Development and Implementation of an Individualized Turning Program for Pressure Injury Prevention Using Sensor Technology in Nursing Homes: A Quality Improvement Program

2021 ◽  
Vol 67 (11) ◽  
pp. 12-25
Author(s):  
Jeanine Maguire ◽  
Denine Hastings ◽  
Mary Adams ◽  
Debra Phillips ◽  
John McKenna ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Nursing Homes ◽  
Nursing Home Residents ◽  
Quality Improvement Program ◽  
Sensor Technology ◽  
Improvement Program ◽  
Support Person ◽  
Risk Levels ◽  
Pressure Injury

BACKGROUND: Turning nursing home residents every 2 hours has been a long-held standard for pressure injury (PrI) prevention in individuals with mobility impairments although evidence to substantiate this practice is limited. New guidelines recommend personalizing turning schedules to support person-centered care but lack specific recommendations about which turning frequencies are appropriate for various risk levels. PURPOSE: This quality improvement program aimed to determine the feasibility and outcomes of using individualized turn schedules for newly admitted nursing home residents. METHODS: An expert panel of wound clinicians developed, tested, and implemented a turn frequency tool that allowed staff in 2 nursing homes to select a turning schedule of 1, 2, 3, or 4 hours based on resident risk factors. Turning schedules were operationalized using a wearable sensor-based visual cueing technology that alerted staff to resident repositioning needs. Nonparticipating resident data were collected for comparison of PrI incidence. Descriptive statistics were calculated for all covariates. Significance of differences tests were performed as appropriate. RESULTS: Over 7 months, 154 residents had their turn period individualized, with 56% qualifying for 3-hour (Q3H) or 4-hour (Q4H) schedules. Facility-acquired PrI incidence was 94% lower in participants than in nonparticipants (P < .0001). Use of 3-hour and 4-hour intervals saved roughly 21 and 35 minutes of staff time, respectively, per resident per shift. CONCLUSION: Individualizing turning schedules is feasible. Residents with longer turning intervals did not develop PrIs, supporting previous studies about safely extending turning periods for most residents.

Implementation of an Evidence-Based Quality Improvement Program towards Nursing Home Care

2013 ◽  
Vol 14 (3) ◽  
pp. B16
Author(s):  
Linda G. Uhrig-Hitchcock ◽  
Linda G. Uhrig-Hitchcock ◽  
Alison Granato ◽  
Vietnam Nguyen ◽  
Ryan Holler ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Home ◽  
Home Care ◽  
Quality Improvement Program ◽  
Nursing Home Care ◽  
Evidence Based ◽  
Improvement Program

A Model Quality Improvement Program for the Management of Falls in Nursing Homes

2007 ◽  
Vol 8 (3) ◽  
pp. S26-S36 ◽  
Author(s):  
J TAYLOR ◽  
P PARMELEE ◽  
H BROWN ◽  
H STROTHERSIII ◽  
E CAPEZUTI ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Quality Improvement Program ◽  
Model Quality ◽  
Improvement Program

scholarly journals Enablers and barriers to implementing care quality improvement program in nursing homes in China

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yinan Zhao ◽  
Lulu Liao ◽  
Hui Feng ◽  
Huijing Chen ◽  
Hongting Ning
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Organizational Support ◽  
Resistance To Change ◽  
Educational Background ◽  
Care Quality ◽  
Quality Improvement Program ◽  
Organizational Level ◽  
Improvement Program ◽  
Clinical Nurses

Abstract Objective To explore the perspectives of key stakeholders on necessary factors to implement care quality improvement program. Methods We conducted qualitative descriptive research in eight nursing homes in four major prefecture-level cities of Changsha, Xiangtan, Zhuzhou, and Yueyang. Data of 50 clinical nurses and 64 nurse assistants were included and analyzed. Ethical approval was given by the medical ethics committee of Chinese Clinical Trial Registry (No. ChiCTR-IOC-17013109, https://www.chictr.org.cn/index.aspx). One-to-one interviews were used with the nursing managers, and separate focus group discussions were used with the clinical nurses and nurse assistants. All of the interviews were audio recorded and later transcribed verbatim. In addition, the first author documented the responses of every participant in the field notes during the interviews and focus groups. Results The participants’ perspectives were characterized by two main themes: (1) enablers, with four subthemes of “organizational support”, “the evidence-based practice ability”, “proactivity”, “nursing supervision and feedback;” and (2) barriers, with five sub-themes of “low educational background”, “the limitations of self-role orientation”, “resistance to change”, “lack of job motivation”, and “organizational constraints”. Conclusion These findings recognize factors at the organizational level, staff level and societal level that are necessary to implement effective mentoring. The results of this study can provide reference for nursing home in improving nursing management quality, formulating, implementing and revising training policies.

scholarly journals Implementation of a national quality improvement program to enhance hand hygiene in nursing homes in Taiwan

2019 ◽  
Vol 52 (2) ◽  
pp. 345-351 ◽  
Author(s):  
Chih-Cheng Lai ◽  
Min-Chi Lu ◽  
Hung-Jen Tang ◽  
Yen-Hsu Chen ◽  
Yi-Hui Wu ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Nursing Homes ◽  
Hand Hygiene ◽  
Quality Improvement Program ◽  
Improvement Program ◽  
National Quality

Upper Extremity Free Flap Transfers: An Analysis of the National Surgical Quality Improvement Program Database

2020 ◽  
Author(s):  
George A. Beyer ◽  
Karan Dua ◽  
Neil V. Shah ◽  
Joseph P. Scollan ◽  
Jared M. Newman ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Upper Extremity ◽  
Free Flap ◽  
Quality Improvement Program ◽  
Readmission Rates ◽  
Improvement Program ◽  
Surgical Quality ◽  
Flap Transfer ◽  
Free Flap Transfer ◽  
Reoperation Rates

Abstract Introduction We evaluated the demographics, flap types, and 30-day complication, readmission, and reoperation rates for upper extremity free flap transfers within the National Surgical Quality Improvement Program (NSQIP) database. Materials and Methods Upper extremity free flap transfer patients in the NSQIP from 2008 to 2016 were identified. Complications, reoperations, and readmissions were queried. Chi-squared tests evaluated differences in sex, race, and insurance. The types of procedures performed, complication frequencies, reoperation rates, and readmission rates were analyzed. Results One-hundred-eleven patients were selected (mean: 36.8 years). Most common upper extremity free flaps were muscle/myocutaneous (45.9%) and other vascularized bone grafts with microanastomosis (27.9%). Thirty-day complications among all patients included superficial site infections (2.7%), intraoperative transfusions (7.2%), pneumonia (0.9%), and deep venous thrombosis (0.9%). Thirty-day reoperation and readmission rates were 4.5% and 3.6%, respectively. The mean time from discharge to readmission was 12.5 days. Conclusion Upper extremity free flap transfers could be performed with a low rate of 30-day complications, reoperations, and readmissions.

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