Introduction
This assignment consists of a thorough analysis of the statistical information from the provided dashboard and a nursing plan to improve one of the quality indicators. The analytical part reviews each data set in conjunction with the others to find dependencies, and the nursing plan provides profound suggestions based on known best practices. This paper aims to develop and demonstrate the practical skill of working with NDNQI dashboards, which is crucial, as they are widely utilized in healthcare institutions in all parts of the US.
Analysis of the Data
According to the data collected in the dashboard sheet, there are several areas of positive performance such as RN Care Hours, RN Courtesy. Meanwhile, there are Nurse-Sensitive Quality Indicators that require immediate improvements. It is supposed that due to the nurse’s work process the issues might be solved and prevented. The modification should occur in such major categories as promptness, attention to special needs, response pain, and care well coordination. The minor area that could bring adverse outcomes for all major ones is the percentage of patients contracting pressure ulcers. The problem of pressure ulcers is that many bedridden patients and relatives caring for them do not know how rapidly a dangerous, destructive process is developing. A few days or even hours are enough for a steady redness to appear on the skin in places that are in close contact with the surface of the bed. Older adults, weakened by an illness, are especially vulnerable to bedsores; a big number of patients with skin pathologies are elderly people. Pressure ulcers slow down the treatment, consequently, severe stages can be fatal for patients.
Nursing Plan
As a cause of pressure ulcers being injuries to the skin can be prolonged compression of the tissues. The skin areas that are located mainly above the bony prominence are at a high risk of bedsores appearance. For instance, the main surfaces are knees, elbows, hips, and sacrum. Sufficient pressure ulcer prevention will ultimately lead to a reduction in direct medical costs associated with the treatment of pressure sores, indirect, and intangible costs. Proper anti-decubitus care should be performed by nursing staff after specialized training. General approaches to the prevention of pressure sores are as follows: timely diagnosis of the risk of developing pressure sores and start of the entire complex of preventive measures, an adequate technique for performing simple medical services, and accurate pain assessment. It might be challenging to give an initial evaluation of pain since pain is a sensation that includes neurological, physiological, behavioral, and emotional aspects.
It is necessary to arrange the patient on a functional bed in a hospital setting. There should be handrails on both sides and a device for lifting the head of the bed. The height of the bed should be at the mid-thigh level of the caretaker. A patient should lay on a bed with a variable height, allowing him to use other improvised means and move out of bed independently. The nurse should change the body position every two hours, including at night, according to the schedule: Fowler’s position, on the side, Sims position, on the stomach as agreed with the doctor. Fowler’s position should coincide with mealtime (Boyko et al., 2018). At each movement, medical staff should inspect risk areas. The results of the examination must be recorded on the Anti-decubitus measures registration sheet (Boyko et al., 2018). It is also useful to teach relatives and other carers to reduce the risk of tissue damage under pressure. They should regularly change body position; use pressure reducing devices; observe the rules of lifting and moving: to exclude friction and shear of tissues. Additionally, it is crucial to inspect the entire skin at least once per day, provide proper nutrition and adequate fluid intake, and adequate hygiene procedures eliminating friction.
In addition to standard methods, these days pressure ulcers prevention combines the usage of specialized equipment and Anti-decubitus advances: functional beds, water, pneumatic mattresses, medical underwear, and antiseptic agents. Maneuvers for the prevention of this problem are carried out from the initial stage of the patient’s illness. With a multifunctional bed and other individual devices, patient care is simplified (Greenwood et al., 2017). Using special mechanisms of the bed, nurses can change the patient’s position: raise his head, legs, and give a sitting or reclining position. The complex of manipulations includes monitoring the absence of folds on bedding, performing hygienic procedures, changing linen, caring for the skin (Greenwood et al., 2017). Prevention of pressure ulcers is done by diminishing pressure on soft tissues, stimulating blood circulation, and eliminating irritations. The devices help reduce or eliminate pressure on the protruding parts of the body.
Finally, nurses can evaluate the intensity of the pain due to the pressure ulcers through the patient’s pain sensitivity, determined by his or her response. If nurses carefully monitor the pain reaction, they can get useful information about the patient’s condition, especially if it is impossible for verbal communication or in case of impaired judgment (Sirsch et al., 2020). Pallor, rapid breathing, hypertension syndrome, and sweating can indicate severe pain. Besides, a person can gnash teeth, bite his or her lower lip, and wrinkle forehead. At the same time, researchers argue that some patients need sisters to tell them that their pain-related behavior is reasonable and appropriate and that other people respond to pain the same way (Sirsch et al., 2020). This leads to nurses’ responsibility to figure out pain duration, factors that enhance or weaken the pain.
Moreover, the pain intensity scale can be used, being a verbal comparative pain rating scale. It represents a line ranging from the point of absence of pain (0 points) to one corresponding to unbearable pain (10 points) (Sirsch et al., 2020). The nurse explains to patients the scale, and then they mark a point corresponding to their sensation of pain. A study of the use of the Memorial Pain Assessment Card showed that this card is a valuable method for assessing pain in 98% of cases (Sirsch et al., 2020). Hospitals may change this card according to the needs of the domain. Studies show that patients often do not report pain; instead, they tend to provide inadequate information, underestimating their sensations (Sirsch et al., 2020). Medical professionals often misinterpret the level of pain relief as a result of analgesia and underrate the pain experienced by the patient.
Summary
Tissue death can be avoided if preventive measures are taken at regular intervals and paying attention to the patient’s condition and pain response. The dashboard analysis provides the needed information is helpful to introduce the suggested methods. Data help to determine the problematic areas, which should be improved for proper medical treatment and increase patient satisfaction. Information that is appropriately utilized can lead to potentially successful health organizations.
Reference
Boyko, T. V., Longaker, M. T., & Yang, G. P. (2018). Review of the current management of pressure ulcers. Advances in wound care, 7(2), 57-67.
Greenwood, C. E., Nelson, E. A., Nixon, J., & McGinnis, E. (2017). Pressure‐relieving devices for preventing heel pressure ulcers. The Cochrane Database of Systematic Reviews, 2017(5).
Sirsch, E., Lukas, A., Drebenstedt, C., Gnass, I., Laekeman, M., Kopke, K., & Fischer, T. (2020). Pain assessment for older persons in nursing home care: An evidence-based practice guideline. Journal of the American Medical Directors Association, 21(2), 149-163.