ANSWER:
Dashboard Analysis and Nursing Plan
Health care organizations continue to evolve rapidly and becoming competitive. They are driven by the need to offer quality and cost-effective patient care. It helps them in sustaining customer satisfaction. To gain a competitive advantage: facilities can make day to day adjustments on how they conduct their patient care. It is acquired through data collection and analysis of the organization’s performance and customer gratification. Dashboards are evidence-based practice tools used to analyze the collected data and lead to improved decision-making.
The National Database of Nursing Quality Indicators (NDNQI) is a nursing database of the American Nurse Association used to collect and evaluate nursing care at the unit level (Waugh & Bergquist-Beringer, 2020). It is used by facilities in the United States to compare their performance against the regional, national, and state progression. NDNQI is nurse-sensitive in that it encourages the importance of the patient-nurse relationship. It shows the effect that nurses have on patient safety and quality care. It has also been rated to be the best in the United States. The purpose of this paper is to examine the sample dashboard provided, to identify the areas that need improvement, and come up with a nursing plan.
Analysis of Data
The dashboard being evaluated is the Nurse- Sensitive Quality Indicators for Adams 5 in the patient Rehab Unit. It depicts three aspects of nursing care, namely; structural indicators, processes, and outcomes. The dashboard is an analysis of four quarters; Q2FY09, Q3FY09, Q4 FY09, and Q1FY10. It consists of the NDNQI data, the Unit-specific-indicators, general indicators, and patient satisfaction survey indicators. Additionally, the dashboard shows the areas that need improvements such as %PRSSULC, %AGNCYHR, %AQPRULC, %RSK&PROT, TOTFALLS, and %CERT. This paper selects pressure ulcers (%PRSSULC) as the nurse-sensitive quality indicator needing improvement.
Pressure ulcers are a significant issue in healthcare organizations with considerable morbidity in the medical fraternity (Pereira et al., 2019). They are defined as sores in the skin or underlying tissues that occur due to long term pressure. Bedridden patients mainly develop sores. It’s approximated that 3 million adults are affected by pressure ulcers. Pressure ulcers harm the quality of the patient’s healthcare and are costly for healthcare facilities to manage.
Nursing Hours Per Patient Day (NHPPD) met performance goals with a slight increase of NHPPD by 0.04% in the fourth quarter. Registered Nurse Care hours and %BSN met performance goals in all the quarters. The Agency Nurse Hours (%AGNCYHR) did not attain performance goals in three quarters. Out of the four quarters analyzed in the dashboard, only one quarter met patients’ performance target with pressure ulcers (%PRSSULC). Only two quarters managed to meet the target of %AQPRULC. %PRSRSKA (point-prevalence assessment), shows a 39% increase. The number of TOTALFALLS and %RSK&PROT failed to meet the performance target by 75% and 20%. As observed %CERT performance decreased consistently but had an increase in the Q1 FY10.
In the Unit-Specific Indicators, the FIM bowel, met the performance in all the quarters while the FIM bladder failed to meet the performance goals in three quarters. There was 1 or 2 Mislabeled Sp in the second, third, and fourth quarters under the General Indicators. Besides, the length of stay (LOS) met all the measured target goals in the quarters.
The Nurse Sensitive Patient Satisfaction Survey Indicators show the RN Courtesy hit the target goals in all the quarters. Promptness failed to meet the target goals in three of the quarters. Attn Spc Needs and Response Pain also showed 75% non-met targets. Instruct Home and Care Well Coord only met the goal in two of the quarters.
Nursing Plan
Pressure ulcers, commonly known as bedsores, are caused by continuous pressure exerted on the skin. It is estimated that 4-10% of patients admitted to hospital developed a pressure ulcer. Individuals of all ages can develop it; however, the figure can be high for older people experiencing mobility issues. There are different categories of pressure ulcers according to the patient’s injury. Pressure ulcers can cause long term pain and distress to patients extending their stay in the hospital. This can be costly to healthcare providers as it consumes both time and finances.
Bearing in mind that healthcare organizations have nursing staff shortages, pressure ulcers can be relatively substantial to manage as it consumes time for healthcare providers. There is a lack of proper management and care plan for handling pressure ulcers. Healthcare facilities need to place preventative measures to improve performance outcomes (Finkelman, 2020). The measures include the use of pressure-reducing mattresses and managing adequate nutrition by giving a high protein diet. It applies to stage I through III of pressure ulcers. The wound healing process is quickened by wet dressing and the use of hyperbaric oxygen treatments.
Taking such preventative measures ensures that patients are ulceration free during their hospitalization period. In case of a pressure ulcer occurrence, the healthcare providers make appropriate assessment and management of the damage. Stage IV of pressure ulcers requires surgical interventions. The role of nursing care is an integral part of pressure ulcer management and treatment.
Pressure ulcers are commonly classified according to the depth of the tissue damage. It is required that all incidents above stage 2 be reported. Practitioners need to have knowledge and understanding in differentiating other skin lesions from pressure ulcers. According to Pereira et al. (2019), the new pressure ulcer reference tool placed at the patients’ bedside can be used to grade and describe the level of tissue damage and severity.
Evidence-based practices
Effective treatment of pressure ulcers requires healthcare providers to use evidence-based guidelines that incorporate clinical expertise and scientific evidence (Grove & Gray, 2018). The nursing plan is supported by the following guidelines; patient preference, clinical expertise, and education-awareness. To provide high-quality care, it is important to consider the patient’s preferences and needs. Since evidence-based practice is based on research, caregivers should research the medical conditions the patients have. The practitioners should consider the patient’s decisions and opinions towards the form of medication and treatment. It is the primary responsibility of nurses to prevent and treat pressure ulcers. They need to have a vast knowledge of using various instruments and measures. Additionally, there needs to be a proactive awareness campaign for the prevention and treatment of pressure ulcers. It is achievable through staff education and local events and campaigns.
Conclusion
Despite the continued prevalence of pressure ulcers in healthcare facilities, it has a variety of treatment solutions. Proper assessment and management would improve its performance goals and lead to quality patient care. Evidence-based guidelines must be: established, practised, and disseminated throughout the healthcare practice to eradicate the dominant occurrence of pressure ulcers. The National Database of Nursing Quality Indicators reflects the patient care offered and quality outcomes. It helps in identifying the areas of improvement and creating an effective action plan.
References
Finkelman, A. (2020). Quality improvement: A guide for integration in nursing. Jones & Bartlett Publishers.
Grove, S. K., & Gray, J. R. (2018). Understanding nursing research E-book: Building an evidence-based practice. Elsevier Health Sciences.
Pereira, S., Fonseca, J., Almeida, J., Carvalho, R., Pereira, P., & Simoes, R. (2019). Embedded textile sensing system for pressure mapping and monitoring for the prevention of pressure ulcers. Proceedings of the 12th International Joint Conference on Biomedical Engineering Systems and Technologies. https://doi.org/10.5220/0007690802910296
Waugh, S. M., & Bergquist-Beringer, S. (2020). Methods and processes used to collect pressure injury risk and prevention measures in the national database of nursing quality indicators® (NDNQI®). Journal of Nursing Care Quality, 35(2), 182-188. https://doi.org/10.1097/ncq.0000000000000428
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QUESTION:
Assignment: Dashboard Analysis and Nursing Plan
As Dr. Rempher and Ms. Manna discussed this week, data from the NDNQI is used to improve nursing practices and support the strategic outcomes of an organization. This data is also used to create the Dashboard. The Dashboard, then, is used to create an action plan. Correctly interpreting information presented on the Dashboard provides nurses with a better understanding of the goals of the action plan.
To prepare
For this Assignment, use the Dashboard located in this week’s Resources, to interpret the data and frame a nursing plan based on best practices.
Review the Week 5 Assignment Rubric, provided in the Course Information area.
Review the Week 4 Resources that pertain to the NDNQI and use of dashboards
Choose a Nurse-Sensitive Quality Indicator that needs improvement based on the data presented in the Dashboard. Reflect on how you would develop a nursing plan with suggestions on how to improve performance in the chosen area.
Develop a nursing plan that outlines suggestions on how to improve performance in the chosen area.
Provide at least three best practices from evidenced-based literature to support your nursing plan.
Assignment
Draft a 3- to 4 page paper analyzing areas where there is good performance and areas of opportunity from the sample Dashboard.
Analyze the data provided in the Dashboard and select an area of performance that needs improvement. Include information on why this area was chosen.
Develop a nursing plan that includes suggestions on how to improve performance on the selected indicator. Be sure to provide at least three best practices from the evidenced-based literature to support your suggested nursing plan.
