AFT Task 4: Periodic Performance Review

Accreditation Audit Case
Introduction
The accreditation process is designed to assist healthcare establishment to identify and enhance the patient’s safety and the quality of service delivery. This paper presents a review of the readiness Nightingale Community Hospital for accreditation audit. The paper comprises of a periodic performance review of the establishment. The review has focus of several priority areas. These areas include; assessment and care; quality improvement; patient safety, and staffing effectiveness. Trend within the hospital indicates the Nightingale has made significant progress towards fulfilling the standards of the Joint Review Commission. However, the trends in staffing …show more content…

HAIs refer to infections that the patient acquires as a result of a medical procedure (WHO, 2010). These infections mainly originate from poor hygiene, inadequate infrastructure, inefficient procedures and understaffing (WHO, 2010). Thus, hospitals need to evaluate these areas in order to prevent these infections. Nightingale has made significant progress in terms of minimizing healthcare associated infections.

However, Nightingale hospital has failed to comply with a number of joint commission standards. One the standards that the hospital has failed to comply with is maintenance of a safe staffing level. Joint commission standard requires hospital to maintain a reasonable staffing level. This is because studies indicate that the there is a direct correlations between staffing levels and patients safety (Liang and Chen, 2012). The staffing level should reflect the number of patients in the hospital, as well as, the needs of the patients. Nightingale hospital has also failed to comply with some of patient assessment standards. Joint commission standards require hospital to have assessment plans that reflect patient needs. However, Nightingale hospital does not have a multidisciplinary plan for patient assessments. Nightingale’s assessment processes are incapable of delivering custom crafted solutions to the patients needs.

Non Compliant Trends
Several trends limit Nightingale Community