Initiative Update

1
Initiative Update Data Analysis
2
Themes for the Day

• Lessons Learned and Best Practices
• Staging of Pressure Ulcers
• Care Coordination

3
Accomplishments

• 80 facilities and agencies and over 446
  participants involved in initiative
• Story Board Examples
• What is occurring day-to-day in our
  facilities/agencies

4
Accomplishments

• During a recent discussion it was the aide that
  identified that the foot pedals were not always
  used. This changed the pressure to the buttocks
  resulting in a pressure area. The director was
  very proud of that staff and shared how front
  line staff is the cornerstone in her fight
  against pressure ulcers.

5
Accomplishments

• A Director of Nursing recently stated the focus
  on the CNAs and facility service personnel as
  critical team members is providing them important
  information for clinical decision-making. She
  reported many of the CNAs were excited to have
  responsibility for care suggestions and
  decisions.
• By offering Saturday care plan meetings, a
  facility has increased family participation

6
Accomplishments

• A facility posted the IPUQII commitment board in
  the entry hallway upon returning from their first
  learning session. After explaining the
  initiative to a resident meeting the residents
  wanted to sign the board along side of the staff.

7
Data Summary

• What is the data telling us?
• How are we going to use this data to improve our
  pressure ulcer systems?
• How are we going to use this data to improve our
  care coordination?

8
Data Analysis
9
Knowledge summary by group
10
Knowledge summary
Most Frequently Missed Questions with Incorrect Response with Correct Response
Who should be actively involved in reduction of patients pressure ulcer? 32.0 68.0
Sites most susceptible to pressure ulcer development? 36.6 63.4
How long does it take for a pressure to form? 38.2 61.8
A daily bath or sponge bath will prevent pressure ulcers. 46.0 54.0
Donut devices or ring cushions help prevent pressure ulcers. 66.5 33.5
Massaging a bony prominence (area) promotes circulation and prevents pressure ulcers. 66.5 33.5
11
Self assessment summary
Performs a comprehensive pressure ulcer risk
assessment within first 24 hours of admission.
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Always 41.7 50.0 66.0
Frequently 0.0 50.0 25.5
Seldom 8.3 0.0 0.0
Never 50.0 0.0 2.1
Missing 0.0 0.0 6.4
q1-q1-q1
12
Self assessment summary
Implements designated interventions that
correlate with identified risk factors after
admission risk assessments are performed.
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Always 8.3 25.0 34.0
Frequently 25.0 75.0 61.7
Seldom 8.3 0.0 4.3
Never 58.3 0.0 0.0
Missing 0.0 0.0 0.0
q3-q3-q3
13
Self assessment summary
Communicates results of both risk and routine
skin assessments to appropriate staff.
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Always 33.3 0.0 21.3
Frequently 50.0 25.0 55.3
Seldom 0.0 75.0 12.8
Never 41.7 0.0 2.1
Missing 0.0 0.0 4.3
q6-q6-q7
14
Self assessment summary
Provides pressure ulcer prevention training as
part of the orientation process.
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Always 16.7 0.0 34.0
Frequently 8.3 0.0 23.4
Seldom 16.7 50.0 19.1
Never 58.3 50.0 19.1
Missing 0.0 0.0 4.3
q8-q8-q9
15
Self assessment summary
Tracks patients with both nosocomial pressure
ulcers and those admitted with pressure ulcers.
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Always 41.7 0.0 97.9
Frequently 0.0 50.0 2.1
Seldom 16.7 50.0 0.0
Never 41.7 0.0 0.0
Missing 0.0 0.0 0.0
q15-q15-q18
16
Self assessment summary
Use a multi-disciplinary team approach to
pressure ulcer prevention?
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Yes 50.0 75.0 85.1
No 50.0 25.0 12.8
Missing 0.0 0.0 2.1
q17-q17-q20
17
Self assessment summary
Have at least one nurse who has specialized
training in wound care and management?
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Yes 50.0 75.0 70.2
No 50.0 25.0 27.7
Missing 0.0 0.0 2.1
q18-q18-q21
18
Self assessment summary
Have one or two designated nurses who measure and
document on all wounds consistently?
Response Percent of facilities Percent of facilities Percent of facilities
Home health (N12) Hospital (N4) Long term care (N47)
Yes 16.7 25.0 85.1
No 83.3 75.0 14.9
Missing 0.0 0.0 0.0
q19-q19-q22