In this assignment you will apply the COPA model competencies and Benner’s Levels of proficiency to five nursing experiences

Directions

Inspect the COPA Model eight core competencies and sub skills. Review your reflective thinking, critical thinking and Benner assignments to identify the COPA Model competency and sub skills that you met in the experiences you described in each of these assignments

Explain why you believe you met the competencies and sub skills you identified. Use Benner’s stages of Clinical Competence to identify your level of proficiency in each of the five experiences you described in the three assignments. These include the reflective thinking experience, critical thinking experience and the three experiences you include in your Benner competency assignment

Use Benner’s criteria to provide a rationale for the level of proficiency you believe you demonstrated in these experiences.

Use the COPA model assessment synthesis APA template for this paper

Development of Chassis and Steering System for a Narrow Track Rapid Response Vehicle under Traffic Congestion Conditions

Introduction

The aim of the current task is to develop a comprehensive plan for improving patient care in relation to the chosen indicator in assessment 2. My chosen indicator in the previous task was Surgical Site Infections, as such; this task will focus on the creation of a plan to improve patient care in relation to Surgical Site Infection. The paper will give a detailed description of the quality indicator and a discussion on the use of the indicator in evaluating care in a given healthcare setting. The chosen indicator is also used in solving a clinical problem using the PDSA quality cycle.

Patient safety indicators

Background Information

Patient safety indicators refer to a set of indicators that give information on the probable in-hospital hurdles or adverse effects following a medical procedure, surgeries or childbirth. The patient safety indicators are essential since they enable the hospital management to determine possible adverse events that may require further diagnosis, or avail opportunity for the assessment of the potential hazardous in-hospital incidences.

Surgical Site Infection is one of the patient safety indicators. According to Presley (2015) Surgical Site Infection is a kind of quality standard that is associated with infection of a surgical incision site. After a surgical procedure, there is a chance that infection can occur within 30 days of the operation and involve only the subcutaneous tissue of the incision area. On the other hand, the infection can also occur within 30 days of the surgical process (if no implant is put in place) and involve the deep soft tissues.

Regardless of the variance in the identified surgical site infection, if left untreated, surgical site infection can result in significant mortality and morbidity. In their report Octuers (2017) have stated that surgical site infections account for more than 16% of the in-hospital associated infections. The surgical infection rates also vary depending on the procedure conducted. For instance, the rate of surgical site infection is higher (more than 10%) for large bowel surgeries and relatively lowers (less than 1%) for orthopaedic procedures. In the event that an infection occurs at the surgical incision site, proper and appropriate treatment and care will minimize the probable morbidity likely to arise from the infection, as such, improving care in relation to Surgical Site infection is therefore important in any assuring quality care to the patients.

Causes of surgical Site Infection

Surgical site infection occurs as a result of the patient’s bacterial composition. The imbalance observed between the pathogenic organisms and the defense mechanisms of the said patient gives an opportunity for the bacteria to invade the wound. A number of factors including, the health status of the patient, clinical intervention strategies or the physical environment of the patient can fuel the development of surgical site infections. Nevertheless, Treawn (2016) has pointed out that a significant number of surgical site infections are as a result of individual risk factors and the patient’s health status. The role exhibited by the surgeon and the caregiver is critical in evaluating the individual factors that are likely to fuel the occurrence of surgical site infection.

Patient related risk factors including conditions of poor nutritional status, diabetes mellitus, smoking, alcoholism or advanced age can reduce the host-defence mechanism. Nutritional status is critical to wound healing following a surgical operation. Similarly, obesity alcoholism or smoking delays would heal thereby promoting the occurrence of site infection. Smith (2009) has indicates that smoking is specifically harmful to any wound healing process. Apart from interfering with the oxidation of the wound, it also affects perfusion thus enhancing the chances of Site infection. The identified individual factors therefore have a significant contribution towards the development surgical site infections.

Intraoperative factors, such as the operative characteristics, surgical attire and preoperative activities are also associated with the occurrence of surgical site infection. A number of studies have examined whether the use of surgical caps, shoe covers and masks will lower the cases of surgical site infection. While there has been no tangible evidence to equate the same to the increasing cases of surgical site infection, it is observes that increase in foot traffic through the operation room, leads to an enhanced microbial levels causing an infection.

Preoperative operations such as antiseptic showering, hair removal and patient or surgeon skin preparations are associated with the occurrence of surgical site infection. A randomized controlled trial test that involved more than 10000 patients examined in the year 2007, revealed that bathing with antiseptic prior to an operation reduces the chances of getting surgical site infection. Similarly, numerous randomized control trials conducted to examine the role of preoperative hair removal on operative site infection, revealed that lack of hair reduces the possibility of developing post operative infection. The surgical site infection risk does not only occur from exposure to the patient’s natural flora, but also the surgical staff and the surgeon. As such, forearm antisepsis by the surgeon, as well as proper preparation of the patient’s skins is mandatory in preventing surgical site infections. Failure to remove the organisms on the patient’s or the surgeon skin surface will definitely cause post operative infection.

Based on the information drawn from literature, I have identified three major causes or surgical site infections. Patient’s risk factors, preoperative and clinical intervention practices and the physical environment of the patient are the major causes of surgical site infection. While the patient’s risk factors, such as the nature of the wound, other historical health and nutritional conditions, may have significant contributions towards the development of post operative infections, the role of the surgeon and the operative team by failing to adhere to the recommended guidelines and recommendations will also have significant role in contributing towards the occurrence of surgical site infections.