PROFESSIONAL GROWTH: Quality improvement: What does it mean at the point-of-care?
Juli Maxworthy DNP, MBA, MSN, RN, CNL, CPHQ

July 2010 
Volume 40  Number 7
Pages 41 - 43
  PDF Version Available!

AT YOUR RECENT staff meeting, a member of the quality management department brings data showing that the number of falls is increasing. You learn that administration wants to see improvement and you're given a graph with your unit listed. You don't know where the data came from or what they really mean, but you don't want to speak up because you think you're the only one who's in the dark. Well, think're not alone.Many point-of-care clinicians are challenged by the recent onslaught of data and mandatory participation in initiatives from such organizations as the Institute for Healthcare Improvement (IHI), The Joint Commission, National Quality Forum, and National Database of Nursing Quality Indicators (NDNQI).This article discusses what you need to know to be successful in a quality improvement project. (For a look at the history of quality improvement in nursing, see Channeling Florence Nightingale.)Data showing that your unit has a higher-than-expected fall rate are probably based on national benchmarks. In the case of falls, this database is primarily obtained from the NDNQI, which focuses mostly on nursing-sensitive indicators (falls, pressure ulcers, and urinary tract infections).1Your unit's fall rates are often determined by event reports, and data can be provided by the quality management department. In the case of falls, the number, type (with or without injury), and outcome (none, injury, death) are the endpoints that are determined. Make sure you use definitions consistently to ensure that you're comparing apples to apples.Get additional help when you're trying to make a change—going it alone can be frustrating. Include anyone who has an interest in preventing falls, such as point-of-care clinicians from other shifts, managers, certified unlicensed assistive personnel, unit secretaries, and physical and occupational therapists.Often placing a sign-up sheet on the information board will start a recruiting

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