NURS 4005 Week 5 Assignment: Dashboard Analysis and Nursing Plan

NURS 4005 Week 5 Assignment: Dashboard Analysis and Nursing Plan

NURS 4005 Week 5 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.

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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.
Be sure to include an introduction and conclusion in your paper.

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Dashboard Analysis and Nursing Plan

            National organizations such as the Joint Commission require healthcare organizations use quality assessment indicators to evaluate their performance of a healthcare organization. Compliance of a healthcare organization or provider’s performance with quality indicators indicates quality patient care. On the contrary, the failure of a healthcare organization or provider to meet the established national benchmark for quality reflects low-quality care. In such cases, the healthcare organization should improve the underperforming area to achieve high-quality care and positive patient outcomes. This analysis paper presents areas of good performance and performance areas that need improvement from the provided sample Dashboard, including suggestions for improving performance on the selected indicator based on three best practices.

Good performance and Areas of Opportunity from the Sample Dashboard

            The provided sample dashboard indicates areas of the organization that is performing well. The area of the healthcare organization performing excellently is the length of stay. The actual length of stay was less than the targeted throughout the entire period. For instance, the targeted length of stay for the second quarter of the 2009 financial year was 11.8 days. On the other hand, the actual length of stay for this period was 8.78 days. The actual length of stay was less than the targeted length by 3.02, indicating quality patient care. Therefore, this performance area gives the organization a competitive advantage over medical facilities located in the neighborhood.

Organizational Areas that Need Improvement

First, the organization’s total fall should be improved. The targeted total fall rate in the medical facility was 3.14 per 1000 patient days in the second quarter of the 2009 financial year. On the contrary, the actual total patient fall in the medical facility was 6.96 per 1000 patient days. The actual total patient fall rate is double the targeted proportion, indicating that the total fall rate in the organization is extremely high. A similar trend was reported in the fourth quarter of the 2009 financial year. The targeted total fall rate during this period was 3.14 per 1000 patient days, while the actual proportion was 5.97 per 1000 patient days. Lastly, the organization reported a similar trend in the first quarter of the 2010 financial year. The targeted total fall rate during this period was 3.14 per 1000 patient days. On the contrary, the actual rate of total patient fall in the medical facility during this period was 9.91 per 1000 patient days, which was almost three times higher than the targeted rate. Additionally, the actual total patient fall rate during the three periods was higher than the national benchmark for patient falls. According to, national benchmarks patient falls in the surgical, general medical, and medical-surgical units are approximately 3.44 falls/1000 patient days (Venema et al., 2019). Therefore, the high rate of patient falls during the three periods indicate underperformance in this practice area.

Suggestions on how to Improve Performance on Total Patient Falls

            The rate of actual patient falls was higher than the targeted rate in the second and fourth quarters of the 2009 financial year and the first quarter of the 2010 financial year. Additionally, actual total fall rates during the three periods were higher than the national benchmark for patient falls, which is 3.44 falls/1000 patient days (Venema et al., 2019). This trend increases the risk of adverse health outcomes, including longer hospital stays, high morbidity and mortality rates, high readmission rate, and high cost of healthcare services. According to Stevens and Lee (2018), patient falls imposes a huge economic burden on individual patients and their families, healthcare organizations, and the United States healthcare system. The overall cost of healthcare increases due to the extra cost incurred in treating fall-related injuries and health complications. For this reason, the healthcare organization should focus on reducing the high rate of total falls by adopting evidence-based interventions for fall prevention, including bed alarm systems, hourly rounding, and bed sitter.

Installing Bed Alarm System

             The bed alarm system is an evidence-based practice for preventing patient falls in healthcare organizations. According to LeLaurin and Shorr (2019), the prevalence of patient falls in inpatient units reduced substantially following the implementation of the bed alarm system. Most falls occur when patients are leaving the bed mostly to visit the washroom. For this reason, a bed alarm is installed beneath the bed of a patient at a high risk of falling. The alarm rings once the patient exerts much pressure while trying to leave the bed, sending a signal to the nurse on duty. The nurse then assists the patient to leave and return to bed, preventing him or her from falling. Hence, installing bed alarm systems will reduce the high rate of patient falls in the healthcare facility.

Hourly Rounding

            Purposefully hourly rounding is another evidence-based practice for preventing patient falls in medical and medical-surgical units. Rounding is a proactive and nurse-driven approach to achieving patients’ healthcare needs (Savage, 2020). It involves regular bedside checks mostly at an interval of one to two hours to monitor the patient’s progress and any need for help. The nurse on duty then provides the needed help such as assisting a patient to visit the washroom and return to bed or access personal properties. Consequently, the client’s need to leave the bed is addressed, reducing fall risk. Additionally, the nurse on duty checks the patient’s position during the rounding to ensure that he or she is not at risk of falling. Therefore, adopting hourly rounding will reduce the high prevalence of patient falls in the organization.

Bedside Sitter

            Sitting at the bedside prevents falls among patients at a high risk of falling, including patients with a fall history and those with newly altered mobility. Patients with a history of falls at home or in hospital are at a high risk of falling again (Cuttler et al., 2021). For this reason, healthcare facilities should take appropriate precautions to reduce the risk of falls in these patients. Having a healthcare provider sited at the patient’s bedside is an evidence-based intervention. The provider will monitor and prevent falls in these patients reducing the risk of falling. Thus, adopting a bedside sitter will lower the high rate of patient falls in the medical facility.

            Overall, the dashboard sample indicates the organization’s performance areas that were doing well and those that are underperforming. The area that performed excellently during the business period was the length of stay. The actual length of stay was less than the targeted throughout the entire period. On the other hand, the underperforming area was total patient falls. The actual total falls were high than the targeted total falls in three business periods. Thus, the healthcare organization should adopt evidence-based interventions for fall prevention, including bed alarm systems, hourly rounding, and bed-sitter to reduce the high rate of patient falls.  

References

Cuttler, S. J., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical inpatient falls and injuries with videos, icons, and alarms. BMJ open quality, 6(2), e000119. https://bmjopenquality.bmj.com/content/6/2/e000119

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283. Doi: 10.1016/j.cger.2019.01.007

Savage, A. (2020). Reducing Patient Falls through Purposeful Hourly Rounding. Preventive Medicine; 2 (4): 1-77. DOI: https://doi.org/10.46409/sr.UOZB3951

Stevens, J. A., & Lee, R. (2018). The potential to reduce falls and avert costs by clinically managing fall risk. American journal of preventive medicine, 55(3), 290-297. Doi: 10.1111/jgs.15304

Venema, D. M., Skinner, A. M., Nailon, R., Conley, D., High, R., & Jones, K. J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study. BMC geriatrics, 19(1), 1-10. https://bmcgeriatr.biomedcentral.com/articles/10.1186/s12877-019-1368-8