QUALITY IMPROVEMENT PROJECT presentation .pptx

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1. QUALITY IMPROVEMENT PROJECT GROUP 1

2. GROUP MEMBERS CHANDNI NURSERY 5 VIJETA PICU MOHAN SHYAM OPD TARUN NEURO ICU SANJAY MALI EMERGENCY NAVEEN KUMAR UROLOGY WARD 31 MANMOHAN ER 1 SURENDRA WARD 15 PARASH MAL NEB 7 FLOOR MERCY RESPIRATORY ICU

3. I DENTIFYING A PROBLEM, FORMING A TEAM AND WRITING AN AIM STATEMENT WHAT PROBLEM DO YOU WANT TO SOLVE ? Reduce the incidence of bedsore in male spine ward TEAM MEMBERS Nursing Officer -2 Senior Nursing Officer – 2 Doctor – 1 Nursing Assistant - 2 Team Leader – Senior Nursing Officer Recorder/ Data Collector – Nursing officer Date of First Meeting - 20.11.2024

4. AIM STATEMENT To reduce the incidence of bed sore in patients admitted in male spine ward from 70% to 20 % during Two months period i.e. from 22.11.2024 to 22.01.2025.

5. ANALYSING THE PROBLEM & MEASURING QUALITY OF CARE Tool used for analysis FISH BONE ANALYSIS PROCESS MEASURE: Patients who developed bed sore during hospital stay in male spine ward for a period of two months from 15.09.2024 to 15.11.2024 Total no. of patients admitted in male spine ward during 15.09.2024 to 15.11.2024 100 70 X 100 = 70 % 100 Data Source: Male Spine ward 29A Data Collector: Nursing Officer Frequency of Data Collection : Weekly

6. Outcome Measures: Total no. of patients admitted in male spine ward during 22.11.2024 to 22.01.2025 100 Patients who developed bed sore during hospital stay in male spine ward for a period of two months from 22.11.2024 to 22.01.2025 Data Source: Male Spine ward 29A Data Collector: Nursing Officer Frequency of Data Collection : Weekly

7. FISH BONE ANALYSIS High incidence of bedsore in male spine ward The Nursing Officer may not be aware of the importance of position change for reduction of bedsore Air Mattress not provided for each patient in general ward Nursing Station is at the corner of the ward It is hard to give position change to obese patient for single person

8. DEVELOPING AND TESTING CHANGES: CHANGE RATIONALE REGULAR SKIN ASSESMENT (BRADEN SCALE ASSESMENT) EARLY INDENTIFICATION OF BEDSORE AT PRESSURE SITES FREQUENT POSITION CHANGE ( SECOND HOURLY) MAINTAINS SKIN INTEGRITY BY IMPROVING CIRCULATION Use of Pressure relieving devices i.e. air mattress Educate the patients and care givers

9. PDSA CYCLE 1 PLAN What is the change idea and how will you try it ? Nurse will do risk assessment ( Braden Scale Scoring ) in each shift Nurse will change patients position ( Second Hourly ) Air Mattress will be provided to each patient Who will try the change Nursing Officer Where will the change will be tried Male Spine Ward What do want to learn from testing the idea ? Reasons behind high incidence of bedsore in male spine ward among patients admitted DO Nurse try to change position of the patient second hourly Provided air mattress to the patient Did braden scale assessment in each shift Not Possible alone for the nurse for obese patient Enough air mattress is not available in supply On emergency days due to heavy patient rush scoring is not done in each shift STUDY QI Team question for nursing officer Do you have enough man power and resources to bring this change ACT ** The team decided to ABANDON this idea due to unavailability of man power and resources.

10. PDSA CYCLE 2 PLAN What is the change idea and how will you try it ? Nurse will teach and assist patients care giver to change patients position ( Second Hourly ) Who will try the change Nursing Officer Where will the change will be tried Male Spine Ward What do want to learn from testing the idea ? Reasons behind high incidence of bedsore in male spine ward among patients admitted DO Educate the patient’s relative about the importance of Second Hourly position change Give demonstration of how to change the position to bed ridden patient and to ask nursing assistant for help if nursing officer is not available. Patient’s relative is able to change position Second Hourly even without the assistance of nursing officer Patient’s relative seems confidence in managing bed ridden patients & does not hesitate in asking help from nursing officer and nursing assistant. STUDY QI Team question for nursing officer Will this change help in reducing the incidence of bedsore ? ACT ** The team tried this meathod for one week and found no new occurrence of bedsore in patient.

11. Outcome Measures: Total no. of patients admitted in male spine ward during 22.11.2024 to 22.01.2025 100 Patients who developed bed sore during hospital stay in male spine ward for a period of two months from 22.11.2024 to 22.01.2025 Data Source: Male Spine ward 29A Data Collector: Nursing Officer Frequency of Data Collection : Weekly 18 X 100 = 20 % 90

12. SUSTAINING IMPROVEMENT MONTHLY AUDIT OF THE DATA COLLECTED BY THE NURSE TO ENSURE THE ASSESSMENT IS DONE EFFECTIVELY. REGULAR TRAINING AND SENSITIZATION OF NURSING OFFICERS SHOULD BE DONE TEAM WORK AND LEADERSHIP QUALITIES TO BE IMPROVED ADEQUATE RESOURCES SHOULD BE AVAILABLE IN WARD NURSING STUDENTS CAN BE INVOLE FOR PROVIDING HEALTH EDUCATION TO PATIENTS DURING THEIR POSTINGS IN WARD INCIDENT FORM SHOULD BE FILLED PROPERLY AND SEND TO QUALITY CELL.