Naas General Hospital Naas General Hospital Nursing MetricsNursing Metrics

October 2011 October 2011

Nora ONora O’’ Mahony Nurse Practice Development CoMahony Nurse Practice Development Co--ordinatorordinator

What are we measuring? What are we measuring? Why did we choose these metrics?Why did we choose these metrics?How are we measuring the metrics?How are we measuring the metrics?What is the benefits of measuring What is the benefits of measuring metrics to nursing & the metrics to nursing & the organisation? organisation?

NURSING METRIC NURSING METRIC

MANDATORY TRAININGMANDATORY TRAININGPERIPHERAL CATHETER CARE BUNDLEPERIPHERAL CATHETER CARE BUNDLEPATIENT SAFETYPATIENT SAFETYPATIENT EXPERIENCEPATIENT EXPERIENCENURSING CARE PLANSNURSING CARE PLANSMEDICATION STORAGE & CUSTODYMEDICATION STORAGE & CUSTODYFALLS ASSESSMENTFALLS ASSESSMENTTISSUE VIABILITYTISSUE VIABILITYNUTRITIONNUTRITION

Basic for Nursing Metrics Basic for Nursing Metrics

Current Nursing Audit PlanCurrent Nursing Audit Plan

Review of LiteratureReview of Literature

Ward Nurses Input Ward Nurses Input

All fluid balances are appropriate, complete & balanced

All patient get appropriate assistance at meal times

Care plan activated for those identified as poor nutritional status/ inadequate oral intake.

Nutritional assessment has been carried out on admission

NUTRITION

Pressure Sores development or progression is minimised or eliminated

Patient re-assessed as condition changed.

Care plan activated for those identified at risk of Pressure Ulcer

A skin inspection was carried out on day of admission

The patient has a Pressure Ulcer Risk Assessment carried out on day of admission

Patients Name and Hospital number on each page of documentation

TISSUE VIABILITY

Patient falls are minimised or eliminated

Patients at risk of falls have falls care plan initiated

Falls assessment carried out

FALLS ASSESSMENT

Medication errors are minimised or eliminated

SCD balance is checked at change of shift

SCD Keys are kept on the nurse in charge or her deputy

Schedule Controlled Drugs (SCD) are maintained in a locked press with in a locked press

All medication are stores in a locked room or cupboard

MEDICATION STORAGE / CUSTODY

Have nurses on the ward talked to your about your discharge

When you call the buzzer is it answered

Do you think nurses do everything they can to control your pain

Have you ever had to share ward with a member of the opposite sex in this ward

Do you get enough help from staff to eat your meal

Do nurses treat you with respect & dignity on this ward

Have nurses given you enough privacy when being examined or treated

Have you received adequate information form nurses about your medication

As far as you know are nurses cleaning their hands between touching patients

Are you satisfied with the cleanliness of the ward (including toilets)

PATIENT EXPERIENCE

Format of Metrics data collectionFormat of Metrics data collectionMeasurement Carried out Quarterly Measurement Carried out Quarterly

Data collected by Senior Nurse Manager Data collected by Senior Nurse Manager assigned to an areaassigned to an area

Sample size of 6 patients per wardSample size of 6 patients per ward

Data collectionData collection-- Manual with pen & paperManual with pen & paper

Results inputted into excelResults inputted into excel

Results colour coded Results colour coded GreenGreen 8080--100%100% Amber Amber 7070--80%80% under 70%under 70% RedRed

Action plan & Feedback Action plan & Feedback Action plan developed for Action plan developed for RedRed & & AmberAmber by by Senior Nurse Manager & CNMSenior Nurse Manager & CNM

All results fed back to Senior Nurse All results fed back to Senior Nurse Manager & Clinical Nurse Managers Manager & Clinical Nurse Managers

Ward results and action plans are fed back Ward results and action plans are fed back to ward staffto ward staff

Print out of results on each ward. Print out of results on each ward.

Pressure Sores development or progression is minimised or eliminated

Patient re-assessed as condition changed.

Care plan activated for those identified at risk of Pressure Ulcer

A skin inspection was carried out on day of admission

The patient has a Pressure Ulcer Risk Assessment carried out on day of admission

Patients Name and Hospital number on each page of documentation

TISSUE VIABILITY

All fluid balances are appropriate, complete & balanced

All patient get appropriate assistance at meal times

Care plan activated for those identified as poor nutritional status/ inadequate oral intake.

Nutritional assessment has been carried out on admission

NUTRITION

% ( /6x100)Total 654321

Nursing Metric for 2011

Benefits Benefits

Structured Framework for Measuring Structured Framework for Measuring Nursing InterventionsNursing InterventionsDocumented evidence of 25% of Documented evidence of 25% of patient population having nursing patient population having nursing metrics measured quarterly, metrics measured quarterly, providing good quality indicators of providing good quality indicators of nursing care delivered within Naas nursing care delivered within Naas General HospitalGeneral Hospital

Additional metrics planned for 2012Additional metrics planned for 2012

Medication AdministrationMedication AdministrationPatient Observations Patient Observations

Benefits Benefits

Nursing involvement from Staff Nursing involvement from Staff Nurse to Senior Nurse MangerNurse to Senior Nurse MangerGood results are raising morale Good results are raising morale Poor results provide incentive to Poor results provide incentive to improve improve Identifies areas that require improve Identifies areas that require improve across all wards across all wards –– so need for so need for change acknowledged change acknowledged

Benefits Benefits Other disciplines wants to adapt our Other disciplines wants to adapt our structured framework for their structured framework for their metrics/Key performance Indicators.metrics/Key performance Indicators.

It will provide us with a method of visually It will provide us with a method of visually presenting the good work that nurses are presenting the good work that nurses are doing doing

Evidence of provision of good nursing care Evidence of provision of good nursing care with good outcomes for patients with good outcomes for patients

Thank you Thank you