Overview In reviewing the Nurse-Sensitive Quality Indicator Dashboard, the plan is to target patient satisfaction indicators and develop a nursing action plan based on best practices. The purpose of this paper is to analyze promptness of nurses in caring for their patients and discuss how best practices could be implemented to improve patient satisfaction. Analysis of the Data The area of performance selected for analysis was patient satisfaction in the relationship to promptness of care.
For the fiscal year 2010, the inpatient rehabilitation unit missed their target goal by 4. 15. However when reviewing the other dashboard indicators there were three other categories under patient satisfaction that did not meet the target for this year; attention to special needs, response pain and instructions home. The decision to choose RN promptness was made due to the effect that promptness has to the patients overall stay in the hospital.
How a patient perceives their quality of care is associated with if the patient will revisit the hospital or recommend the hospital to a friend (Teng, 2010). For example if nurses are more prompt with answering call lights, rounding on patients and administering pain medications this will increase overall patient satisfaction. With targeting promptness of the nurse, this will directly increase other scores on the quality indicator dashboard such as attention to special needs, response to pain, and falls.
Nursing Plan Interventions by nursing on how to improve the scores on the dashboard in association to nursing promptness would be: 1) Purposeful hourly rounding 2) Focus on patient experience 3) Promptness of answering and addressing call lights. Each of these best practices will directly improve patient’s perception of promptness of nursing. Purposeful rounding would consist of the nurse or charge nurse rounding hourly during the hours of 6am to 10pm, and then every two hours from 10pm to 6am.
There are three factors that have been continually tested to improve patient care. These factors are: 1) fall rates 2) call light usage and 3) overall patient satisfaction 4) pressure ulcers developing. The protocol that would be initiated would consist of attention to pain, positioning, toileting needs, call light and personal belongings within reach, and checking the environment for safety (Kessler, 2012). Before the nurse would leave the room, they would say something to the order of “Can I get you anything else right now?
Please use your call light if you need anything and I will be back in and hour to round on you. ” Near the white board in the room there will be a flow sheet to document who rounded and the time. Focusing on the patient experience, nursing care is what patients in the hospital receive primarily, and studies have showed that nursing care is the most important element of the patients overall satisfaction with their hospital stay (Oflaz, 2010). When a patient is dissatisfied with their care, it can be steamed from a single nursing situation.
So if there is a complaint the manager on the nursing unit, nursing supervisor or the patient advocate should directly speak with the patient, soon after the problem has been reported to the team. Nurses must work with ancillary departments to find out times of therapies, procedures or other patient care activities so that they can talk with the patient about their plan of care for the day. It is vital to include the patient in the plan of care and have them take an active role.
By involving the patient, a nurse can get a better understanding of what is most important to the patient to acquire during their hospital stay. Providing education about procedures, medications, diagnosis, diets and any other information they will need is important to do with each interaction during their hospital stay. Patients feel that they appreciate the promptness of education and answering their questions as they arise. The hospital already currently uses Vocera devices for communication by implementing the feature of call lights going directly to the RN or PCA improves responsiveness.
Hospitals who use Vocera communication in the relationship to the call lights have seen a dramatic improvement in HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) in promptness scores (Vocera, 2014). Nursing staff that are assigned to the patient log into the computer as their primary care nurse or nursing assistant, then when a patient uses the call light for nurse or pain medication the RN gets the Vocera call. When a patient uses the call light for water or personal needs then the PCA gets the Vocera call.
This feature allows the primary care staff answer and can respond to the call instantly which is reassuring for the patient. Purposeful hourly rounding shows the patient and family that the nursing staff is taking an active interest in their needs. During the rounds, the nurse is asking them about their pain and with this assessment the nurse can either medicate the patient or communicate with them when the next medication is due. By focusing on patient experience, the nurse will review the plan of care with patient and assess what is important for the patient and/or family.
Patients like to know the timeline of when to expect certain tests or doctors rounding. Promptness of answering call lights is just as important as addressing what the need was and following through in a timely manner. The use of “Vocera” communication to assigned staff members cuts down on forgetting to inform the nurse she comes out of another room. Summary Nurse-Sensitive Quality Indicator targeting patient satisfaction based on promptness of the nurse. This paper analyzed the importance of promptness in caring for patients.
The choice of this quality indicator was made because it has a large impact of the overall care the patient receives and has the greatest potential to improve many scores on this dashboard. The best practices that were chosen to implement were 1) Purposeful hourly rounding 2) Focus on patient experience 3) Promptness of answering and addressing call lights. Nursing care is what patients in the hospital receive primarily and studies have showed that nursing care is the most important element of the patients overall satisfaction with their hospital stay (Oflaz, 2010).
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