit will provide you with information on how to develop a team, assess your work practices, develop an action plan, implement changes, and evaluate your success.

Hospital Roadmap for Person and Family Engagement (PFE): Achieving the Five PFE Best Practices to Improve Patient Safety and Health Equity

This material was prepared by American Institutes for Research (AIR). It is redistributed by IPRO HQIC, a Hospital Quality Improvement Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS).

A growing body of work—captured in peer-reviewed
literature and the experiences of hospitals and health
systems across the United States—highlights the benefits
of PFE, suggesting that successful implementation of PFE
practices can contribute to better outcomes. This PFE Roadmap provides practical guidance to help hospitals implement five PFE best
practices.

How Person and Family Engagement Can Help Hospitals Achieve Equity in Health Care Quality and Safety

This material was prepared by American Institutes for Research (AIR). It is redistributed by IPRO HQIC, a Hospital Quality Improvement Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS).

Person and family engagement (PFE) is central to the mission of PfP and is recognized as a promising mechanism to aid in achieving equity in quality and safety. The PfP 3.0 Strategic Vision Roadmap for Person and Family Engagement lays out six overarching strategies to guide
hospitals in meaningfully engaging patients and families and describes how to apply these strategies to the five PFE metrics,

Preadmissions Planning Checklist (English)


This material was prepared by American Institutes for Research (AIR). It is redistributed by IPRO HQIC, a Hospital Quality Improvement Contractor, under contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services (HHS).

HOW TO PREPARE FOR A SAFE HOSPITAL STAY”

This resource is a planning checklist for patients to use prior to admission to the hospital, while admitted, and before they leave the hospital