Question

The nurses on a medical unit have seen an increase in the number of pressure injuries developing in their patients. The nurses decide to initiate a performance improvement project using the PDSA model. Which of the following is an example of "Plan" from that model? A. Orienting patients to the unit's practice of hourly rounding on patients B. Reviewing the incidence of pressure injuries on patients cared for using the protocol C. Based on findings from patients who developed injuries, implementing an evidence-based skin care protocol on all units D. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries

Short answer

D. Meeting with all disciplines to develop a multidisciplinary approach for reducing pressure injuries.

Step-by-step solution

Identify the PDSA Model

The PDSA model stands for Plan-Do-Study-Act. It's a problem-solving method used for continuous improvement in quality management. The 'Plan' phase involves establishing objectives and processes necessary to deliver results in accordance with the expected output.

Eliminate Non-Planning Options

Distinguish which of the options provided corresponds to the 'Plan' phase. Options that involve implementation, action, or evaluation (Do, Study, and Act) are not part of the 'Plan' phase and can be eliminated.

Select the Correct Answer

Choose the option that represents the 'Plan' phase, which is typically about developing strategies and preparations for improvement before any action is taken. In this case, it will involve planning measures to prevent pressure injuries.

Key concepts

Quality Improvement in Healthcare

Quality improvement in healthcare is an essential aspect of modern medical practices, aimed at enhancing patient care, optimizing outcomes, and reducing unnecessary costs. It incorporates a systematic approach to identify areas where health services can be improved, followed by the implementation of targeted strategies. One widely used framework for embarking on quality improvement initiatives is the Plan-Do-Study-Act (PDSA) cycle.

The PDSA model facilitates healthcare professionals in structuring their improvement efforts effectively. During the 'Plan' phase, healthcare teams establish objectives and devise detailed plans to reach the desired outcomes. This phase is crucial as it sets the foundation for the changes to be tested. The 'Do' phase sees the execution of the plan on a small scale to observe the effects. The 'Study' phase involves assessing and analyzing the data gathered from the 'Do' phase to evaluate the effectiveness of the changes. Finally, the 'Act' phase is where the lessons learned are implemented on a broader scale to make the improvement part of regular practice.

For healthcare providers, staying committed to quality improvement means continuously monitoring performance, remaining flexible to embrace new evidence-based practices, and fostering a culture of learning and adaptability.

Pressure Injury Prevention

Pressure injuries, also known as bedsores or pressure ulcers, are areas of damaged skin and tissue caused by prolonged pressure on the skin. They often occur in patients who are immobile or have limited mobility, such as those confined to beds or wheelchairs.

Preventing pressure injuries is a critical aspect of nursing care, involving regular patient assessment, timely repositioning, and using support surfaces like specialized mattresses or cushions. Nurses also play a pivotal role in educating patients and caregivers about the risk factors and preventive measures. The importance of skin care, nutrition, and maintaining mobility as much as possible cannot be overstressed. When it comes to planning for pressure injury prevention, it involves evaluating the current state of patient care, identifying risk factors, and developing comprehensive protocols that everyone in the healthcare setting can follow.

Implementing a prevention plan may include measures such as adopting new cushioning technologies, setting up a schedule for patient turning, and educating the staff about early signs of skin breakdown. It involves an interdisciplinary approach, ensuring that all professionals involved in patient care are aware of, and adhere to, the best practices for pressure injury prevention.

Nursing Continuous Improvement

In nursing, continuous improvement is a commitment to regularly assessing and enhancing the quality of patient care. It is a cycle of ongoing reflection and action, aimed at optimizing all aspects of nursing practice. This process not only benefits patient outcomes but also contributes to the professional development of nurses.

One application of this concept is found in addressing the uptick in pressure injuries in a healthcare setting. Using the PDSA model, nurses would 'Plan' by investigating the causes of increased pressure injuries and developing protocols based on best practices. They might 'Do' by piloting these protocols on selected units. The 'Study' phase requires collecting data on the effectiveness of the interventions, and during the 'Act' phase, successful strategies are implemented throughout the facility.

Nurses should engage in lifelong learning to stay updated with the latest in care standards and technologies. They can also participate in workshops and training sessions to refine their skills. To foster a culture of continuous improvement, healthcare settings should encourage open communication, allow for the sharing of insights, and support nurses in undertaking quality improvement projects. Through this collaborative and proactive approach, the nursing profession can ensure high-quality care that evolves with the needs of patients.