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Questions and Answers
What does HCAHPS stand for?
Hospital Consumer Assessment of Healthcare Providers and Systems
Public reporting of HCAHPS results does not create any incentives for hospitals.
False
What is Magnet Status?
An award for quality patient care, nursing excellence, and innovations in nursing practice
Which organization has set international quality standards known as ISO 9000?
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What is the responsibility of every technician in the Central Service department?
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CS technicians should check their work for ______ to ensure quality.
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Attaining CS certification is optional for technicians.
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Match the following Zones with their requirements:
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What should be done if a wrapper or instrument has fallen on the floor?
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Quality improvement processes involve every employee in the CS department.
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Employees must follow established ______ for safety.
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What is the purpose of hemostats in surgical procedures?
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What do scissors do in surgical procedures?
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What is the role of retractors during surgery?
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What should CS technicians ensure regarding quality levels for their products and services?
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How does a successful CS department impact healthcare professionals?
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What dramatic consequences can lack of quality have in healthcare?
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What must top-level administrators do to emphasize quality?
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What does empowerment in a CS context involve?
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What must managers provide to empower their employees?
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What does FMEA stand for?
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What is the goal of the root cause analysis (RCA)?
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What major quality assurance program is focused on reducing defects in processes?
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Which of the following is a method used to analyze quality issues?
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What does TQI stand for?
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Match the following quality programs with their definitions:
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Study Notes
Introduction
- Central Service (CS) professionals are responsible for establishing and maintaining quality standards for products and services.
- Quality products and services impact patient outcomes and the success of healthcare facilities.
- CS technicians serve internal customers (physicians, nurses, and other professionals) and need to meet their needs to ensure patient care.
Components of Quality
- Achieving world-class quality requires a multi-year plan and commitment from top-level administrators.
- Quality should be multidisciplinary and intradepartmental, involving all CS professionals and a cross-section of customers.
Empowerment
- Empowering employees to make decisions within defined areas can improve process efficiency.
- Managers must provide training on empowerment and encourage idea sharing.
Leadership
- Committed leaders are essential for managing data, planning opportunities, establishing priorities, and empowering employees.
- Leaders define quality standards that drive strategies to address customer satisfaction and facility goals.
- All staff members should adhere to standards and priorities set by senior managers.
Standard Data
- Departments must select data for monitoring quality processes.
Planning Tools and Procedures
- Quality planning involves studying other facilities and identifying ideal processes.
- Steps of quality planning include:
- Identifying customer needs and requests
- Identifying ideal processes
- Comparing actual steps and outcomes to ideal outcomes
- Planning process control activities
- Measuring errors
Staff Members
- All staff members must be fully engaged in the quality program.
- Employees should be empowered to address immediate problems and participate in problem-solving projects.
Process Management
- Studying processes is crucial because process problems cause errors.
- Processes commonly studied for improvement include:
- Instrument set turnaround times
- Instrument set accuracy
- Surgical case cart accuracy
- Inventory fill rates
Quality Control Indicators
- Indicators help determine how well the department is meeting its objectives.
- Examples of CS quality indicators include:
- Customer departments receiving STAT supplies within five minutes
- Availability of sterile supplies with current dates on unit supply carts
- Acceptable sterilization processes based on physical, chemical, and biological indicator results
- Instrument sets containing clean, functional, and correct contents
- Availability of patient care equipment and supplies in proper working condition
- Availability of instruments for scheduled procedures
- Biological indicators accompanying every load requiring biological monitoring
- Case carts containing correct contents
Analysis of Quality
Failure Mode and Effects Analysis (FMEA)
- FMEA is used to identify and prevent problems with products and processes before they occur.
- Involves defining a topic, assembling a team, identifying potential hazards and causes, and identifying actions and outcomes for each potential problem.
Root Cause Analysis (RCA)
- RCA is a reactive process used to analyze adverse outcomes and prevent recurrence.
- Involves examining contributing factors to adverse events and determining how to prevent recurrence.
Quality Program Alternatives
- Many departments utilize quality assurance programs to ensure consistent quality.
Total Quality Improvement (TQI)
- TQI involves measuring current output and modifying processes to increase output, efficiency, and effectiveness.
Continuous Quality Improvement (CQI)
- CQI is a statistical method to improve work processes, involving input from all stakeholders.
Total Quality Management (TQM)
- TQM is an organization-wide approach based on participation, aiming for long-term success through customer satisfaction.
Six Sigma
- Six Sigma focuses on delivering high performance, reliability, and value to the end customer.
- Strives to eliminate variations in products and processes to prevent defects.
- Uses DMADV (define, measure, analyze, design, and verify) for new processes and DMAIC (define, measure, analyze, improve, and control) for existing processes.
Lean
- Lean focuses on preserving value with less work (eliminating waste).
- Eliminating wasteful processes reduces production time and costs.
Quality at Work
- Active participation in quality processes ensures solutions are workable.
- Examining processes and identifying opportunities for improvement is essential.
Quality Programs and Standards
- External agencies impact quality efforts in healthcare facilities.
- CS technicians should be familiar with requirements from:
The Joint Commission (TJC)
- TJC accredits healthcare facilities and ensures quality standards are met.
- Sets health and safety program requirements for patients and staff.
- Requires reporting and investigation of sentinel events.
The Centers for Medicare & Medicaid Services (CMS)
- CMS focuses on quality in healthcare, patient safety, and security.
- Conducts surveys to ensure industry standards and regulations are being followed.
National Committee for Quality Assurance (NCQA)
- NCQA assists facilities in identifying quality goals, measuring them, and promoting improvement.
Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS)
- HCAHPS is a standardized survey tool used to measure patient perception of their hospital experience.
- Goals of HCAHPS include:
- Allowing meaningful comparisons of hospitals
- Creating incentives for hospitals to improve quality of care
- Enhancing accountability in healthcare
Value-Based Purchasing (VBP)
- VBP initiatives compare HCAHPS scores to penalize facilities not reaching goals through reduced government reimbursement.
Magnet Status
- Magnet status is awarded to hospitals by the American Nurses Credentialing Center for quality patient care, nursing excellence, and professional nursing practice.
International Standards Organization (ISO) 9000
- ISO 9000 is an international standard used by companies to ensure their quality system is effective.
- Aims to guarantee consistent delivery of quality services and products.
Quality Central Service Procedures
- Attaining and maintaining high quality CS standards is everyone's responsibility.
- Technicians should play an active role in the department's quality program and report others who are struggling with processes.### Central Service Audits
- Outside departments, like Safety or Infection Prevention and Control, can perform audits.
- CS staff can also perform audits, or a combination of both.
- Technicians are valuable for audits due to their familiarity with the environment and processes.
Department Policies, Procedures, and Protocols
- Developed to ensure safety of all CS department members and product quality.
- Non-compliance can lead to lower-quality products, potentially harming patients.
Technology and Quality Control
- Advancements in technology improve work checking capabilities.
- New products for residual blood and protein checks, lumen cleanliness, and processing equipment functionality.
- Technology is essential for ensuring quality with complex instrumentation.
Quality Improvement
- CS technicians should actively participate in quality improvement projects.
- Their in-depth department knowledge makes them vital in identifying and resolving problems.
Survey Readiness
- Each member of the CS team is responsible for keeping the department prepared for TJC and CMS surveys.
- Maintaining cleanliness, following established practices, and knowing safety and disaster processes is a year-round requirement.
Teamwork and Collaboration
- Team members should assist and accept help from colleagues.
- Seek guidance when expertise is lacking and provide assistance to those in need.
Certification
- Certified technicians understand the scientific basis for procedures.
- This knowledge ensures consistent quality due to correct practice execution.
Quality Standards in Central Service
- CS professionals are expected to consistently meet desired quality standards.
- They play a crucial role in implementing quality within their facilities by following instrument procedures.
- Collaboration with the entire healthcare team is essential for achieving the highest quality of patient care.
Quality Processes: Decontamination Zone
- Always wear personal protective equipment (PPE) to protect oneself, other staff, and patients.
- Disassemble items for thorough cleaning.
- Measure chemicals accurately to ensure effectiveness.
- Operate equipment properly to guarantee efficient cleaning.
- Follow written procedures for cleaning and disinfection, referencing manufacturer's Instructions for Use (IFUs).
- Check processing equipment before use to ensure it is operational.
Quality Processes: Preparation and Packing Zone
- Inspect wrappers and disposable filters for holes before sterilization.
- Discard any wrapper, filter, or instrument dropped on the floor and re-clean the instrument.
- Utilize FDA-approved wrappers, containers, and sterilization methods.
- Follow count sheets for case carts and instrument counts.
- Verify instrument functionality, cleanliness, alignment, assembly, and sharpness.
Quality Processes: Sterilization Zone
- Load sterilizer carts according to training to prevent wet or non-sterile loads.
- Set appropriate sterilizer parameters (temperature, exposure, and dry time) based on load contents.
- Verify physical and chemical indicators after sterilization to ensure proper process completion.
- Do not touch sterilized items until cool.
- Complete all documentation, including load, biological, and implant logs.
Quality Processes: Storage and Distribution Zone
- Adhere to established pick sheets to ensure all items are collected and delivered.
- Maintain clean and dry transport and case carts.
- Inspect product packaging for integrity, expiration dates, and indicator color changes.
All Central Service/Distribution Zone
- Maintain focus on the task at hand, avoiding distractions to prevent errors.
- Inform others if asked to perform a task for which training is lacking.
- Seek verification if unsure about a completed project to avoid errors.
- If distracted, double-check the entire project for accuracy.
- Avoid starting projects that cannot be completed to a high standard or will require someone else to finish them.
- Recheck all completed work to minimize incidents.
- Maintain orderliness in the work area.
- Assist and accept help from colleagues.
- Report any inoperative or damaged equipment promptly.
- Attend relevant educational programs and seminars to enhance skills and knowledge.
- Always adhere to departmental policies, procedures, and protocols to protect staff and patients.
Quality: A Shared Responsibility
- All employees are responsible for maintaining quality.
- Motivation and knowledge are essential for producing and delivering high-quality products and services.
Conclusion
- Quality is paramount in the healthcare environment and should be at the core of Central Service operations.
- Attention to policies, procedures, participation in quality projects, and teamwork are essential for ensuring optimal CS outcomes.
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Description
This quiz covers the importance of quality standards in Central Service (CS) roles within healthcare. It discusses the impact of quality products and services on patient outcomes and emphasizes the necessity of leadership and employee empowerment in achieving high standards. Test your understanding of these key elements and their relevance to healthcare success.
