Introduction
In their effort to reduce cost of treatment, the Minnesota Hospital firstly identified five avoidable negative situations on July 2, 2010, with four more events suggested on May 15, 2011. They have developed a plan for assisting control costs through rejection of payment of the greater analytic class when these situations happen as an inferior analysis in intensive healthcare section. This practice, which started a gradual implementation in the intensive-care environment on 13 November 2009, has generated a few logistical and adoption issues in the medical field. The economic inferences for pressure-based ulcers will be measured through the Available on Admission Pointer (AAP). The AAP determines if patients have pressure-based ulcers during admission (Marquis & Huston, 2012).
Hospital-based ulcers are normally those that initially develop 3 days after patients are hospitalized in a hospital or any other Medicare institution. Hospital-based ulcers may be caused by surgical practices, a catheter inserted in the urinary position or a blood vessel, or by materials from the nose that are breathed into the body. Any hospitalized patient is prone to getting hospital-based wounds.
Certain inpatients are more vulnerable than others – old people, children, and a person with compromised immune system are candidates for hospital wounds. A hospital infection can be caused by a parasite, fungus, or virus. Such micro-organisms may originate from the hospital surrounding, infected hospital equipments, staff, or other inpatients (Bennet et al., 2008; Sussman & Jensen, 2007).
Problem statement
Currently there is a replenished necessity and increased focus on prevention since starting on November 15, 2012, the hospice will not get extra funds to treat patients who have acquired the pressure-based ulcers while undergoing treatment. Like any pioneering practice, this presents drive for change. We see this disbursement as taxing, but one that gives all nursing staffs and in particular ulcer safety professionals with a chance for assuming headship in critical protective health safety strategies.
Goal for planned change
The goal of the safety plan is that pressure-based would evaluation, ulcer inspection and prevention strategy will take place constantly for patients undergoing treatment not only at intensive care department, but also at the outpatient environments. Besides, it is an aspiration that pressure-based would risk evaluation will turn out to be a patient safety critical indicator (Huston, 2010).
Objectives
The objectives of this safety plan include: minimizing the occurrence of pressure-based would development, precisely identifying people at risk of getting pressure-based would in the hospital and non-hospital care environment, and enhancing training in the prevention and spreading of pressure-based wounds to patients, relatives and health-providers.
Changes made
Various safety alterations were identified through the implementation agency (Minnesota Hospital) as major plans for clinical policy to integrate with a view of supporting the adoption of this plan. These include: Initiating a program for training personnel, patients and health-providers on threat evaluation and pressure ulcer identification methods, together with ulcer safety measures; and dealing with hindrances to adopting pressure-based would avoidance strategies.
Theoretical framework
Specialist evaluation and documentation at the time of hospitalization that the pressure-based would was visible during admission is significant. Because this indicates an alteration in approach from existing ulcer evaluation tools, in addition to a model change with economic inferences, it needs a few emerging concepts in regard to how specialists in the intensive-care environment deal with patients at threat for pressure-based wound or a patient hospitalized with visible pressure wounds (Huston, 2010).
Project approach
Minnesota Hospital, effective November 15, 2012, announced an organizational change in hospice disbursements. This transformation called for the adoption of a modern disbursement plan that rewards hospices for patient safety and prevents payments for needless and avoidable cost (Marquis & Huston, 2012).
Barriers to change
Patient complexity
The capability of preventing pressure wound growth is influenced through sophistication and severity of patient ailment conditions, natural state, age, overweight and starvation, and required supporting system that may differ during admission (Gibbons et al., 2008).
Patient compliance
The willingness of a patient to get involved in pressure-based wound prevention plans may be influenced by natural and conduct aspects. Non adherence may be associated with incapability of participating, life concerns, traditional beliefs, health status, natural condition, and absence of confidence or awareness issues (Gibbons et al., 2008).
Recommendations
Based on the barriers to change, this implementation plan recommends the following: establishing a system and/or e-medical documentation indication on every hospitalization record made for completing skin inspections and threat evaluations, developing a procedure and an instrument for identifying at-threat patients, and using pressure-based wound prevention policies/procedures/orders for a vulnerable patient (Sussman & Jensen, 2007).
Conclusion
Based on the source of hospital wounds, ulcers may begin in any part of the body. Specific infections are restricted to certain parts of the patient body and bear a specific symptom(s). By definition, a hospital-based ulcer is normally one that emerges three days following admission to a hospital. Hospital-based ulcers may be caused by either surgical practices, catheter inserted in the urinary position, or by breathing in foreign matter. Generally, any hospitalized patient is prone to getting hospital-based ulcers.
References
Bennet, G., Dealey, C., & Posnett, J. (2008). The cost of pressure ulcers in the UK. Age and Ageing, 33(3), 230-233.
Gibbons, W., Shanks, H., Kleinhelter, P., & Jones, P. (2008). Eliminating facility- acquired pressure ulcers at ascension health. Journal on Quality and Patient Safety, 32(2), 488-496.
Huston, C. (2010). The imperative for nursing leadership skills: Logic. Journal of the New Zealand Nurse’s Organization, 9(3), 2-8.
Marquis, B., & Huston, C. (2012). Leadership roles and management functions in nursing: Theory and application (7th ed.). Philadelphia: Lippincott Williams & Wilkins.
Sussman, C., & Jensen, B. (2007). Wound care: a collaborative practice manual for health professionals (3rd ed.). Philadelphia: Lippincott Williams & Wilkins.