The form was developed by the Turning Point Initiative to assess if an organization has the needed systems in place to improve quality and performance. Performance Management Self-Assessment Tool. Instructions: This tool should be filled out by the implementation team leader in consultation with the QI department. The "you" refers to your organization as a whole. Check the box that most accurately describes your organization's current resources. Use: If you find that your organization has fully operationalized QI processes, connect the pressure ulcer prevention initiative with these existing processes.
If some processes are missing, advocate for them to be put into place in the context of the pressure ulcer initiative. Background: Before beginning a quality improvement initiative, you need to understand your current methods. This tool can be used to describe key processes in your organization where pressure ulcer prevention activities could or should happen.
Use: Determine if there are any gaps and problems in your current processes, and use the results of this analysis to systematically change these processes. Continue asking questions that are important in learning more about this process. Background: This worksheet can be used to determine if your facility has a policy for preventing and managing pressure ulcers. The tool is one of a series of Facility Assessment Checklists used to identify areas that need improvement in nursing homes and has been modified for hospitals.
Pressure Ulcers: Facility Assessment Checklists. Instructions: Complete the checklist. For certain questions, you may want to consult with appropriate staff in your organization. Use: Use the results of this assessment to identify issues that you need to deal with, and formulate goals for your pressure ulcer prevention initiative.
Does your facility's policy for the prevention and management of pressure ulcers include these components? Internet Citation: 7. Tools and Resources. Content last reviewed October Browse Topics. Topics A-Z. Quality and Disparities Report Latest available findings on quality of and access to health care. Notice of Funding Opportunities.
Preventing Pressure Ulcers in Hospitals 7. Previous Page. Next Page. Are we ready for this change? How will we manage change? What are the best practices in pressure ulcer prevention that we want to use? How do we implement best practices in our organization? How do we measure our pressure ulcer rates and practices? How do we sustain the redesigned prevention practices? Thus, the implementation of new prevention approaches may require, for example, the efforts of: Materials and supplies: Do we have the most evidence-based products and equipment necessary for preventing pressure and skin breakdown?
Are new products evaluated with this outcome in mind? Housekeeping: Do standard bed-making techniques and materials result in too much moisture being retained next to patient skin?
Information technology: Is information about skin assessment and pressure ulcer prevention interventions effectively integrated into the electronic medical record? Respiratory therapy: Is all respiratory equipment appropriately placed to reduce the chances of pressure sores developing where tubing or mouthpieces are in contact with patient skin?
Medicine: Are appropriate orders on file or available for any needed special surfaces or other preventive measures? Quality improvement: Are QI training and techniques available to the team working on this effort? Transport: Is patient time on hard wheelchairs or stretchers minimized or mitigated when patients are taken off the unit for diagnostic or therapeutic activities?
Instructions: Administer the survey. All patients are at potential risk of developing pressure ulcers 2. Pressure ulcer prevention is time consuming for me to carry out 3. In my opinion, patients tend not to get as many pressure ulcers nowadays 4. I do not need to concern myself with pressure ulcer prevention in my practice 5.
Pressure ulcer treatment is a greater priority than pressure ulcer prevention 6. Continuous assessment of patients will give an accurate account of their pressure ulcer risk 7. Most pressure ulcers can be avoided 8. I am less interested in pressure ulcer prevention than other aspects of care 9. My clinical judgment is better than any pressure ulcer risk assessment tool available to me In comparison with other areas of care, pressure ulcer prevention is a low priority for me Stakeholder Interest or requirement in the project What the project needs from stakeholder Perceived attitudes and risks Actions to take Example: health information systems officer Gatekeeper for making any changes to the electronic medical record EMR system.
Not necessarily interested in the project beyond his general mandate to keep the EMR tied to clinical documentation needs. The project may need to add or make changes to any parts of the EMR that concern skin assessment, preventive measures, and skin care.
May not want to make changes until other changes are also in process, or other changes may already be in process. Top of Page 1C: Leadership Support Assessment Background: This tool can be used to assess senior leadership support for implementing a pressure ulcer prevention project. Instructions: Complete the form with all the required information. Use: Use this list to form your implementation team. Do you have a process es to improve quality or performance?
Is an entity or person responsible for decision-making based on performance reports e. Are the steps in the process communicated? Are managers and employees evaluated for their performance improvement efforts i. Are performance reports used regularly for decisionmaking? Is performance information used to do the following? Do you have the capacity to take action to improve performance when needed? Do you have processes to manage changes in policies, programs, or infrastructure?
Do managers have the authority to make certain changes to improve performance? Do staff have the authority to make certain changes to improve performance? Does the organization regularly develop performance improvement or QI plans that specify timelines, actions, and responsible parties? Is there a process or mechanism to coordinate QI efforts among programs, divisions, or organizations that share the same performance targets?
Is QI training available to managers and staff? Are personnel and financial resources allocated to your QI process? Top of Page 2C: Current Process Analysis Background: Before beginning a quality improvement initiative, you need to understand your current methods. Instructions: Have the implementation team identify and define every step in the current process for pressure ulcer prevention.
When defining a process, think about staff roles in the process, the tools or materials staff use, and the flow of activities. Everything is a process, whether it is admitting a resident, serving meals, assessing pain, or managing a nursing unit. The ultimate goal of defining a process is identifying problems in the current process.
Tips: Take time to brainstorm and listen to every team member. Make sure the process is understood and documented. Make each step in the process very specific.
Use one post-it note, index card, or scrap piece of paper for each step in the process. Lay out each step, move steps, and add and remove steps until team agrees on the final process. If a process does not exist for example, there is no process to screen for pain upon admission and readmission , identify the elated processes for example, the process for admission and readmission.
If the process is different for different shifts, identify each individual process. If supplies are missing, go to the store and purchase them. Check to see if the toaster is plugged in. If not, plug in the toaster. Check setting on toaster. Adjust to darker or lighter as preferred.
Put a slice of bread in toaster. Turn toaster on. There was no statistical difference in pressure ulcer incidence between the three groups Waterlow 7. Authors' conclusions: Two studies were identified which evaluated the effect of risk assessment on patient outcomes; In one study, there was no statistically significant difference in pressure ulcer incidence between people who were assessed using the Braden risk assessment tool compared with those receiving unstructured risk assessment.
Methodological limitations of this study prevent firm conclusions being drawn. However, a further high quality RCT identified no statistical differences in pressure ulcer incidence when people were assessed using either the Waterlow risk assessment tool, the Ramstadius risk assessment tool, or using clinical judgement alone. There is no reliable evidence to suggest that the use of structured, systematic pressure ulcer risk assessment tools reduces the incidence of pressure ulcers.
Abstract Background: Use of pressure ulcer risk assessment tools or scales is a component of the assessment process used to identify individuals at risk of developing a pressure ulcer. Gov't Review Systematic Review.
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