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The modern development of healthcare depends on solving the problem of improving the quality of medical services. That is why it is of the utmost importance to analyze data and make decisions based on quality factors. The purpose of this assignment is to overview the National Database of Nursing Quality Indicators (NDNQI) dashboard, choose an indicator that needs improvement, and provide a plan that could make the situation better. In order to provide a reliable plan, thorough research of evidence-based literature will be conducted.
The dashboard indicated a number of different factors that demonstrate the required quality of healthcare and the actual results. According to it, there are several apparent problems that need further discussion and attention. For instance, the real amount of fall injury reports is higher than the expected one. It would be wrong, however, to assume that NDNQI is ineffective since researchers state that “NDNQI falls with injury measure is reliable and valid in supporting hospitals’ fall prevention efforts and future injurious falls research” (Garrard et al., 2016, p. 111). However, even though the number of such traumas is tracked, it is not categorized. In other words, it is difficult to define the nature of falls, why they occurred and what are the consequences. The lack of this information prevents medical facilities from defining risk factors and implementing measures that could improve treatment for patients. For this reason, it would be rational to take this factor into account and provide a plan that could improve reporting of falls.
Fall-related injuries are very common in healthcare emergency work. Falls during a hospital stay often lead to prolonging the time of hospitalization and thus, create higher costs not only for patients but for doctors as well. The significance of reporting and tracking fall injuries cannot be overestimated. If a problem cannot be evaluated, it would be difficult to make proper decisions that could solve it. Therefore, it seems reasonable that while inventing and implementing quality improvement programs and initiatives, it is necessary to monitor performance. However, researchers argue that in most cases, NDNQI data cannot be enough to improve the situation. For example, Staggs, Mion, et al. (2015) believe that “there are a number of unmeasured patient and unit characteristics which could not be controlled for using NDNQI data, including fall risk” (p. 986). The reason for this is that this system has several limitations regarding tracking patient-level information. In other words, it mostly provides statistics, but no reason as to why the fall occurred and what measures have been implemented to help a patient. Therefore, there is an apparent need to expand the possibilities of reporting and define what data on cases of injuries could be added to records.
One of the suggestions that could upgrade the current system is to make data more detailed. For instance, it would be useful to include information about the reasons for the fall, the level of the patient turnover, and how the treatment was conducted. According to researchers, “highly detailed data may be useful for addressing a specific quality-related problem on a particular unit in a limited time frame” (Staggs, Davidson, et al., 2015, p. 106). Acquiring such data is worth considering if medical facilities want to prevent the increase in the number of falls.
In addition, tracking repeated falls would be a useful initiative because it would prevent the statistics from distortion in the case where there is one patient who constantly suffers from this type of injuries. Furthermore, the data about reasons for the fall should also be included because it allows doctors to estimate risks factors. While there could be causes of fall injuries beyond anyone’s control, for example, accidents, there is a reasonable amount of cases that could be prevented. For instance, if the statistics state that the most number of falls are due to patients’ mental health problems, then medical staff should pay attention to psychological treatment as well. Aside from taking care of the consequences of the fall, a doctor should also consider prescribing therapy for a patient with the possibility of taking medication for mental disorders. There are many definitions and circumstances as to why a patient might fall; that is why defining them is vital for improving the quality of healthcare.
The information about the level of injury is vital as well. The reason for this is that there could be fatal falls, non-fatal falls and even non-injury falls. Therefore, combining all this information without categorizing it would seriously harm the statistics. A suggestion is aside from tracking a total fall rate; it would be useful to make a classification of falls according to their severity them.
In conclusion, it would appear that there are several indicators of quality that need new practices for further improvement. While the NDNQI indicated a total number of fall injuries, there is a serious lack of information that could help medical professionals to estimate the issue and take measures in order to improve it. Acquiring more detailed data, such as the reason for the fall, its severity, and the number of repeated falls seems like an appropriate solution.
References
Garrard, L., Boyle, D. K., Simon, M., Dunton, N., & Gajewski, B. (2016). Reliability and validity of the NDNQI® injury falls measure. Western Journal of Nursing Research, 38(1), 111-128.
Staggs, V. S., Davidson, J., Dunton, N., & Crosser, B. (2015). Challenges in defining and categorizing falls on diverse unit types: Lessons from expansion of the NDNQI Falls Indicator. Journal of Nursing Care Quality, 30(2), 106.
Staggs, V. S., Mion, L. C., & Shorr, R. I. (2015). Consistent differences in medical unit fall rates: Implications for research and practice. Journal of the American Geriatrics Society, 63(5), 983-987.
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