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. Improvement of cross-setting management of pain management during transitions of care to prevent adverse drug events and subsequently reduce emergency department visits, hospitalizations, and readmissions.

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

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.

Workplace Violence Mitigation & Resource Collection

Curated by IPRO HQIC

Workplace violence (WPV) is defined as an act or threat occurring at the workplace that can include any of the following: verbal, nonverbal, written, or physical aggression; threats, intimidation, harassment, or humiliating words or actions; bullying; sabotage; sexual harassment; physical assaults; or other behaviors of concern involving staff, licensed practitioners, patients, or visitors.

By assessing worksites, preparing employees through training, and providing resources such as clear reporting procedures, healthcare facilities can help to reduce the impact of this hazard on the workforce and continue to ensure a safe place to provide care for patients. Whether your facility already has a workplace violence program or is just starting to develop one, IPRO HQIC has a compendium of tools and resources to ensure that all aspects of this hazard are considered throughout the process.

This collection contains research articles, best practices webinars, planning templates, assessment tools, and online trainings related to workplace violence in healthcare settings.

Using the IPRO HQIC Planning Tool to Implement a PFAC in Your Hospital

Prepared by IPRO

The Self-Directed Learning Series for IPRO HQIC Hospitals is Now Available

  • Purpose
    • The goal of this learning series is to help a team of hospital employees and a patient and family advisors implement a functioning and sustainable patient and family advisory council or PFAC to meet PFE Best Practice.
    • You will learn the process and steps required to plan and initiate a PFAC.
    • The learning series includes an introductory video and five learning modules—one for each of the five steps of the process (illustrated below).

What is PFE Best Practice 5?
Hospitals are required to have at least one active Person and Family Engagement Committee, Patient and Family Advisory Council (PFAC), or other committee (e.g., Patient Safety) with full membership positions for patient or family representatives.

Background
The series has two major components (1) the PFAC Planning Tool which includes tools and activities that your hospital can use to create and sustain a Patient and Family Advisory Council (PFAC); (2) six pre-recorded learning modules of the Creating and Sustaining a Patient and Family Advisory Council to Improve Patient Safety and Enhance Quality Improvement.

  • How to Access
    • Go to IPRO Learn: Log in to the site to login or create a new account. More information about this process is available on the IPROLearn Account Creation Instructions.
    • Under “all courses” search for PFAC Learning Series.
    • Start with the introductory video and work your way through the five learning modules at your own pace!

View slides and the webinar recording from the Using the IPRO HQIC PFAC Learning Series to Implement a PFAC in Your Hospital to:

  • Learn about how to meet PFE Practice 5: PFAC or Representatives on Hospital Committee.
  • Learn about the new self-directed learning series on IPRO Learn, Creating and Sustaining a Patient and Family Advisory Council (PFAC) to Improve Patient Safety and Enhance Quality Improvement.
  • Discuss how your hospital can use the learning series to develop or strengthen your PFAC.

Opioid Stigma Resources Collection

Compiled by IPRO HQIC

The following are websites where you can resources related to Opioid Stigma:

Articles:

  1. CDC. “Patients’ Frequently Asked Questions | CDC’s Response to the Opioid Overdose Epidemic | CDC.” Www.cdc.gov, 19 Oct. 2021, www.cdc.gov/opioids/patients/faq.html. Spanish Language version available here.
  2. CDC. “Stigma Reduction.” Www.cdc.gov, 25 July 2023, www.cdc.gov/stopoverdose/stigma/index.html. Accessed 10 Oct. 2023.
  3. IPRO HQIC. “Naloxone Saves Lives – HQIC Resource Library.” IPRO HQIC Resource Library, 20 Sept. 2022, hqic-library.ipro.org/2022/09/20/naloxone-saves-lives/. Accessed 10 Oct. 2023. Spanish language version available here.
  4. IPRO HQIC. “People Matter, Words Matter – IPRO QIN-QIO Resource Library.” IPRO HQIC Resource Library, 28 July 2023, qi-library.ipro.org/2023/07/28/people-matter-words-matter/. Accessed 10 Oct. 2023.
  5. Where Opioid Use Disorder Stigma Comes From and How to Prevent It Opioid Use Disorder Stigma: Causes, Impact, Prevention (healthline.com) 
  6. 4 Factors That Add to Stigma Surrounding Opioid Use Disorder 4 factors that add to stigma surrounding opioid-use disorder | American Medical Association (ama-assn.org) 
  7. Stop Overdose: Stigma Reduction Stigma Reduction (cdc.gov) (PDF flyer REDUCING STIGMA (cdc.gov)
  8. The stigma that undermines care The stigma that undermines care (apa.org) 
  9. Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery Stigma: Overcoming a Barrier to Pain Treatment and Addiction Recovery | NIH HEAL Initiative 
  10. Substance Use Disorder Stigma: What it is and How You Can Prevent it Substance Use Disorder Stigma: What it is and How You Can Prevent it | USU 
  11. Punishing Drug Use Heightens the Stigma of Addiction Punishing Drug Use Heightens the Stigma of Addiction | National Institute on Drug Abuse (NIDA) (nih.gov) 
  12. Medical Stigma and Patients with Substance Abuse Disorder Medical Stigma and Patients with Substance Abuse Disorders | Psychology Today 
  13. Panel Discussion: Stigma Around Opioid Use Disorder Presents Challenges to Treatment Stigma Around Opioid Use Disorder Presents Challenges to Treatment | The Pew Charitable Trusts (pewtrusts.org) 
  14. Stigma of opioids a hurdle to solving crisis Stigma of opioids keeps users from seeking help, taints views of medical professionals – Harvard Gazette 
  15. Why Opioid Addiction Should Be Viewed-And Treated-Like a Chronic Disease Opioid Use Disorder: Managing Stigma & Treatment | The Well by Northwell 

Blogs Posts:

  1. Part 1: Guiding Principles for Addressing the Stigma on Opioid Addiction Guiding Principles for Addressing the Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 
  2. Part 2: A Roadmap to Reduce Stigma on Opioid Addiction A Roadmap to Reduce Stigma on Opioid Addiction | Bloomberg American Health Initiative (jhu.edu) 

Journal Articles:

  1. Confronting the Stigma of Opioid Use Disorder- and Its Treatment Confronting the Stigma of Opioid Use Disorder—and Its Treatment | Substance Use and Addiction Medicine | JAMA | JAMA Network 
  2. Social Stigma Toward Persons with Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health-Oriented Policies Social Stigma Toward Persons With Prescription Opioid Use Disorder: Associations With Public Support for Punitive and Public Health–Oriented Policies | Psychiatric Services (psychiatryonline.org) 
  3. Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination Portraying mental illness and drug addiction as treatable health conditions: Effects of a randomized experiment on stigma and discrimination – ScienceDirect 
  4. The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy The Impact of Stigma on People with Opioid Use Disorder, Opioid Treatment, and Policy – PubMed (nih.gov) 
  5. Stigma, discrimination and the health of illicit drug users Stigma, discrimination and the health of illicit drug users – PubMed (nih.gov) 
  6. The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder The role of stigma in U.S. primary care physicians’ treatment of opioid use disorder – ScienceDirect 
  7. Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review Addressing Bias and Stigma in the Language We Use With Persons With Opioid Use Disorder: A Narrative Review – PubMed (nih.gov) 
  8. Opioid use-related stigma and healthcare decision-making Opioid use-related stigma and health care decision-making – PubMed (nih.gov) 

Ready or Not, Here it Comes: Preparing to Submit the CMS Health Equity Structural Measure

Prepared by IPRO

Hospitals participating in the CMS Inpatient Quality Reporting (IQR) Program are required to submit structural measures for CY2023 into the CMS Hospital Quality Reporting system. Submissions are due between April 1, 2024 – May 15, 2024.

One of the required structural measures is the Hospital Commitment to Health Equity. In this 30-minute session, IPRO will share what you will need to report to CMS, which documentation you will need to support your submission, the optional Social Drivers of Health process measures, and what’s coming related to health equity for the CY2024 Hospital Quality Reporting programs.

Watch Presentation

Presentation Slides

Hospital Commitment to Health Equity Submission Tool: This fillable PDF resource created by IPRO may be helpful for preparing for attestation of the CMS Hospital Commitment to Health Equity Measure.