A Nurse-Led Evidence Based Practice (EBP) Initiative to ...
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25 OCTOBER 2018 A Nurse-Led Evidence Based Practice (EBP) Initiative to Prevent Hospital Acquired Pressure Injury GABRIELLE HUTCHENS RN MAPPMGT(NURS) CPHIMS CPHQ NURSING QUALITY IMPROVEMENT COORDINATOR KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTER, JEDDAH, SAUDI ARABIA
Transcript of A Nurse-Led Evidence Based Practice (EBP) Initiative to ...
25 OCTOBER 2018
A Nurse-Led Evidence Based Practice (EBP) Initiative to Prevent Hospital
Acquired Pressure Injury
GABRIELLE HUTCHENS RN MAPPMGT(NURS) CPHIMS CPHQNURSING QUALITY IMPROVEMENT COORDINATOR
KING FAISAL SPECIALIST HOSPITAL & RESEARCH CENTER, JEDDAH, SAUDI ARABIA
Declaration of
Financial Interests or Relationships
Speaker Name: Gabrielle Hutchens
I have no financial interest or relationships to disclose
Agenda
12345
Background
The setting: KFSH&RC – Jeddah, Saudi Arabia
HAPI data
How we managed to sustain results
Interventions from Performance Improvement project
Background
• Journey to become High Reliability Organisation (HRO)
• Transitioning from government (public) hospital to private not for profit hospital
• Zero Harm initiative started to set a new standard of excellence in the region
• Zero Harm – The only acceptable standard for harm is zero
King Faisal Specialist Hospital &
Research Center - Jeddah2017 Statistics
1 of 3 hospitals in KFSH&RC General Organization
Hospital
385 Bed Tertiary Specialist Hospital
Demographics Population
Patients: 93% Saudi & 7% ExpatriatesNurses: More than 25 Nationalities
Results 2016
0
0.2
0.4
0.6
0.8
1
1.2
Dec-15 Jan-16 Feb-16 Mar-16 Apr-16 May-16 Jun-16 Jul-16 Aug-16 Sep-16 Oct-16 Nov-16 Dec-16
HA
PI
rate
/ 1
00
0 p
ati
en
t d
ays
Months of the year
Hospital Acquired Pressure Injuries per 1000 patient days
Pre Intervention Post Intervention
InterventionPerformance Improvement
Project
Interventions
Critical EBP ReviewA critical evidence based literature
review relating to decreasing HAPI was
completed.
PI ProjectA performance improvement (PI) project
utilising the FOCUS PDCA methodology.
Policy & Standards of
Practice ChangesNational Pressure Ulcer Advisory Panel
(NPUAP) Guidelines were updated in
2016 and implemented into policy.
EMR ChangesSkin integrity documentation was given
enhanced options.
Education CampaignOrganisation-wide education campaign
on HAPI prevention.
New Risk Assessment
ToolNew EBP tool “Glamorgan Pressure
Risk Assessment” was implemented.
Interventions (cont.)
EMR Changes
Skin integrity
documentation
Education Campaign
Organisation-wide education
campaign on HAPI prevention.
New Age-Specific Risk
Assessment Tool for
Pediatrics Implemented
Results 2018
0
0.1
0.2
0.3
0.4
0.5
0.6
0.7
0.8
0.9
Q4 2015 Q1 2016 Q2 2016 Q3 2016 Q4 2016 Q1 2017 Q2 2017 Q3 2017 Q4 2017 Q1 2018 Q2 2018
HA
PI
rate
/ 1
00
0 p
ati
en
t d
ays
Months of the year
Hospital Acquired Pressure Injuries per 1000 patient days
Pre Intervention Post Intervention
Intervention
Results
Sustainable results
2016, 2017, 2018Dec 2015 – above internal
trigger.
2015
Year
HAPI incident
rate/1000 patient days
Increase/
Decrease Movement
Increase/
Decrease
2015 1.1
2016 0.59 46% decrease
2017 0.24 78% decrease
2018 0.18 84% decrease
Baseline
Results
HAPI Strategic Plan
Organisational Organisational Nursing
Zero Harm
2018 Strategic Priority:
Journey to High
Reliability
Organization
Organisational KPI
HAPI: Nursing specific
KPI reported at
executive level.
Nursing KPI
HAPI: reported KPI to
Nursing Executive,
ward level/monthly
Ward
Ward based goal
1 yearly goal must be
KPI at ward level
Know your data!
Data must be owned by
frontline staff
References
Select Medical UK
http://www.selectmedical.co.uk/feature
s/pain-of-pressure-ulcers/ accessed
28 Sep 2018
Image by freepik.com accessed 1 Oct
2018
Tayyib & Coyer (2016)
Willock, J., Baharestani, M.M. &
Anthony, D. (2009). The development
of the Glamorgan pediatric pressure
ulcer risk assessment scale. Journal of
Wound Care, 18 (1), pp. 17-22
https://4kpics.rocks/saudi-arabia-and-in
dia-map/ accessed 23 Sep 2018
National Pressure Ulcer Advisory Panel
(NPUAP) http://www.npuap.org/resourc
es/educational-and-clinical-resources/n
puap-pressure-injury-stages/ accessed
23 Sep 2018
Irish Association of Healthcare Assistant
s http://iaha.ie/event/1-day-training-end-
life-pressure-ulcer-awareness-preventio
n/ accessed 28 Sep 2018
Thank youGabrielle Hutchens RN, MAppMgt(Nurs), CPHIMS, CPHQ
Nursing Quality Improvement Coordinator, Nursing Practice &
Research
Email: [email protected]
