Nov 4, 2019
No Blind Sticks: Vital Element to a Patient-centric Care Model
The Patient-centric Care Model is a concept that has
been evolving over the past three decades.
In 1985, professors Irwin Press, PhD and Rod Ganey, PhD brought the
science of sound survey design to healthcare through patient satisfaction
surveys. Hospitals began receiving
financial incentives for participating in Hospital Consumer Assessment of
Healthcare Providers and Systems (HCAHPS) in 2007 as part of the Deficit
Reduction Act of 2005. The Affordable
Care Act of 2010 raised the patient satisfaction bar even higher when hospital
Medicare reimbursement became directly tied to HCAHPS survey results. The voice of the patient is more powerful
than ever in driving best practices for healthcare.
Patients routinely express dissatisfaction with needle
puncture procedures. Common
dissatisfiers include multiple punctures, unsuccessful puncture attempts and
pain associated with the procedure. Complications
of blood collection may include hematoma(s), phlebitis, air embolism,
thrombosis, compartment syndrome, excessive bleeding and nerve damage. Drawing blood is the single most frequently
performed invasive procedure in United States’ hospitals. “Roughly 760 blood draws are performed every
minute,” (Behm and Dunn, 2016). Inpatient
blood draws occur nearly 500 million times a year in the U.S., offering 500
million opportunities to enhance patient experience and improve patient
satisfaction (Transforming Healthcare, 2107).
This idea extends on a 2017 article published in the
Journal of Patient Safety encouraging practitioners to utilize Point of Care
Ultrasound (POCUS) to help guide deep needle puncture procedures, “There is now
mounting evidence that clinician-performed POCUS improves patient safety,
enhances healthcare quality and reduces healthcare costs for deep needle
procedures. Furthermore, the
miniaturization, ease of use and the evolving affordability of ultrasound have
now made this technology widely available,” (Peabody and Mandavia, 2017). Utilizing POCUS to guide central venous
catheter (CVC) placement was recognized by the Agency for Healthcare Research
and Quality as one of the top eleven evidence-based best practices in 2001;
using POCUS as a visual tool was discovered to increase patient safety and
prevent complications. The application
of POCUS should be expanded to all needle puncture procedures including
phlebotomy, arterial punctures, arterial cannulations and peripheral
intravenous (PIV) catheter placements.
Adopting a No Blind Sticks initiative supports the transformation to a
Patient-centric Care Model.
Behm, S., Dunn, T. (2016). Blood draws:
a mandate to improve patient experience.
Hospital Review. Retrieved
Needle free blood draws possible during
hospital stays. (2017, November). Transforming Healthcare. Retrieved from https://intermountainhealthcare.org/blogs/topics/transforming-healthcare/2017/11/needle-free-blood-draws-possible-during-hospital-stays/.
Peabody, C.R., Mandavia, D.P.
(2017). Deep needle procedures: improving safety with ultrasound
visualization. Journal of Patient
Safety, 13(2), 103-108. doi: 10.1097/PTS.0000000000000110.
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