Older Adults Quality Of Care: Quality Analysis

Quality improvement issues in healthcare focus on the care that patients receive and the outcomes that patients experience. Nurses play a major advocacy role for ensuring safe and quality care to all patients. Also, nurses share the responsibility in leading the efforts in improving patient care in all settings (Berwick, 2002). One of the ongoing problems plaguing hospitals and nursing homes is the development of new pressure ulcers in patients after admission. A pressure ulcer can be defined as a localized area of necrotic tissue that is likely to occur after soft tissue is compressed between a bony prominence and a surface for prolonged periods of time (Andrychuk, 1998). According to the Centers for Medicare and Medicaid,

Goal three by the National Patient Safety Goal for 2014 is to use medicines safely. Many errors occur regularly with medications which is why communication is so important with the doctors, nurses and patients. One process that Joint Commission requires in accredited HCO’s is medication reconciliation “creating the most accurate list possible off all medications a patient is taking, including drug name, dosage, frequency, and route, and comparing that list against the physician’s admission, transfer, and/or discharge orders with the goal of providing correct medications to the patients at all transition points within the hospital (Finkelman & Kenner, 2012, p. 388)”. Ensuring medication reconciliation to the patient, health providers and any new consults that are

In 2009, An Bord Altranais published guidelines for nursing older people, person centred care and its provision was discussed in depth as a Standard in Nursing Practice, it is also the number one Standard in Nursing Practice. Person centred nursing care is provided within the organising framework of assessment, identification of needs, planning, implementation and evaluation (An Bord Altranais, 2009). Besides her hair going grey and wrinkles appearing a number of other changes are slowly happening within the body during the ageing process. These include changes to the cardiovascular system, the digestive system, cognition and memory, the bladder, bones, the senses and sexual function. (www.mayoclinic.org/healthy/lifestyle/healthy-aging/in-depth/aging/art-20026070 ).Their functionality may slow down, or begin to fail, leaving the older person in the care of a nurse. I t is the nurses duty to deliver person centred care in doing so recognise the individual and their unique interests, qualities, needs and preferences, rather than solely focusing on the illness. (

Fortunately, according to Chan et al., (2008), 95% of pressure ulcers can be prevented and nursing care is believed to be a primary method of preventing pressure ulcer development. Research was conducted on accredited search databases such as CINAHL, Nursing Resource Center and OvidSP on prevention measures for pressure ulcers. A number of credible evidence based research was found that supported the nursing intervention of

The primary goals for conducting nursing research are to generate new knowledge to promote positive outcomes for patients, enhance quality and cost-effectiveness of care, improve the healthcare delivery system, and validate the credibility of the nursing profession through evidence-based practice (Schmidt & Brown, 2012). The purpose of this paper is to explore the practice-related problem of pressure ulcers and the importance of the problem in the nursing profession.

Now, the quality improvement department will need to determine what processes can be modified to improve outcomes. For example, if they see an increase in pressure sores and prevalence of restraints. They could use computerized charting and order entry, along with the evidence-based guidelines, to identify specific groups of patients who are vulnerable to developing pressure ulcers or closely monitoring use of restraints. With early identification, automatic orders for preventive interventions can be implemented quickly. With the assistance of the automated consults and orders, the appropriate equipment, the interdisciplinary task force, continuing education, and monitoring, the hospital system would be able to reduce unnecessary use of restraints and hospital-acquired pressure ulcer prevalence rate (Cherry & Jacob, 2010).

Many elderly and their family cannot determine what are normal aging and what are not; therefore, educating them is the key role for nurses to promote safety and health for older adults. Not only assessing physical changes but also mental health assessment is important because those age-related physical changes may cause depression in older adults, which leads to other problems like “difficulty with sleeping,

The main priority of the Veterans Affairs system is getting zero pressure ulcers. To achieve this goal, staff must be knowledgeable of the basic principles of skin disease, preventions, and treatments when providing care for the elderly patients. They provide education and training on the current evidenced-base practice on pressure ulcer preventions. The approach that has been effectively used is the care bundle (AHRQ, 2014). We

A reoccurring issue such as bedsores is something nursing home facilities try their best to prevent. Unfortunately, the rate at which it is occurring in our nursing home is 12%, a little higher than that of the national average. This is a number that we as a facility are not proud of, and as Director of Quality Improvement, new strategies will be implemented to improve the quality of care in which our patients are receiving. This simple plan mimics that of the FOCUS PDSA and can be broken down into a few steps in order to be better assessed. The first step involves creating a team of employees to research and better understand the main source of the bedsores. The second step includes developing a strategy, without any errors, within the team

According to the Agency for Healthcare Research and Quality (AHRQ), 2.5 million patients are affected by pressure ulcers and incur costs anywhere from $9.1 billion to $11.6 billion per year in the United States (AHRQ, 2014). As of October 1, 2008, the Centers for Medicare and Medicaid Services (CMS) will not reimburse hospitals for cases in which the pressure ulcer was acquired after admission (CMS, 2008). Because of this high cost, the number of patients affected each year, and insurances no longer reimbursing hospital acquired pressure ulcers (HAPU), an accurate skin assessment upon admission is critical to reduce costs, ease pain in patients, and lower incidences of pressure ulcers. This paper will address what leadership and management skills and functions are required of a wound care nurse who identifies a problem with the accuracy of skin assessments on newly admitted patients.

According to Statistics Canada, aging population has steadily increased since the mid-1960. The age of 65 and older comprised 15.7% of the country’s population. Promoting health in these aging population is very crucial to minimise the severity of health complications that might occur in the long run. Gerontological Nursing involves the care of aging people and emphasize the promotion of the highest possible quality of life and wellness throughout the lifespan (Eliopoulos, c2014 p73). Aging people need Gerontological Nurses who are knowledgeable and willing to promote health and optimum quality of life with the consideration of their core needs such as physiological balance, connection and gratification (Eliopoulos, c2014 p78).

This paper examines the quality of care received by the elderly with an emphasis on measurements for care, recommending additional tools to be adopted to measure the overall well-being for the elderly in order to gain a more comprehensive understanding of the quality of care for those living in senior care facilities.

Pressure ulcer prevention has been the nursing worry for many years. Florence Nightingale in 1859 wrote, “If he has a bedsore, it’s generally not the fault of the disease, but of the nursing” (Nightingale, F). People may think pressure ulcers associated with poor nursing care. Prevention of pressure ulcers is a multidisciplinary responsibility; however, nurses have a primary role. Patient participation in prevention of pressure ulcers (pup) care has been shown to result in improved patient safety and satisfaction with care ((Weingart, S.N., Zhu, J., Chiappetta, L., Stuver, S.O., Schneider, E.C., Epstein, A.M. 2011). Purpose of the study includes the nurses and patients partnering together with prevention of pressure ulcers (pup) may be an effective strategy for reducing pressure ulcers (PU) among at-risk individuals. So the research team developed a pressure ulcer prevention care bundle (PUPCB) targeted at both patients and nurses, encouraging patient participation in PUP care with three simple evidence-based messages: 1) Keep moving; 2) Look after your skin; and 3) Eat a healthy diet. Messages were provided to patients with a poster, brochure and DVD. Nurses had training regarding how to be companion with patients in pressure ulcer prevention (Roberts et al. 2016).

Reminiscing to 2010, when I was faced with my grandmother 's illness during the adolescent years in my life I knew that I had a passion to care for the elderly (aging) population. From this passion, it ignited a fire so strong that I pursue my certified nursing assistant certification to gain a better understanding of working with the elderly population. By doing so, it has been a great benefit to my life; aging is an inevitable experience that we all will go through during our life. It is important to ensure that our elderly individuals are still able to enjoy the best quality of life after retirement. However, as we age, there will be a lifestyle change that the aging population must encounter.

Pressure ulcer is an adverse outcome in the clinical care setting that also linked to poor quality of nursing care. Though pressure should never happen in a professional care setting, it is still prevalent throughout the world’s medical settings. This article looks at many other previous studies from 1992 to present to compare and find the underlying issues that may contribute to pressure ulcer. A closer look at the nurse’s knowledge versus actual decision will be observe, because it is the key factor in pressure ulcer prevention.