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Quality
Over the past two
years, the Center has started to take an active role in
quality management. With the increasing integration of
research methods with QI projects, the Center represents
the interests of more than 1,500 nurses within the
Department of Nursing. The objective is to create a
culture of safe patient and family centered care driven
by leadership and clinical staff nurses. The Center
supports innovative approaches to measure nursing
quality and monitor patient outcomes The following are
examples of the activities and initiatives.
Data
Collection
The Center provides the
technology, infrastructure, customized tools for data
collection and standardized processes to measure
practices for the evaluation of optimal quality
performance
" The Center has collaborated with
the wound care specialists and unit skin care
representatives to establish a consistent, decentralized
data collection process for pressure ulcer prevalence
studies. The electronic Pressure Ulcer Database was
developed to facilitate immediate access to the data
with automatically calculated findings following the
monthly prevalence studies. A preliminary report from
this Excel database communicates the findings in a
timelier period to leadership and clinical staff. The
pressure ulcer database has enabled earlier
identification of patients at risk and earlier
implementation of prevention and intervention
protocols.
" The Center guided the development
of a Chart Audit Tool utilizing scanning technology.
This new approach has helped to standardize the data
collection for chart audits. The collected data is quick
and easy to analyze and the findings are possible to
report systematically and similarly to units.
" The Center originated and developed the Raw
Data Bank to collect and store unit-specific quality
data in a central repository. This has increased both
access to the data as well as its visibility and
utilization by nursing staff, administration and other
departments at MMC. The availability of data in the bank
has improved satisfaction among its users with shortened
turn-around times for data retrieving and
reporting.
" The Center guided the development
and accessibility of the icon "Nursing" on all clinical
workstations and nursing managers' PCs. This has allowed
all campuses to provide staff nurses direct access to
unit-specific quality monitors.
" The Center has
supported and encouraged the utilization of the Incident
Reporting (IR) system which notifies risk management of
all types of errors, incidents, injuries, near misses,
and other patient safety concerns. The robust IR system
provides nurses and other disciplines with numerous data
elements to conduct more in-depth analysis of patient
events to improve processes.
Quality
Monitoring
The Center has
established Quality Monitoring Processes that are
emphasized as priorities according to Regulatory
Standards of Practice, National Patient Safety Goals,
and the institution's performance expectations outlined
in Maine Medical Center's Strategic Plan More
specifically:
" Nursing Sensitive Indicators
have been reported by the Center since 2003 to the
National Database of Nursing Quality Indicators (NDNQI),
and since 2006 to the Maine Quality Forum (MQF). NDNQI
provides its members with comparison data from other
organizations to explore relationships between nursing
care and patient outcomes. MQF is currently creating an
informative resource for the citizens of Maine to access
meaningful health information that also describes and
compares the quality of heathcare services specific to
Maine healthcare organizations. The Center coordinates
all of the data collection, data entry, communications
with NDNQI and MQF, and reporting of the findings back
at MMC .
" The Center coordinated the house-wide
Nurse Satisfaction Survey of Work Satisfaction and Job
Enjoyment in 2005 and 2006, The organization of the
satisfaction surveys has required systematic and careful
planning for marketing, pre-enrollment of the survey
units and identification of all eligible RNs, It also
required coordination of designated computers for the
Web-based survey questionnaire so that all nurses in
various patient care areas could participate. Extensive
recruitment activities are developed with administrative
support to ensure a high response rate. A variety of
communication strategies are utilized to publicize the
survey, including weekly reminder emails to all RNs.
Unit response rates are monitored closely and used to
target recruitment efforts. The success of the surveys
has been excellent and is reflected by the response
rates of 70% and 60% in respective years.
" The
Center coordinated the prioritization of performance
indicators for monitoring, analysis of trends and
process improvements to promote patient safety and
ensure quality of care Indicators include: dangerous
abbreviations, labeling medications, medication
reconciliation, nursing assessment of falls, pain and
skin integrity, patient teaching, and restraints. This
approach has enabled nursing leadership and staff to
focus on high-risk, problem-prone patient care needs in
a health care environment that is fast-paced with
increasing demands on resources and productivity while
preserving patient safety.
Projects
The Center provides
consultation and assistance to nurses for QI projects.
This can include crystallization of study design;
proposal and IRB application writing; data collection,
entry and analysis; and interpretation and utilization
of the findings. This helps to ensure meaningful results
from the quality initiatives.
Nursing Research and
Quality Outcomes page
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