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Decrease Documentation

Errors of TPR Sheet at


the NeuroSurgery Ward of
Southern Philippines
Medical Center
Adenir , Angelie Dixil Fortugaliza, Ria
Bandala , Aize Mondragon ,
Dominique
Barriga , Henry Torno , Rizaluz
Zabala , Heidee Joy


Introduction
STEP 1 Reason for
Improvement
MULTIVOTING

A Proper donning of ICU watchers gowns
B Lack of suction machines
C Documentation Errors in TPR sheet
D Unrepaired electrical socket
E Inappropriate type of garbage bin
F Unrestricted implementation of visiting hours
G Inability to give prescriptions on time
H No emergency lights
I Presence of stray cats and pests
J Insufficient hand washing liquid/ soap
K Inadequate supply of personal protective equipment (PPE) per shift
L Need for continuous learning training/ updates on neurological assessment
M Usage of medication tray per patient for primary nursing approach
O Enhancement of NVS Assessment Form
Theme Letters Themes
L Need for continuous learning training/ updates
on neurological assessment
O Enhancement of NVS Assessment Form
C Documentation Errors in TPR sheet

TOP 3

Theme
Letters
Themes
Theme Selection Matrix

THEMES CUSTOMER(S)
IMPACT ON
CUSTOMERS
NEED TO
IMPROVE
OVERALL

RANK

Step 2 Current Situation
Proportion of Completeness of Medication sheet of Phil
health charts at Medical Ward for
First Quarter of 2007
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
Jan Feb March
Complete
Incomplete
Problem Statement:
From January 1 to March 31, 2007,
66% of medication sheet of Phil Health
patients charts at the Medical Ward of
Davao Medical Center were incomplete;
thus causing delays in PHIC claims and
reimbursement.
Target for Improvement:
By the end of December 31, 2007,
Incomplete medication sheet at the
Medical Ward will be reduced to 30%.
Incomplete
Medication
sheet
Nurse
Process
Materials
Step 3: Analysis
Step 4 Countermeasures
Action Plan
Problem Statement:
From January 1 to March 31, 2007, 66% of medication sheet of Phil Health
patients charts at the Medical Ward of Davao Medical Center were
incomplete; thus causing delays in PHIC claims and reimbursement.
Target for Improvement:
By the end of December 31, 2007, Incomplete medication sheet at the
Medical Ward will be reduced to 30%.


Counter-
measures
Practical
Methods
Tasks Resources Who
Does
Start
Date
End
Date
How
Done
Compliance
with
Standards
Of nursing
Practice on
docu-
mentation


Re-
orientation
Seminar on
docu
mentation
Every
Other
month

Prepare
Training
materials

Visual
aids
On
Standards
of
Nursing
Practice
Hosp.
Guidelines
and
policies

Vilma L.
Comoda,
Elizabeth
Barriga,
Lani Paler,
Charito
Barga-
mento,
Christine
Aquino

Aug. 15,
2007

July 15
2008
Coordinated
with
Training
office and
assistant
chief nurse
For schedule
Of staff

Step 5 Results
Proportion of Completeness of Medication sheet
of Phil health charts at Medical ward in 2007
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
J
A
N
M
A
R
C
H
M
A
Y
J
U
L
Y
A
U
G
O
C
T
D
E
C
COMPLETE
INCOMPLETE
I
N
T
E
R
V
E
N
T
I
O
N
BEFORE AFTER
----------------------------------------------
Target 30%
Step 6 Standardization
Step 7 Future Plans