Abstract
Session presented on Saturday, July 23, 2016 and Sunday, July 24, 2016:
Project Purpose and/or Objectives: We have leveraged technology in the data collection for NDNQI and quality improvement projects surrounding pressure ulcer prevention, documentation, and education. The electronic medical record (EMR) has aided with data collection for the determination of the prevalence of hospital acquired pressure ulcers with the use of the EMR technology.
Background and Significance: Pressure ulcer prevalence and incidence rates are highest in those receiving palliative/hospice care, spinal cord injuries, critical care and for long term care. It is important to distinguish pressure ulcers that are present on admission from those pressure ulcers that have been hospital acquired. HAPU are a measure of nursing quality and are reportable to multiple sources in comparing quality and safety. Early identification of individuals at risk and early interventions are essential for maintaining goals for prevention and management.
Methods: We established a process in the EMR, to have a best practice act (BPA) added to the EMR admission process in order to identify patients who were admitted with pressure ulcers. Before the BPA was instituted as a mandatory field, the data collected from this field showed 5-pressure ulcers/week-- present on admission. Once the mandatory BPA was instituted the reported pressure ulcers present on admission was 35-50 pressure ulcers/week. We reviewed the choices for documentation in the EMR and defined the information to be collected from EMR. The data collection points were set for computer extraction for every patient for the designated NDNQI data collection date. The set data collection points (documentation) were extracted: a) skin assessment, b) pressure ulcer risk assessment, c) risk assessment scale and scores, and d) all of the defined interventions that were documented according to set parameters. Measurement tools and research data collection was used to involve staff in siloed areas. Staff were involved in data collection and deciding new interventions. All measured data outcomes were shared with staff using photos and graphs.
Results/Outcomes: Early identification of patients with pressure ulcers present on admission Efficient data collection (work hours and associated RN pay) as compared to manual abstraction of the data Data abstracted was more reliable and accurate We had immediate access to the outcome data We were able to perform 'just-in-time' education to units to improve the documentation and quality of care.
Conclusion: The measurement of the HAPU prevalence and incidence allows organizations to monitor patient outcomes for comparison over time and between institutions. Using the EMR for data collection (NDNQI, CalNOC surveys) enhances the reliability and accuracy of the measurement of the risk and the interventions associated with the prevention of pressure ulcers.
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
N/A
Research Approach
N/A
Keywords:
HAPU, Quality and Safety, Measurements and Methods
Recommended Citation
Kirkland-Kyhn, Holly, "Using technology to improve quality: A HAPU Project" (2016). INRC (Congress). 81.
https://www.sigmarepository.org/inrc/2016/posters_2016/81
Conference Name
27th International Nursing Research Congress
Conference Host
Sigma Theta Tau International
Conference Location
Cape Town, South Africa
Conference Year
2016
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record.
All permission requests should be directed accordingly and not to the Sigma Repository.
All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Acquisition
Proxy-submission
Using technology to improve quality: A HAPU Project
Cape Town, South Africa
Session presented on Saturday, July 23, 2016 and Sunday, July 24, 2016:
Project Purpose and/or Objectives: We have leveraged technology in the data collection for NDNQI and quality improvement projects surrounding pressure ulcer prevention, documentation, and education. The electronic medical record (EMR) has aided with data collection for the determination of the prevalence of hospital acquired pressure ulcers with the use of the EMR technology.
Background and Significance: Pressure ulcer prevalence and incidence rates are highest in those receiving palliative/hospice care, spinal cord injuries, critical care and for long term care. It is important to distinguish pressure ulcers that are present on admission from those pressure ulcers that have been hospital acquired. HAPU are a measure of nursing quality and are reportable to multiple sources in comparing quality and safety. Early identification of individuals at risk and early interventions are essential for maintaining goals for prevention and management.
Methods: We established a process in the EMR, to have a best practice act (BPA) added to the EMR admission process in order to identify patients who were admitted with pressure ulcers. Before the BPA was instituted as a mandatory field, the data collected from this field showed 5-pressure ulcers/week-- present on admission. Once the mandatory BPA was instituted the reported pressure ulcers present on admission was 35-50 pressure ulcers/week. We reviewed the choices for documentation in the EMR and defined the information to be collected from EMR. The data collection points were set for computer extraction for every patient for the designated NDNQI data collection date. The set data collection points (documentation) were extracted: a) skin assessment, b) pressure ulcer risk assessment, c) risk assessment scale and scores, and d) all of the defined interventions that were documented according to set parameters. Measurement tools and research data collection was used to involve staff in siloed areas. Staff were involved in data collection and deciding new interventions. All measured data outcomes were shared with staff using photos and graphs.
Results/Outcomes: Early identification of patients with pressure ulcers present on admission Efficient data collection (work hours and associated RN pay) as compared to manual abstraction of the data Data abstracted was more reliable and accurate We had immediate access to the outcome data We were able to perform 'just-in-time' education to units to improve the documentation and quality of care.
Conclusion: The measurement of the HAPU prevalence and incidence allows organizations to monitor patient outcomes for comparison over time and between institutions. Using the EMR for data collection (NDNQI, CalNOC surveys) enhances the reliability and accuracy of the measurement of the risk and the interventions associated with the prevention of pressure ulcers.