NURS FPX 6085 Assessment 5 Evaluation Plan Design

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NURS FPX 6085 Assessment 5 Evaluation Plan Design

Student name

NURS-FPX6085

Capella University

Professor Name

Submission Date

Evaluation Plan Design

One of the priorities of modern quality improvement in healthcare is enhancing patient safety, as well as ensuring the appropriate and timely registration (Mistri et al., 2023). The evaluation is based on an intervention involving a formal audit and feedback program to enhance pressure injury risk documentation for adult medical-surgical patients within 24 hours of admission. It unites the leadership as well as the interprofessional combining technology and policy alignment strategies by sealing the loopholes in practice. The plan will incorporate an implementation plan, assessment strategies, and areas of improvement that will help to minimize pressures in hospitals, enhance compliance, and instill a culture of quality care.

Evaluation of Plan

Outcomes that are the Goal of an Intervention Plan

The most significant outcomes of the intervention plan are the enhancement of the timeliness, accuracy, and completeness of the risk documentation of adult patients in regards to pressure injuries within the first 24 hours of admission. It will be measured with regard to the desirable outcomes in the form of an increased adherence rate to standard documentation practices, which is justified by the evidence-based instruments like the Braden Scale (Huang et al., 2021). The outcomes that have been considered secondary are reducing the incidence of hospital-acquired pressure injuries, the enhancement of interprofessional collaboration in terms of the risk status of the patients, and the continuity of care. The intervention is also directed at enhancing the compliance of the staff with assessment guidelines that will be reinforced by frequent audits and feedback. As it has been predicted, documentation will also be automated with the use of technology, including electronic health record (EHR) notifications and computer-based reminders (Tsai et al., 2020). This will be done not only through quantitative gains in documentation steps, but also through qualitative ones, including the satisfaction of staff and their subjective perception of usability. These findings combined are used to the end of advancing patient safety, improve resource utilization, and are in line with the national quality standards.

Evaluation Plan to Determine the Impact of the Intervention

The structured audit and feedback intervention evaluation plan will be hybrid as it will incorporate the mixed-method design in measuring the effectiveness of the intervention in enhancing the pressure injury risk-documentation compliance within the first 24 hours of admission. Compliance rates before and after the intervention will be assessed using EHR reports and secondary outcomes, such as pressure injury rates, audit-based scores, and time spent on the completion of documentation (Bunting and Klerk, 2022). The data will be gathered every week throughout the 12-week implementation process and will be compared to the baseline data gathered at the end of the last quarter. The quality measures will be represented by the staff feedback that will be received in the form of the post-implementation surveys and the focus group aimed at knowing the usability perceptions, the impact on the workload, and the effectiveness of the feedback.

The process evaluation will track the adherence to the components of the interventions, like education session attendance, the rate of timely use of EHR, and the timely feedback. The statistically significant and clinically significant improvements will be measured in terms of the outcomes. Economic measures will also be measured, such as the fall in the cost of treatment of pressure injuries and the use of resources. In the plan-do-study act (PDSA) cycle, rapid modification will be possible when routine monitoring in the rollout is conducted (Abuzied et al., 2023). The decision to scale up or not scale up the intervention, to amend or incorporate it into regular policy in a long-term implementation, will be informed by the final report.

Discussion

Advocacy

Nurse’s Role in Leading Change and Driving Improvements

Nurses are well-positioned to make a difference in change and quality improvement and experience of care, especially in interventions such as structured audit and feedback of pressure injury risk documentation. The latter are the nearest to caregivers and have the immediate chance of responding to one of the areas that have an issue, act as a voice of defending evidence-based practice, and show that they comply with document requirements (Flaubert et al., 2021). Transformational leadership approaches enable nurse leaders to motivate and involve teams and create a commitment to patient safety and quality outcomes.

The nurses during this intervention will be change agents because they will facilitate compliance with the 24-hour documentation requirement, good feedback, and interdisciplinary collaboration to overcome the barriers. Nurses make education programs practical, relevant, and staff-centered. Nurses can also facilitate communication between the bedside teams, quality improvement experts, and information technology (IT) personnel and integrate their workflow (Baloyi, 2022). The involvement and limitation of resistance can be reached in nurses by means of encouragement of accountability and the establishment of a psychologically safe space. Process changes end up generating the outcomes in terms of quality of care, patient outcomes, and patient experience due to their leadership.

Effect of Intervention Plan on Nursing and Interprofessional Collaboration

The structured audit and feedback intervention of the risk documentation of pressure injury improves the nursing and interprofessional practice directly, as it creates a shared accountability for assessing adequately and timely manner. The interaction of wound care experts, quality improvement teams, and IT support closely accompanies nurses as the key users and must obtain efficient workflow, EHR prompts must be operational, and feedback must be actionable (Baloyi, 2022). Communication is convened through interdisciplinary leaders like nurse educators and unit managers, whereby all individuals on the team have expectations and can help in finding solutions to problems.

This process promotes the element of respect since the two practices will result in achieving compliance and improvement of safety for patients. As a result of regular audit review and huddles, there is an opportunity to discuss the practices in real-time and allow the teams to change the practice in real-time and solve the barriers without blame (Sarkies et al., 2023). The plan enjoys practical advantages to the larger health care community: Fewer pressure injuries in hospitals, fewer treatment costs, improved compliance with regulations, and improved data with which to track quality. The plan also establishes a culture of continuous improvement in which disciplined processes, technology, and teamwork can be used to promote constant patient care improvement and safety.

Future Steps

One of the possible methods of extending the depth of impact of the project is targeting the obtained results. Incorporation of analytics in the documentation system may outline the compliance in risk compliance models in terms of longitudinal stratification of high-risk patient samples. The electronic health records (EHRs) will be informed by a cross-walking stratification of evidence-based bed and borden scores as compared to other clinical measures of mobility and nutrition, and comorbidities (Moorman, 2021). Knowledge of nurses and interprofessional teams who will be capable of implementing preventive interventions to reduce unnecessary risk escalations. Adjuncts in the context of maintaining skin risk assessment and real-time recording include adjunct wear that measures the pressure in deep tissue and under sub-epidermal moisture (SEM) scanning units, in the context of nurse-led care. The accuracy of the assessment will be optimized with the help of the Ousey et al. (2022) real-time skin monitoring framework, which will improve the amendments to the skin care records to act in the moment. These are nurse-led mobile health bedside systems that encompass reminders, compliance supervision, and nurse-led mobile systems with educational modules, which they can easily integrate into practice. 

Discussing the topic of innovation regarding patient care, i.e., by conducting team rounds with wound care and quality improvement (QI) leaders, would make sure that the risk mitigation strategies become embedded in everyday life. In addition, they should involve patients and families in the feedback process by means of repositioning education and skin checks to introduce collective responsibility towards prevention. By the combination of using technology-enabled early detection methods and interdisciplinary care, the intervention would serve a significant improvement in patient outcomes (Gala et al, 2024). This combined strategy would impact the culture of safety and minimize the hospital-acquired injuries.

Reflection on Leading Change and Improvement

Impact of Project on My Ability to Lead Change

This project helped me to increase my leadership capacity to effect transformational change by enriching my knowledge of the highly developed evidence-based, structured interventions. The necessity to combine evidence-based decision-making with supportive leadership based on data was reiterated by the preparation to lead the design of an audit and feedback process to support risk documentation of pressure injury (Foy et al., 2020). I have also learned practical skills like stakeholder engagement, intervention alignment with the organizational priorities, and integration of technology into workflow processes. 

The encouragement of feedback through the involvement of psychological safety and constructive resistance, and ownership of the results also taught me to anticipate and avoid resistance. The experience also highlighted the importance of flexible change and the capacity to shift the focus strategy and aim towards the long-term objectives with what objectives to gauge. In the future, as a leader, I will be in a far better position to address quality improvement initiatives that will involve clinical as well as interprofessional collaboration. This project has made me realize that the power to make a change does not emerge out of a group of mandates, but a willingness to create a culture that motivates every team member to feel part of, awake, and motivated towards influencing safer quality care.

Ways to Transfer Completed Intervention, Implementation, and Evaluation into my Personal Practice

The final intervention with its application and analysis will be the final section that will meet the demand of describing the evaluation methodology and logic that will support quality improvement. The practice-focused, personalized audit-and-feedback model, with the support and smooth connection of EHR processes and educational content available in my immediate practice area, offers a flexible and highly scalable solution to maintaining improvement in a variety of clinical issues, whether pressure injury prevention, medication safety, infection control, or efficient discharge planning.

Through the implementation plan, I have learned to appreciate the engagement of stakeholders, more staggered implementation, and streamlining of work routines to increase adoption and sustainability of the integrated approaches. Monitoring of the real-time data and continuous refining process of the PDSA cycle can be applied in other projects to maintain attention to the frontline problems. Additionally, the quantitative and qualitative appraisal integrated in the evaluation plan also acts as a prototype of the real outcome and employee feedback against their constructive and actionable opinions. The implementation of these methods enables me to create specific compliance and organizationally motivated interventions that operate to maximize patient outcomes and employee satisfaction under different care settings. This has the effect of making sure that future improvement activities remain evidence-based, collaborative, and observant.

Conclusion

The formal audit and feedback approach is the most effective way to address the problem of recording the risk of developing a pressure injury, based on compliance and patient/quality care safety aspects. The strategy integrates the leadership and involvement of the representatives of other professions and communication and technology in order to eliminate the unbalances of the existing situation and facilitate the actual improvement. To ensure the realization of the long-term objectives, the process of evaluation and improvement will have to occur frequently.