Preventing Pressure Ulcers in Connecticut Hospitals by Using the Plan-Do-Study-Act Model of Quality Improvement
Authors: Lyder Courtney H.; Grady Jackie; Mathur Deepak; Petrillo Marcia K.; Meehan Thomas P.
Source: Joint Commission Journal on Quality and Patient Safety, Volume 30, Number 4, April 2004 , pp. 205-214(10)
Publisher: Joint Commission Resources
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Abstract:
Background: Seventeen hospitals and the Peer Review Organization of Connecticut (Qualidigm) attempted to increase early identification of high-risk patients and utilization of pressure ulcer preventive measures.Methods: A multihospital retrospective cohort study with medical record abstraction was used to obtain a total of 1,955 (baseline) and 891 (follow-up) patients aged 65 years and older discharged after treatment for pneumonia, cerebrovascular disease, or congestive heart failure with a length of stay
five days. During a nine-month period, the hospitals conducted four plan-do-study-act improvement cycles and shared their results in conference calls and group meetings.Results: Statistically significant increases were noted from baseline (1/1/96–12/31/96) to follow-up (10/1/97–3/31/98) in identification of high-risk patients, repositioning of bed-bound or chair-bound patients, nutritional consults in malnourished patients, and staging of acquired Stage II pressure ulcers. Daily skin assessments occurred at a high rate in both periods. There were no statistically significant changes in other processes of care, pressure ulcer incidence, or mortality.Discussion: Performance of four pressure ulcer prevention processes of care increased concurrently with a multifaceted improvement intervention.
Document Type: Research article
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