solved. Question
Answered step-by-step
Asked by marcop2001
Nancy is an advanced practice nurse with expertise in wound, ostomy, and continence care in the surgical division of Mt. St. Elsewhere Hospital. She has been asked by her clinical director and the quality improvement director for the hospital to develop a strategy to address the increase in pressure injuries (formerly known as pressure ulcers) reported on the hospital’s recent quality scorecard. Data on pressure injuries are captured in what is abstracted from the patients’ charts, analyzed in an aggregate format, and displayed on a dashboard. In addition to hospital reporting, the hospital’s pressure injury rates are publicly reported and benchmarked with other hospitals in their state. Patients on Nancy’s units had a very high number of injuries, many of which were not documented on admission, suggesting that they occurred during the patients’ hospital stays. This finding is concerning from a quality of care perspective and financially because added hospital days and costs related to nosocomial pressure injuries are not billable to the Medicare program and other health insurance carriers. When determining the indicators to be measured to evaluate the
impact of a targeted pressure injury intervention, Nancy needs to consider the following questions:
1. Using the AHRQ criteria, how could Nancy be sure that the indicators selected to measure the impact of the pressure injury intervention are sound measures? In answering this question consider drawing up a list of potential explanations that reflect a real decline in quality of care related to pressure injury prevention on the surgical service or related to something other than quality of care.
2. What are the structure, process, and outcomes elements associated with pressure injury
incidence?
3. What would Nancy want to clarify about these data and how they were collected before getting too far into a discussion about next action steps?
4. If Nancy or her colleagues wanted to compare the division’s rates of pressure ulcers with
those of other units or hospitals (or even to last year’s figures), what cautions should be applied? Where would they go to find benchmarks?
5. Drawing on your background and/or a search of the Internet, what investment of resources could be allocated to change this situation?
6. How would Nancy and her colleagues know if the approaches in question 5 worked? What kinds of data would you suggest they gather?
SCIENCE
HEALTH SCIENCE
NURSING
NURS 4034
