Meaning of Quality Indicator:
Quality Indicators are
standardized, evidence-based measures of health care quality that
can be used with readily available hospital inpatient administrative data to
measure and track clinical performance and outcomes. Highlight potential quality improvement
areas. Track changes over time.
The organisation should collect data on structures,
processes and outcomes, especially in areas of high-risk situations. The
collected data should be collated, analysed and used for further
improvements.
Key performance indicator is a term used
to measure or monitor performance against an agreed goal. Using a KPI is a
great way of showing how your service contributes to national or local
targets/performance. Performance indicators are usually nationally or locally
agreed.
Selection of Key Performance Indicator:
When choosing a
performance indicator for your nursing service take some time to choose one or
two things to record data about. If possible, choose an influential or national
indicator for example if working in cancer you might choose to use compliance
with undertaking a holistic needs assessment or record why it was not done. In
other specialisms you might choose some best practice guidance to audit
performance against. The easiest way to approach this is to choose something
that should happen in a patient pathway and see how often it does or does not
happen. If it does not happen record why. It’s also a good idea to record a
little more fundamental data such as patient number, date etc. This will also
help you build a picture of your caseload.
Some
Important Quality Indicators for Nursing Staff:
Meaning
of Urinary Tract Infection and its Calculation Formula:
An
infection in any part of the urinary system, the kidneys, bladder or urethra. Urinary
tract infections are more common in women. They usually occur in the bladder or
urethra, but more serious infections involve the kidney. A bladder infection
may cause pelvic pain, increased urge to urinate, pain with urination and blood
in the urine.
Meaning
of Surgical Site Infection and its Calculation Formula:
A surgical site infection (SSI) is an infection that occurs after surgery in the part of the body where the surgery took place. Surgical site infections can sometimes be superficial infections involving the skin only.
Meaning of Ventilator Associated
Pneumonia (VAP) and its Calculation Formula:
Ventilator-associated
pneumonia is a lung infection that develops in a person who is on a ventilator.
A ventilator is a machine that is used to help a patient breathe by giving
oxygen through a tube placed in a patient’s mouth or nose, or through a hole in
the front of the neck. An infection may occur if germs enter through the tube
and get into the patient’s lungs.
Meaning of Central Line Associated Blood
Stream Infection (CLABSI) and its Calculation Formula:
A central line (also known as a central
venous catheter) is a catheter (tube) that doctors often place in a large vein
in the neck, chest, or groin to give medication or fluids or to collect blood
for medical tests. You may be familiar with intravenous catheters (also known
as IVs) that are used frequently to give medicine or fluids into a vein near
the skin’s surface (usually on the arm or hand), for short periods of time.
Central lines are different from IVs because central lines access a major vein
that is close to the heart and can remain in place for weeks or months and be
much more likely to cause serious infection. Central lines are commonly used in
intensive care units.
Meaning of Needle Stick Injury (NSI) and
its Calculation Formula:
A penetrating stab wound from a needle (or
other sharp object) that may result in exposure to blood or other body fluids.
The main concern is exposure to the blood or other body fluids of another
person who may be carrying infectious disease. The pathogens of primary concern
are the human immunodeficiency virus (HIV), hepatitis B virus (HBV) and
hepatitis C virus (HCV).
Meaning of Pressure ulcers and its Calculation Formula:
Pressure ulcers, also known as bedsores,
are localized damage to the skin and/or underlying tissue that usually occur
over a bony prominence as a result of usually long-term pressure, or pressure
in combination with shear or friction. The most common sites are the skin
overlying the sacrum, coccyx, heels, and hips, though other sites can be
affected, such as the elbows, knees, ankles, back of shoulders, or the back of
the cranium.
Being
exposed to sharps (needles) or body fluids means that another person's blood or
other body fluid touches your body. Exposure may occur after a needle stick or
sharps injury. It can also occur when blood or other body fluid touches your
skin, eyes, mouth, or other mucosal surface. It should be reported immediately to
your infection control nurse.
Meaning of Compliance to Hand Hygiene and
its Calculation Formula:
Hand hygiene is the
action of cleaning hands. There are two ways to clean hands. Using an alcohol-based
hand rub which kills organisms in seconds or, when hands are visibly soiled, using
soap and running water. The single most common way of transferring health
care-associated infections (HAIs) in a health care setting is on the hands of
health care providers. Health care providers move from patient to patient and
room to room while providing care and working in the patient environment. This movement
provides many opportunities for the transmission of organisms on hands that can
cause infections. Monitoring hand hygiene practices is vital to improving rates
and, in turn, reducing HAIs.
Main Four Focusing Points for Compliance of Hand Hygiene:
- Before Touching the Patient Environment
- Before Aseptic Procedure
- After Body Fluid Exposure Risk
- After Touching the Patient Environment
Meaning of Reintubation and its Calculation Formula:
Reintubation was defined as intubation after
extubation of a patient who had been initially tracheal intubated under
general anaesthesia or combined general and regional anaesthesia. Extubation
failure and the need for reintubation within 72 h are common mishaps in the
intensive care unit (ICU) setting which can lead to increased morbidity, longer
length of hospital stays, and high treatment costs. Reintubation is a common
high-risk procedure, especially in critically ill patients.
Meaning of Medication Error and its Calculation Formula:
Medication error are a
serious threat to patient safety in hospital. Healthcare professionals should
take a more proactive approach to preventing medication incidents in hospital.
There is requirement for close error Monitoring and Reporting culture to
analyze the events.
A medication error is any preventable event that may
cause or lead to inappropriate medication use or patient harm while the
medication is in the control of the health care professional or patient.
A nursing care plan
provides direction on the type of nursing care the individual/family/community
may need. The main focus of a nursing care plan is to facilitate standardized,
evidence-based and holistic care. Nursing care plans have been used for quite a
number of years for human purpose. A care plan includes the following
components: assessment, diagnosis, expected outcomes, interventions, rationale
and evaluation.
Meaning of Nursing Hand Over and its Calculation Formula:
A nursing handover occurs
when one nurse hands over the responsibility of care for a patient to another
nurse, for example, at the end of a nursing shift. On average, nursing
handovers occur three times a day for each patient.
Handover is an important communication tool used by healthcare workers. Handover documentation by each shift can be used as a guide to capture the information.
Meaning of Nurse Patient Ratio and its Calculation Formula:
The nurse patient ratio
is a number to describe the number of patients assigned to each nurse. Nurse
patient assignments are based on the acuity or needs of the patient for nursing
care. In critical care units such as the ICU (intensive care unit) the ratio
may be 1:1 for the sickest patients or 1:2 or 1:3 for patients who are acutely
ill but stable. On general care units the nurse to patient ratio is higher for
example 1:5 or 1:8 depending on the type of unit and the needs of the patient.
This type of nurse patient ratio is based on guidelines from professional
organizations and accreditation bodies, but is also fluid based on the needs of
the individual patients at a given point in time.
Written by:
Dr. Praveen Bajpai
Director of Ingenious Healthcare Consultants Pvt. Ltd.
Founder of Skill Sathi
Director of Ingenious Healthcare Consultants Pvt. Ltd.
Founder of Skill Sathi
MBA in Hospital administration, PG Diploma in Quality Accreditation, PG Diploma in Medico Legal System, M. Phil in Hospital Mgmt. from BITS Pilani, P.hD in Management, Certified NABH Auditor, Certified NABL Auditor, Certified Auditor for Clinical Audits, Green Belt in Six Sigma, Certified in Hospital Infection Control Practices, Certified trainer for International Patient Safety Goals, Certified Auditor for JCI 7th Edition Standards
www.skillsathi.in
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