Writing on how would conduct a quality improvement plan on pressure ulcers with pts on hospice servi

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Asked by Liznicolealbulov
Writing on how would conduct a quality improvement plan on pressure ulcers with pts on hospice services. By initial skin assessment and Braden scale calculated then the regular rn case case manager doing both skin assessment and Braden score (both collaborate to explain to doc) either no PUor stage one that looks as if could soon become 2, or multiple stage 2 and 3s. Most of these patents at this point have adequate or poor nutritional intake therefore Already at disadvantage, being older (most the time), co-morbidities, etc things make person more at risk patients at end of life with aims to change how pu are addressed from the beginning to the end of life so manage/ maintain pu if have and not increase further skin breakdown which most times is associated increased pain and decrease last qol days. Start with collaboration of RNCM and admissions nurse to come up w best plan of action example for stage 2 pu make so each has specific protocol for most part of course will be exceptions ( wash wound warm soap to and water, Pat dry apply calmoseptine lotion to area and cover with allyvn dressing to stay on at least 3 days unless soiled or needs to be changed. discuss w doc for orders using the pdsa tool which also take into account wether for example a support surface is necessary such low air loss mattress so we know at least has one stage 3 as manager has to approve it. Educating family and and/or facility staff on importance to follow POC including regular turning of pt and floating heaps to decrease posss of heel friction etc ensuring they understand provide written instructions as nurse will be there or heath aid and can detect changes. Team of strong RN admissions RN doc home health aid when givin g showers or bed baths constantly in communication w Rn regarding condition and following POc in regards to using barrier creme calmoseptine or a&d whatever in care plans also turning and repositioning and reinforce to family or staff then doc and manager concludes team. Every tied take 15-20 min to discuss patients and numbers to see what’s working etc small things if change snything. Set 3month time station then evaluate numbers w help from IT building into emr tool rn can easily mark/chart regarding wound status which gives our numbers. Cycle continues. 3 months evaluate. Stakeholders would be considered- all team members rest Of staff, manager. doc, who communicates w higher ups q1 month or gets monthly report. CMS would be steakhoder, either family or facility staff or or private duty aids. Why is it imp to indenting/engage stakeholders ? Because they will be more engaged? The root cause could be nutritional status sooo poor thst not a chance won’t get worse or not everyone on board etc more examples if can think of ? Or family member staff lack of education need more training mixed up a and d w calmoseptine. Would continue to cycle on until 3 months and evaluate effectiveness based on numbers and no new or worse pressure ulcers, pain level of pt if still conscious or non verbal and all that would tell if successful or not. I’m struggling with stating the problem in clear concise wording based on above. Any suggestions would be grateful. See picture of assignment description. Hmm maybe I cannot attatcj a picture I’ll try it sepertley. Thanks you
SCIENCE
HEALTH SCIENCE
NURSING
NUR 522

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