在家庭医疗保健中实施以证据为基础、内容经过验证的标准化支持面算法工具:质量改进项目。

IF 1.7 3区 医学 Q2 NURSING Journal of Wound Ostomy and Continence Nursing Pub Date : 2024-03-01 DOI:10.1097/WON.0000000000001062
Monica Timko-Progar, Jerri Drain, Kimberly Stovall-Patton
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引用次数: 0

摘要

目的:本质量改进项目旨在提供一个标准化、可重复且易于使用的流程,用于选择支撑面以预防或治疗压力性损伤(PIs):选择伤口、造口和失禁护士协会支撑面算法来指导临床医生选择合适的支撑面。这些临床医生每年为全国约 46.5 万名患者提供服务:该质量改进项目旨在确定临床医生在推荐支撑面时的知识水平和舒适度,并在患者被确定为高危患者后,提供一种标准化的方法来确定合适的支撑面。支撑面算法已纳入本机构的电子病历 (EMR);我们选择了这种交互式算法,以方便不具备 PI 治疗或预防专业知识的临床医生选择支撑面:结果:临床医生报告称,在实施临床决策支持工具后,他们对选择适当支持面的能力有了进一步的了解,并提高了舒适度。基准数据显示,美国医疗保险与医疗补助服务中心围绕与 PI 相关的潜在可避免事件的质量结果衡量标准的同比总趋势(2018 年 9 月至 2021 年 9 月)有所下降:实施支持面算法有助于临床医生选择支持面,提升和规范临床医生的实践,减少潜在可避免事件。作为该项目的成果,伤口、造口和失禁护士协会支撑面算法工具已完全整合到我们的电子医疗记录系统中,并成为我们临床评估的标准化部分。
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Implementation of an Evidence-Based, Content-Validated, Standardized Support Surface Algorithm Tool in Home Health Care: A Quality Improvement Project.

Purpose: The purpose of this quality improvement project was to provide a standardized, repeatable, and easy-to-use process for selecting a support surface for prevention or treatment of pressure injuries (PIs).

Participants and setting: The Wound, Ostomy, and Continence Nurses Society Support Surface Algorithm was chosen to guide clinicians in selection of an appropriate support surface. These clinicians provide services to approximately 465,000 patients across the nation annually.

Approach: This quality improvement project aimed to establish clinician knowledge and comfort levels when recommending a support surface and providing a standardized way to identify the appropriate support surface once a patient had been identified as at risk. The support surface algorithm was incorporated into our agency's electronic medical record (EMR); we chose this interactive algorithm to facilitate support surface selection among clinicians with no specialized expertise in PI treatment or prevention.

Outcomes: Clinicians reported an increase in knowledge and comfort levels in the ability to select an appropriate support surface following implementation of the clinical decision support tool. Benchmarking data illustrated a decrease in the year over year aggregate (September 2018 to September 2021) trending for the Centers for Medicare & Medicaid Services quality outcome measures surrounding potentially avoidable events related to PIs.

Implications for practice: Implementing the support surface algorithm assisted clinicians with support surface selection, elevated and standardized clinician practice, and reduced potentially avoidable events. As a result of this project, the Wound, Ostomy, and Continence Nurses Society Support Surface Algorithm Tool has been fully integrated into our EMR and is a standardized part of our clinical assessment.

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来源期刊
CiteScore
3.10
自引率
34.60%
发文量
186
审稿时长
6-12 weeks
期刊介绍: ​​The Journal of Wound, Ostomy and Continence Nursing (JWOCN), the official journal of the Wound, Ostomy and Continence Nurses Society™ (WOCN®), is the premier publication for wound, ostomy and continence practice and research. The Journal’s mission is to publish current best evidence and original research to guide the delivery of expert health care. The WOCN Society is a professional nursing society which supports its members by promoting educational, clinical and research opportunities to advance the practice and guide the delivery of expert health care to individuals with wounds, ostomies and continence care needs.
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