Joint HQIC 4-Part Series: Workplace Violence Prevention

Prepared by the HQIC collaborative group (IPRO, Alliant, Compass, and Telligen)

Defined as “violent acts, including physical assaults and threats of assault, directed toward persons at work or on duty,” workplace violence (WPV) is a growing concern.1 An April 2020 Bureau of Labor Statistics Fact Sheet revealed that healthcare workers accounted for 73% of all nonfatal workplace injuries and illnesses due to violence in 2018. This number has been steadily growing since tracking these specific events began in 2011.2

Now, it is time to act!
Why Now? According to OSHA (2016)3, workplace violence rates among healthcare workers between 1993 and 2009 were 20% higher than that for other industries. The COVID-19 pandemic increased the factors leading to workplace violence, such as staffing shortages leading to a decrease in the amount of staffed (available) beds, a high workload causing stressed staff, and frustrated patients and families who feel as though their needs are not being met. A memo to State Survey Agency Directors dated November 28, 2022, states CMS’ continued enforcement of regulatory expectations that patients and staff have an environment that prioritizes their safety while effectively delivering healthcare.2 To effectively maintain a safe environment for healthcare delivery, hospitals can develop policies and procedures to mitigate the risk of workplace violence.


The HQIC collaborative group consisting of Alliant, Compass, IPRO and Telligen appreciates your interest in the Workplace Violence Prevention series. Access event materials here:

Part 1:  Workplace Violence Prevention (WPV): Best Practices for Safer Care

  • WPV is defined as an act or threat occurring at the workplace from physical and verbal assaults.
  • 2020 Bureau of Labor Fact Sheet found that health care workers accounted for 73% of all nonfatal workplace injuries and illness due to violence in 2018.
  • WPV prevention takes more than security.  Requires commitment from organizational leadership, interdisciplinary, collaboration and allocation of resources.
  • It is an investment in our workforce not a cost.

SLIDES.

Part 2:   Key Components of an Effective Workplace Violence Prevention Program: Leadership Engagement and Communication

  • Workplace violence is more than a written Policy, it is a series of action steps that serve as a foundational guide for educating staff and acting quickly in an emergency.
  • Communication is critical. WPV prevention policies must be communicated to patients and families in a way that is non-threatening, clear, concise and at the appropriate reading level.   
  • The way an organization addresses WPV AFTER an event (debriefing, counseling, performance improvement action plan) is just as important as how your organization responds during the event.
  • Leadership is a partnership. At the heart of all good policies, procedure, and programs is good two-way communication. Find what’s missing by including all perspectives.

SLIDES.

Part 3:   Uncovering Unconscious Bias for Safer Healthcare Interactions

  • Unconscious bias affects healthcare interactions and can lead to poor, inequitable outcomes.
  • Self-reflection is crucial for bias identification and improvement.
  • De-escalation must be a priority to promote safe, healing environments.
  • Organizations must implement training, diversity initiatives, reporting mechanisms, and community engagement to address and mitigate bias in healthcare.

SLIDES.

The Interdisciplinary Care Team’s Role in Pressure Injury Prevention

Prepared by IPRO NQIIC

This resource guide provides education, evidence-based practices, and guidance on how to engage the interdisciplinary team to collaborate and improve the assessment, management, and prevention of pressure injuries. It is intended for use by healthcare providers who work with patients/residents who either have pressure injuries or are at risk of developing them. It will guide healthcare teams to implement effective pressure injury prevention practices through an interdisciplinary approach (AHRQ, 2023).

Pain Management Essential Communication Elements for Transitions of Care Guide

Prepared by IPRO QIN-QIO

This resource is designed for use in any facility by staff or a healthcare provider to improve cross-setting management of pain management during transitions of care, to prevent adverse drug events and subsequently reduce emergency department visits, hospitalizations, and readmissions.

Readmissions Miniseries Webinars 2024

IPRO NQIIC

It is well known that effective care transitions help reduce readmissions and are essential to patient safety. Yet, many organizations struggle with structures and processes that depend on collaboration across the continuum of care. The purpose of these mini-series sessions is to share evidence-based interventions and best practices to reduce readmissions. Speakers will provide guidance and education on specific readmissions reduction strategies. Participants will learn how to reduce readmissions and sustain their practices. They will also be challenged to reconsider aggregated readmissions rates as a measure of program effectiveness.

Solar Eclipse Provider-Facing Safety Tips

On Monday, April 8, 2024, a total solar eclipse will cross North America. The eclipse will travel across portions of Mexico, the central and eastern United States, and southeastern Canada. According to NASA, a solar eclipse occurs when the Moon passes between the Earth and the Sun at just the right time, with the Moon creating a shadow on a portion of the Earth’s surface. If you have plans to view the solar eclipse or if you live in an area that will experience a total solar eclipse, it’s important that you plan ahead and review these safety tips. This document is intended to assist hospitals, nursing homes, home health agencies, dialysis centers, and all other health care providers plan for the upcoming total solar eclipse. In preparation, please take the time to review this document and share this information with your patients/ residents, facilities, and staff.

Collection:  Antibiotic Stewardship Guidelines and Algorithms Compendium

Compiled by IPRO HQIC

Urinary Tract InfectionGuidelines

Guidelines for Treatment of Urinary Tract Infections Michigan Hospital Medicine Safety (HMS) Consortium

Urinary Tract Infection and Asymptomatic Bacteriuria Guidance Nebraska Medicine

URINARY TRACT INFECTIONS IN ADULTS Michigan Medicine, University of Michigan

Clinical Practice Guidelines for the Antibiotic Treatment of Community-Acquired Urinary Tract Infections NIH

UTI References

International Clinical Practice Guidelines for the Treatment of Acute Uncomplicated Cystitis and Pyelonephritis in Women: A 2010 Update. Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases 

Topic: Urinary Tract Infection (UTI) AHRQ

UTI Toolkit

Toolkit for Reducing CAUTI in Hospitals AHRQ

Appendix K. Infographic Poster on CAUTI Prevention (ahrq.gov)

UTI Clinical Pearls

Single-Dose Aminoglycoside for Cystitis: An Oldie but Goodie – KY Antimicrobial Stewardship Innovation Consortium

Staphylococcus aureus in a urine culture – KY Antimicrobial Stewardship Innovation Consortium

Aminopenicillins for Enterococcal Cystitis: Teaching an Old Dog New Tricks – KY Antimicrobial Stewardship Innovation Consortium

Skin and Soft Tissue Infection

Cellulitis: A Review (JAMA)

Cellulitis: A Review (NIH)

Cellulitis: Information for Clinicians (CDC)

IDSA Skin & Soft Tissue guidelines 2014

Skin and Soft Tissue Infections: Treatment Guidance Jasmine R Marcelin MD, Trevor Van Schooneveld MD, Scott Bergman PharmD Reviewed by: Mark E Rupp MD, M. Salman Ashraf MBBS

AAFP patient education materials

UCSF Medical Center Guideline for the Management of Suspected Skin and Soft Tissue Infections in Adults Original Author(s): Jennifer S. Mulliken, MD and Sarah M. Doernberg, MD, MAS

SHC Clinical Guideline: Outpatient Management of Skin and Soft Tissue Infections

Prophylaxis/SSI

Strategies to prevent surgical site infections in acute-care hospitals: 2022 Update with essential practices. 

Additional guidelines (all adapted from consensus guidelines):

ASHP Clinical Practice Guidelines for Prophylaxis in Surgery.

Stanford Health Care- Surgical Prophylaxis Guidelines

University of Michigan- Surgical Prophylaxis Guidelines

University of California San Francisco- Surgical Prophylaxis Guidelines

ICHE Compendium 2022- Updated Surgical Site Infection Prevention Compendium

IV to PO Conversion

Article – Intravenous-to-Oral Switch Therapy: Overview, Antibiotics, Antidepressants (medscape.com)

Article – (2023) – Switching patients from IV to oral antimicrobials – The Pharmaceutical Journal (pharmaceutical-journal.com) (from the UK)

Guidelines

Galway Antimicrobial Prescribing Policy / Guidelines (GAPP) – Galway: GAPP (megsupporttools.com)

 (2018) Intravenous to Oral Conversion for Antimicrobials (northernhealth.ca)

SHC-IV-to-PO-Interchange-Protocol.pdf (stanford.edu)

A Resource To Help With Changing From IV To PO Antibiotics (idstewardship.com)

Public Health Ontario: https://www.publichealthontario.ca/-/media/documents/A/2016/asp-iv-oral-conversion.pdf

Community Acquired Pneumonia- Updated Recommendations ATS and IDSA 2020

ATS/IDSA Guidelines for Diagnosis and Treatment of Adults with Community Acquired Pneumonia 2019

C. difficile

Clinical-Pearl-CDI-Risk-2.8.23.pdf (kymdro.org)

CDI Prevention Strategies- https://www.cdc.gov/cdiff/clinicians/cdi-prevention-strategies.html

MN Department of Health C difficile guidelines  https://www.health.state.mn.us/diseases/cdiff/hcp/guidelines.html

UC Davis Guidelines 2021  https://health.ucdavis.edu/antibiotic-stewardship/pdfs/cdi_tx_ucd.pdf

University of Nebraska  2021 https://www.unmc.edu/intmed/_documents/id/asp/clinicpath-cdi_final.pdf

UNC Medical Center 2022  https://www.med.unc.edu/pediatrics/cccp/wp-content/uploads/sites/1156/gravity_forms/1-c06e424ddddee8826f29e1bc5926a251/2022/11/CASP-UNCMC-CDI-Guideline_FINAL.pdf

AHRQ  Best Practices in the Diagnosis and Treatment of C difficile 2019  

Management of C difficile in adults: review and comparison of IDSA/SHEA, ESCMID and ASID guidelines

IDSA C difficile clinical practice guidelines in adults: 2021 Update by SHEA/IDSA

Solar Eclipse Patient Safety Tips

On Monday, April 8, 2024, a total solar eclipse will cross North America. A total solar eclipse happens when the moon passes between the Sun and Earth, causing the sky to darken as if it were dawn or dusk. Visit the NASA website on the flyer to see if your area is in the path of the eclipse. Follow these safety tips when viewing the eclipse to stay safe. Be sure to share these tips with your family and friends.

Managing Opioids Safely After Discharge: A Communication Tool for Patients and Care Partners

Prepared by IPRO HQIC

The goal of this tool is to help you communicate with your healthcare team about the opioids you will be taking after you are discharged from the hospital. You and your doctor have decided that you should continue taking opioids after you leave the hospital as part of your pain management plan. A pain management plan lists the ways in which you can control your pain. The plan may include prescribed opioids and over-the-counter medicines and when you should take them, as well as other things you can do (e.g., ice, massage). You and your clinician may need to adjust your plan as you recover.

Advancing the Culture of Patient Safety: Strategies to Prevent CLABSI and CAUTI

Prepared by IPRO HQIC

Hospital-Acquired Infections (HAIs) are among the most common complications in hospitals and continue to be a significant concern in the healthcare system. The Agency for Healthcare Research and Quality estimates that approximately 633,300 patients contract one of these infections annually, costing billions for healthcare organizations. These infections can lead to significant morbidity and mortality, with tens of thousands of lives lost each year.

To improve the overall quality of care, it is important that healthcare professionals direct their focus toward identifying and creating opportunities for improving performance and outcomes. In this Lunch & Learn we will cover:

  • The prevalence of Central Line Associated Blood Stream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI).
  • The causative factors and evidence-based strategies for CLABSI and CAUTI prevention.
  • How the Appalachian Regional Healthcare System successfully implemented evidence-based strategies that resulted in a significant decrease in CLABSI and CAUTI rates.