NUR 630 Benchmark Outcome and Process Measures

Benchmark Outcome and Process Measures Example

Continuous quality improvement is an essential aspect of healthcare that entails incremental progressive improvement of care processes, hence quality and safe patient care. CQI focuses on improving operations, outcomes, processes, environment, and policies. These interventions help healthcare facilities improve efficiency, reduce resource wastage, and improve employee and patient satisfaction. These interventions must also be evaluated to determine if they are effectively implemented and if they achieve the results they are thought to achieve. Process and outcome measure measures are significant to continuous quality improvement and are the focus of this essay.

Two Process Measures in Continuous Quality Improvement

Process measures are specific and evidence-based measures that streamline the processes, whereas outcome measures look at the project’s product. The problem/ process/ service of interest informs them. The problem of interest is surgical complications in the facility, which is to contain and lead to high-quality patient care with better patient outcomes and care quality. Essential and selected process measures in preventing surgical complications include the selection, timing, and administration of antimicrobial prophylaxis and hair removal techniques used. These process outcomes can be used to control the process of surgical site infection prevention. Researchers argue that process measures are more significant than outcome measures because they directly influence outcomes by ensuring that recommended best practices are implemented as planned (Tanner & Melen, 2021).

Antimicrobial prophylaxis selection, timing, and administration are crucial to surgical site infection prevention. This process measure was selected because the importance of prophylactic medications has been long recognized and appreciated. In some cases and surgery types (such as open-heart surgeries and all clean-contaminated), prophylaxis antibiotics are routinely administered to protect patients from infections. Prophylactic antibiotics have different potency, which is significant to infection prevention.

Branch-Elliman et al. (2019) note that the medications selected are informed by the risk associated with the surgical intervention. Depending on hospital policy, the prophylactic medications are administered before or during surgery. Evidence-based best practices and government agency recommendations show that administering antimicrobial prophylaxis 30-60 minutes before incisions is associated with the best results (de Jong et al., 2021). In addition, antimicrobials with fast infusion time are considered for quality patient outcomes.

For this process measure, the type of prophylactic antimicrobial medication used will be recorded for each surgery. The timing and administration will also be collected for each surgery. Surgical site infection for each case will also be corrected and analyzed individually and collectively. The prophylactic antibiotics and their outcomes, use versus disuse of prophylactic medications. The data generated will show which medications have the least or most significant infection risks,

Bashaw and Keister (2019) note that perioperative hair removal practices are vital predictors of surgical site infections, and hair removal practice used affects the infection rates. Human hair harbors bacteria and also obstructs operation site view. Their removal practices are thus significant to the prevention of infection. Changing the hair removal techniques can thus significantly affect the rate of SSIs. According to Tanner and Melen (2019), clippers or depilatory cream use is associated with lower SSI rates than other hair removal practices. Razor-mediated hair removal practice is associated with the highest number of medication errors. Thus, a significant process measure is the number of surgical procedures utilizing clippers or depilatory cream compared to other methods.

For this process measure, data collection will be the percentage of surgeries that utilized clippers compared to those that used razors. This process measure will also help understand how the interprofessional teams in the surgical room perceive surgical site infection prevention practices and their significance. An increased percentage of hair clippers use will significant process success on the road to preventing surgical site infections. The surgical information for all surgeries should thus include the hair removal technique to ensure these best practices are implemented are recommended for quality patient outcomes.

Outcome Measures Selected

Surgical complications are essential to mortalities and the quality and safety of patient issues. The interest is increased complications rate in surgeries. Most surgeries are life-saving interventions that target improving the health of individuals with a life-threatening illness. Complications, particularly infections, increase mortality rates and healthcare costs, hence their significance to the population. The outcome measures for significant to continuous quality improvement care are surgical site infection rates, readmission rates, and mortality rates following surgery.

Surgical Site Infection Rates (SSI rate)

More than 10 million patients undergo surgery annually, contributing to about a quarter of all hospital stays. The selected outcome measure of interest is the surgical site infection rate due to its significance in care quality, safety, and healthcare costs. The CDC (n.d.) defines surgical site infections as “infections related to operative procedures occurring near the surgical incision that occur within 30 days of surgery of 90 days post prosthetic insertion.” The surgical site infection rates reflect effective perioperative infection prevention measures.

Surgical site infection prevention measures include pre-op showers with antiseptic soaps, intact skin cleansing, prophylactic drug administration, hair removal method, and glucose monitoring in surgeries. These processes, among others healthcare professionals, prevent surgical site infections. According to Sieldelman et al. (2023), surgical site infections are vital culprits in inpatient mortalities, morbidity, prolonged hospital stay, and healthcare costs. SSIs can be severe and difficult to treat, leading to poor quality outcomes, poor patient satisfaction, and decreased perceived quality measures ().

Data collection for this measure is quite elaborate. The healthcare providers keep data on all surgical interventions/ procedures and evaluate patients to determine those who developed infections (Bashaw & Keister, 2021). The number of individuals who developed surgical site infections within 30 days post-op is then compared to those who did not. The ratio is then converted into a percentage and monitored over time. Surgical site infections are not a one-time prevention intervention. They require continuous monitoring and evaluation because each new surgery or left step could lead to significant problems in care outcomes, hence the measure’s significance.

Success Determination

When evaluating process and outcome measures, goals and 0objectives are significant. Institutions can determine success using internally or externally generated benchmarks. The local healthcare facility’s target has a surgical site infection rate below 4%. Surgical site infections (SSIs) are the third most common nosocomial infections after catheter-acquired urinary tract infections and central line-associated bloodstream infections (Ekanem et al., 2021). SSIs are most common in obstetric and gynecological surgeries, primarily due to a large number of these surgery types.

An SSI rate below 5% could be considered significant/successful, considering the national average is 16% (Strobel et al., 2021). Revaluating the value each year could help the institution continually improve its preventive processes hence quality patient outcomes. In addition, rates above 90% in clippers use, appropriate prophylactic use, medication selection, and optimal administration timing (within 60 minutes of incision) would indicate success in the continuous quality improvement process.

Cost-Effective Solutions to This Challenge

Surgical site infections are a significant healthcare issue that must be addressed to ensure quality patient outcomes and enhance patient safety. Healthcare data and patient outcomes often drive improvements. According to current literature, staff education is an effective intervention in managing this problem (Ariyo et al., 2019). Theatre staff must be reminded of the significance of surgical site infections and the means to prevent them. Another intervention is surveillance tools for risk identification and management. The tools are derived from the national agencies’ guidelines for surgical site infection prevention (CDC, n.d.).

Wall et al. (2022) note that the tool uses electronic health records data to alert the care providers of patient risks, allowing them to intervene and prevent infections. The tool helps protect vulnerable populations and thus reduces the overall surgical site infection rates. Patients with immunocompromise and other risk factors such as diabetes should be monitored using a checklist, and the risks mitigated, as the agency recommends for healthcare research and quality (Wall et al., 2022). The surveillance tool is digital and cost-effective because no additional costs are used in collection and data analysis for risk identification.

Conclusion

Process and outcome measures are significant to project monitoring and evaluation. In continuous quality improvement, measures are collected more than once over time, and the goal is to produce sustainable change that leads to quality improvement in healthcare. Given the rising surgical complication rates in healthcare facilities, the focus is on surgical site infections. The interest is to ensure low surgical site infection rates and associated mortalities. Process outcomes such as selection, timing, and administration of prophylactic antimicrobials and hair removal best practices are significant to surgical site infection rates and continuous quality improvement in the facility.

NUR 630 Benchmark Outcome and Process Measures References

Ariyo, P., Zayed, B., Riese, V., Anton, B., Latif, A., Kilpatrick, C., Allegranzi, B., & Berenholtz, S. (2019). Implementation strategies to reduce surgical site infections: a systematic review. Infection Control & Hospital Epidemiology, 40(3), 287–300. https://doi.org/10.1017/ice.2018.355

Bashaw, M. A., & Keister, K. J. (2019). Perioperative strategies for surgical site infection prevention. Aorn journal, 109(1), 68–78. https://doi.org/10.1002/aorn.12451

Branch-Elliman, W., O’Brien, W., Strymish, J., Itani, K., Wyatt, C., & Gupta, K. (2019). Association of duration and type of surgical prophylaxis with antimicrobial-associated adverse events. JAMA Surgery, 154(7), 590-598. https://doi.org/10.1001/jamasurg.2019.0569

Center for Disease Control and Prevention (CDC), (n.d.). Surgical Site Infections (SSI): Infection Control. Accessed March 21st 2023, from https://www.cdc.gov/infectioncontrol/guidelines/ssi/index.html

de Jonge, S. W., Boldingh, Q. J., Koch, A. H., Daniels, L., de Vries, E. N., Spijkerman, I. J., Wim A., Gino K., Marce;, D., Markus, H., & Boermeester, M. A. (2021). Timing of preoperative antibiotic prophylaxis and surgical site infection: TAPAS, an observational cohort study. Annals of Surgery, 274(4), e308-e314. https://doi.org/10.1097/sla.0000000000003634

Ekanem, E. E., Oniya, O., Saleh, H., & Konje, J. C. (2021). Surgical site infection in obstetrics and gynecology: prevention and management. The Obstetrician & Gynaecologist, 23(2), 124-137.https://doi.org/10.1111/tog.12730

Strobel, R. M., Leonhardt, M., Förster, F., Neumann, K., Lobbes, L. A., Seifarth, C., Lee, L. D., Schinei, C. H. W., Kamphe=ues, C., Weuxler, B., Kreis, M. E., & Lauscher, J. C. (2022). The impact of surgical site infection—a cost analysis. Langenbeck’s Archives of Surgery, 1-10. https://doi.org/10.1007/s00423-021-02346-y

Tanner, J., & Melen, K. (2021). Preoperative hair removal to reduce surgical site infection. Cochrane Database Of Systematic Reviews, (8). https://doi.org/10.1002/14651858.CD004122.pub5

Wall, R. T., Datta, S., Dexter, F., Ghyasi, N., Robinson, A. D., Persons, D., Boling, K. A., McCloud, C. A., Krisanda, E. K., Gordon, B. M., Koff, M. D., Yeager, M. P., Brown, J., Wong, C. A., & Loftus, R. W. (2022). Effectiveness and feasibility of an evidence-based intraoperative infection control program targeting improved basic measures: a post-implementation prospective case-cohort study. Journal of Clinical Anesthesia, 77, 110632. https://doi.org/10.1016/j.jclinane.2021.110632

NUR 630 Benchmark Outcome and Process Measures

Need a 1,000-1,250 word paper, consider the outcome and process measures that can be used for CQI. Include the following in your essay:

At least two process measures that can be used for CQI.
At least one outcome measure that can be used for CQI.
A description of why each measure was chosen.
An explanation of how data would be collected for each (how each will be measured).
An explanation of how success would be determined.
One or two data-driven, cost-effective solutions to this challenge.

Prepare this assignment according to the guidelines found in the APA Style Guide, apa 7^th edition, An abstract is not required. Please use at least 4 sources. NUR 630 Benchmark Outcome and Process Measures

This assignment uses a rubric. Please review the rubric prior to beginning the assignment.

This is the milestone for this assignment: 6.5 Generate data-driven, cost-effective solutions to organizational challenges. NUR 630 Benchmark Outcome and Process Measures

Health Care Culture

The purpose of this assignment is to discuss health care culture and describe how CWV can be used to
improve ethical practices. In a 1,000-1,250-word essay, discuss the important factors associated with health care culture. Include the following in your essay:

1. A definition of health care culture, including culture of excellence and safety.
2. Two or three examples of principles for building a culture of excellence and safety.
3. An explanation of the role of various stakeholders in improving health care culture.
4. An explanation of how Christian worldview (CWV) principles might be used by health care organizations to improve ethical practices, whether the organizations are Christian or not.
5. Two or three examples of how the integration of faith learning and work at GCU can be implemented by individuals to improve health care culture.

This assignment requires a minimum of three peer-reviewed scholarly sources.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student
Success Center.

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.