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Five year study research article about pressure ulcer prevention
Previous studies in prevention of pressure ulcer
Five year study research article about pressure ulcer prevention
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Today health care systems are expected to meet set standards and core measures to earn everything from accreditation and recognition to payment. Reports need to filled to accomplish this, as well as what is being done to improve areas that may not be meeting standards. One way this is done is by utilizing dashboards. The purpose of this paper is to analyze the data from a dashboard and develop a nursing plan for improvement of a low scoring area. Analysis of the Data The Centers for Medicare and Medicaid Services (CMS) have recently begun requiring hospitals to report to the public how they are doing on patient care. Brown, Donaldson and Storer Brown (2008) introduce and explain how facilities can use quartile dashboards to transform large amounts of data into easy to read and understandable tool to be used for reporting as well as to determine areas in need of improvement. By looking at a sample dashboard for an inpatient rehab unit a greater understanding of dashboards and their benefits can be seen. The sample dashboard includes four general areas, including nurse sensitive service line/unit specific indicators, general indicators, patient satisfaction survey indicators and NDNQI data. The overall performance was found to improve over time. There were areas with greater improvement such as length of stay, than others including RN care hours and pressure ulcers. The areas of pressure ulcers and falls did worse the final quarter and can be grouped under the general heading of patient centered nursing care. The area of patient satisfaction saw a steady improvement over the first three quarters only to report the worst numbers the final quarter. A facility then takes the data gathered and uses it to form nursing plan... ... middle of paper ... ...., Johnson, D., & Thomas, C. M. (2009). The sbar communication technique: teaching nursing students professional communication skills. Nurse Educator, 34(4), 176-180. Centers for medicare and medicaid services. (2011). Retrieved from https://www.cms.gov/center/quality.asp Ford, B. M. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. MedSurg Nursing, 19(3), 188-191. Merwin, E & Thornlow, D. (2009). Managing to improve quality: the relationship between accreditation standards, safety practices, and patient outcomes. Health Care Managment Review, 34(3), 262-272. DOI: 10.1097/HMR.0b013e3181a16bce Vanhook, P. M. (2009). Overcoming the barriers to ebp. Nursing Management, August, 9-11. The joint commission. (2011). Retrieved from http://www.jointcommission.org/national_quality_forum_nqf_endorsed_nursing-sensitive_care_performance_measures/
Not only does The Francis Report call for more compassionate care, but it also states that stronger leadership is required of all ward nurse managers. It also insists on a change with regards to the appraisal and support system for nurses. This appraisal system is a means of assessing the performance of nurses so that any shortcomings can be corrected through methods such as training and transfer. On the other hand, a positive assessment is to be rewarded by promotion.
State and federal regulations, national accreditation standards, and clinical practice standards are created, and updated regularly. In addition, to these regulations, OIG publishes a compliance work plan annually that focuses on protecting the integrity of the program, and prevention of fraud and abuse. The Office of the Inspector General examines quality‐of‐care issues in nursing facilities, organizations, community‐based settings and occurrences in which the programs may have been billed for medically unnecessary services. The Office of the Inspector General’s work plan for the fiscal year 2011 highlights five areas of investigation for acute care hospitals. Reliability of hospital-reported quality measure data, hospital readmissions, hospital admissions with conditions
Young, W. B., Minnick, A. F., & Marcantonio, R. (1996). How wide is the gap in defining quality care?: Comparison of patient and nurse perceptions of important aspects of patient care. The Journal of Nursing Administration, 26(5), 15-20.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
A clinical area of concern in the nursing discipline on 8 West orthopedics at Mount Carmel West is hourly patient rounding. Currently the nursing staff on 8 West does not do patient hourly rounding when providing patient care even thou the nursing manger has tried to implement hourly rounding. There have been many research studies that have shown that hourly rounding has improved patient outcomes and improved quality care nurses give to their patients. Hourly rounding can help address a potential patient problem before the problem occurs (Ford, 2010).
Utilizing this tool will allow The Restorative Nurse and Wound Nurse to generate a graph based off of the data retrieved from the Center of Medicare and Medicaid Services (CMS) quarterly Quality Measures Report (APPENDIX B). The Wound Nurse and Restorative Nurse will start with the last data reported before the start of the On-Time Project and then graph the data every three months during the On-Time Project for the following areas: falls, weight loss, in- house acquired pressure injuries and nosocomial infection. For that purpose, to monitor the effectiveness of the On- Time Project the Wound Nurse and Restorative Nurse will provide a designated share drive to present to the Director of Nursing and other stakeholders on a quarterly schedule at the quarterly Quality Assurance Improvement Program(QAIP)
Hourly rounding has been proven to be effective in many hospitals throughout the United States. With many hospitals, trying to improve their patient satisfaction scores implementing an hourly rounding program seems like the right way to go. Patient satisfaction will go up when the patient feels like they are being cared for. Checking on a patient once every hour will make them feel like there is concern for their well-being, which would help them ease their anxiety. In turn hourly rounding will reduce stress for nurses making for happier nurses who are more satisfied with their work and are capable of taking care of patients better. Hourly rounding is a positive situation for both the nursing staff and the patient and should be implemented as part of standard care in every hospital.
A clinical area of concern in the nursing discipline on 8 West orthopedics at Mount Carmel West is hourly patient rounding. Currently the nursing staff on 8 West does not do patient hourly rounding when providing patient care even thou the nursing manger on the unit tried to implement hourly rounding several times. There are numerous research studies done on hourly rounding and research has proven that hourly rounding has improved patient outcomes and improved quality care nurses give to their patients. Hourly rounding can help address a potential patient problem before the problem occurs (Ford, 2010).
Not only is professional communication important in the portrayal of a good nursing image and behaviour, it also plays a vital role in patient care and health outcomes. The ANMC standards serve as a good guidance on the need to establish therapeutic relationship through effective communication. As nurses spend relatively more time with patients, they play a significant role in bridging a patient and doctor. Hence, it is would help for nurses to constantly hone their communication skills through experience over time.
The purpose of this paper is to identify a quality safety issue. I will summarize the impact that this issue has on health care delivery. In addition, I will identify quality improvement strategies. Finally, I will share a plan to effectively implement this quality improvement strategy.
“Communication is the heart of nursing… your ability to use your growing knowledge and yourself as an instrument of care and caring and compassion” (Koerner, 2010, as cited in Balzer-Riley, 2012, p. 2). The knowledge base which Koerner is referring to includes important concepts such as communication, assertiveness, responsibility and caring (Balzer-Riley, 2012). Furthermore, communication is complex. It includes communication with patients, patient families, doctors, co-workers, nurse managers and many others. Due to those concepts and the variety of people involved, barriers and issues are present. Knowing how to communicate efficiently can be difficult.
Poor Communication between Physician and Nursing – To optimize nurse-physician communication both need to apply patient centered cultural change; in particular, to use structured communication tools such as Situation, Background, Assessment, Recommendation (SBAR), and supportive technology that is system wide, for example electronic medical record (EMR). (B. Schmidt, 2012).
In nursing practice, communication is essential, and good communication skills are paramount in the development of a therapeutic nurse/patient relationship. This aim of this essay is to discuss the importance of communication in nursing, demonstrating how effective communication facilitates a therapeutic nurse/patient relationship. This will be achieved by providing a definition of communication, making reference to models of communication and explaining how different types of communication skills can be used in practise.
Nurse staffing is a complex issue. There are many factors which need to be considered when staffing a nursing unit. Evidence shows an association between Registered Nurses (RNs) having decreased workloads and better patient outcomes, including a decrease in patient mortality (Aiken et al., 2011; Needleman et al, 2011; How Lin, 2013; Patrician et al., 2011; Wiltse-Nicely, Sloane, Aiken, 2013). A small percentage of patients expire during their hospitalization as evidence suggests that a portion of these deaths can be attributed to RN staffing levels (Shekelle, 2013). As the reimbursement system for hospitals today emphasizes quality outcomes, this has an increase in the importance of the nurse’s role in patient care (Frith, Anderson, Tseng, & Fong, 2012). The quality of care is effected when there are higher RN-to-patient ratios. Mortality rates can be decreased by 50% or more when there is a lower RN-to-patient ratio. The morale of nursing staff and the hospital’s reputation are effected when there is a large nurse turnover and poor patient outcomes (Martin, 2015; Knudson, 2013). Having adequate nurse staffing levels saves lives (Martin, 2015). The purpose
An activity report can provide operational statistics such as occupancy rate, average daily census, and average length of stay (Finkler, Jones & Krover, 2013). Though these numbers are important and have a great influence on the operational budget, a nurse leader needs more information in order to justify staffing. Nurse leaders can obtain additional information from workload reports. Patient classification system measure workload by assigning each patient a classification level based on his or her unique care needs and then determine the number of care hours required per patient per day. Many organizations express this in hours per patient day (HPPD) or relative value units (RVU) (Finkler et al., 2013). Workload reports are useful because they can identify changes in patient mix that can increase or decrease the need for nursing personnel. Bi-weekly fulltime equivalent (FTE) reports are also useful because they convey to nurse leaders exactly how many man-hours were used by each FTE (Liberty University, 2015). Furthermore, the report provides a breakdown of productive time; contract hours, paid time off (PTO), and overtime. It also accounts for nonproductive time such as time spent on education, training, and orientation (Liberty University,