Handout Skin Cleansing

Document Sample
Handout  Skin Cleansing Powered By Docstoc
					                                                                                                                      6/11/2010




 Faculty of Medicine, Siriraj Hospital
       Mahidol University, Thailand.             Using Six Sigma Methodology
                                                   to Reduce the Number of
                                                 Patients with Skin Damage in
                                                     Incontinence Patient
                                           Yuwadee Kestsumpun ... PhD, APN, CETN
                                                    Quality Improvement Nursing Division, Siriraj Hospital Thailand
                                           Luerat Anuratpanich ... B.Sc. (Pharmacy), M.B.A. Six Sigma Certificate.
                                           Chulaphorn Prasungsit ... MS, APN, CETN
                       Good Afternoon      Malee Ngamprarsert ... MS, APN, CETN
                                           Vimalux Chaisakchatree ... MS, CETN




 What does Six Sigma mean?                 Six sigma methodology (DMAIC)
                                                  Define           Measure       Analyze      Improve     Control
                                                  Project                                                 Project
• A quality improvement methodology               charter
                                                                   Process Map    FMEA          DOE
                                                                                                          charter

  that applies statistics to measure and                              C&E        Multi Vari

  reduce variation in processes.                                     Initial
                                                                    Capability

• A management system that is                                         MSA

 comprehensive and flexible for                 Many Xs       Many Xs            Few Xs       Few Xs      Few Xs
 achieving, sustaining, and maximizing         (x1,x2,...xn) (x3,x4,x6,x7)       (x4,x7)      (x4,x7)     (x4,x7)
                                                   32X               12X
 success.

                                              Y=f(x1,x2,....xn)                                          Y=f(x4,x7)




                                                   Wound Decision Criteria
                 DEFINE                                     •     Class 0 : Normal Skin
                                                            •     Class 1 : Erythema
                                                            •     Class 2 : Broken Skin
                                                            •     Class 1 and 2 show a ‘Defect in Process’
Project Charter:
      Project Goal and Objective;
      Identify Team Member and Champion



                                                                Class 1                        Class 2




                                                                                                                             1
                                                                                                                                                           6/11/2010




                              Project Statement                                                                      MEASURE
Problem                             Skin damage cause by incontinence.                                • Focus on the process that needs to improve
Statement                           The consequence of skin damage is                                 • Decided what is the key input that has influence
                                    not only a cause of patient suffering                               on the project Y (Number of Skin Damage in
                                    which leads to dissatisfaction, but                                 Incontinence patient)
                                    also increases the cost of treatment.                             • Using Six Sigma tools:
                                                                                                            Process mapping
Objective                      •     Reduce the number of Skin Damage in
                                     Incontinence patient from 17 wounds per day to                         C&E Matrix (Cause and Effect matrix)
                                     10 wounds per day.                                                     MSA (measurement System Analysis) and
                                                                                                            Get Initial Capability.
                               •     Increase % patient satisfaction from 80% to 90 %




                                             Process map
Nurse awareness-knowledge
Nurse experience-skill
Patient compliance                                              Degree of Skin Damage
ET nurse knowledge                                              2 Treatment plan
ET nurse workload                                               3 …………………………
ET nurse experience-skill                   Assessment skin     4 …………………………
Workload of all nurse (No. of Pt./nurse)
Guideline for skin assessment
                                                                5…………………………
                                                                                                                      C&E matrix
Hospital policy
Severity of patient

Degree of skin damage
Treatment plan                                                  Skin irritation on reduction
Cleanser                                                        Shorten the time to contact foreign
Cleaning procedure                                              body
Skin Type                                      Clean skin       Clean skin
Cleansing material                                              4 …………………………
Cleansing technique                                             5…………………………
Patient compliance
9

Clean skin                                                      Excessive skin moisture reduction
Dry method                                                      Patient comfort
Dry equipment                                  Make it dry      3 …………………………
4                                                               4 …………………………

Selected product
                                                                Skin protection
Patient affordable
Reimbursement (insurance .ect)                                  Skin treatment
Product availability                                            3 …………………………
Patient knowledge                             Apply product     4 …………………………
Nurse product knowledge                                         5 …………………………
Nurse skill experience
Monitor frequency

Type of containment
                                                                Skin protection
Pt affordable
                                                                Exudate absorption
Product availability
Monitor frequency                           Add containment     3 …………………………
                                                                4 …………………………
Nurse skill and experience
Nurse product knowledge




Analyze Phase: Look for Root Cause and generate prioritized
                                                                                                                        Multi Vari
    FMEA (Failure Mode Effect Analysis)




                                                                                                                                                                  2
                                                                                  6/11/2010




        IMPROVE
                                        Improvement Result Conclusion
Incontinence Skin Care Guideline
                                      Clinical X        Stat Test    Result
                                          X2                         P=0.00
                                                        2 T-Test
                                   (Skill Experience)               Significant

                                          X4                        P=0.003
                                                        2 T-Test
                                   (Treatment Plan)                 Significant

                                          X5                         P=0.00
                                                        2 T-Test
                                    (Product Used)                  Significant




        CONTROL
                                                        Result
                                   • After control plan implementation, a
                                     great reduction in skin damage patients
                                     - from 17 to 2.4 wounds per day.

                                   • Patient satisfaction increased from 80%
                                     to 94.5%




    Thank You




                                                                                         3

				
DOCUMENT INFO
Shared By:
Categories:
Stats:
views:14
posted:7/3/2010
language:English
pages:3
Description: Handout Skin Cleansing