Implementation and Evaluation of a Risk-Based Intervention Matrix Based on Braden Subscale Scores

2.50
Hdl Handle:
http://hdl.handle.net/10755/160779
Type:
Presentation
Title:
Implementation and Evaluation of a Risk-Based Intervention Matrix Based on Braden Subscale Scores
Abstract:
Implementation and Evaluation of a Risk-Based Intervention Matrix Based on Braden Subscale Scores
Conference Sponsor:Midwest Nursing Research Society
Conference Year:2009
Author:Cuddigan, Janet, PhD
P.I. Institution Name:University of Nebraska Medical Center
Title:Adult Health & Illness
Contact Address:985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA
Contact Telephone:402 559 6612
Co-Authors:J.E. Cuddigan, Adult Health & Illness Department, University of Nebraska Medical Center, Omaha, NE; A. Didier, L. Janousek, V. Rabiola-Thomas, D. Miller, C. Troia, P. Moffatt, Burn, HBO, Wound & Ostomy Services, The Nebraska Medical Center, Omaha, NE;
Pressure ulcer prevention plans are usually triggered by total scores on risk assessment scales; interventions tend to be general. The purpose of this study was to examine outcomes of an evidence-based matrix of interventions targeted to the type and level of risks identified by Braden Scale subscores. These interventions were integrated into a hospital computerized care planning system and all staff received mandatory education. The Braden-Bergstrom Conceptual Schema was used as a conceptual framework for identifying pressure ulcer risk. The Plan-Do-Study-Act Model of continuous quality improvement was used as a framework for implementation. Pressure ulcer outcomes, compliance with careplanning and preventive care were measured in patients hospitalized in an acute care facility during a series of sixteen, one-day, cross-sectional surveys of all hospitalized patients. Average census for each of the surveys was 325. All patients were examined by certified wound care nurses. Ten percent of patients were re-examined with 95-100% test-retest reliability. Facility and community acquired ulcers were differentiated using methods established by the National Database of Nursing Quality Indicators (NDNQI). Compliance with care planning for at-risk patients increased from a low of 52% pre-matrix implementation to a high of 94% post-matrix implementation. Hospital acquired pressure ulcer rates decreased from a high of 9.6% pre-matrix to a low of 1.4% post-matrix. Correlations between risk status on a given subscale and interventions specific to that subscale were examined. The contingency coefficients for the six subscales ranged between .158 and .380 with p < .01 for all subscales. Targeting interventions to the level and type of patient risk factors may result in more efficient use of limited resources. These strategies have yielded sustained positive patient outcomes in one large teaching hospital and can be tested in other settings.
Repository Posting Date:
26-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Midwest Nursing Research Society

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleImplementation and Evaluation of a Risk-Based Intervention Matrix Based on Braden Subscale Scoresen_GB
dc.identifier.urihttp://hdl.handle.net/10755/160779-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Implementation and Evaluation of a Risk-Based Intervention Matrix Based on Braden Subscale Scores</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Midwest Nursing Research Society</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2009</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Cuddigan, Janet, PhD</td></tr><tr class="item-institute"><td class="label">P.I. Institution Name:</td><td class="value">University of Nebraska Medical Center</td></tr><tr class="item-author-title"><td class="label">Title:</td><td class="value">Adult Health &amp; Illness</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">985330 Nebraska Medical Center, Omaha, NE, 68198-5330, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">402 559 6612</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">jcuddiga@unmc.edu</td></tr><tr class="item-co-authors"><td class="label">Co-Authors:</td><td class="value">J.E. Cuddigan, Adult Health &amp; Illness Department, University of Nebraska Medical Center, Omaha, NE; A. Didier, L. Janousek, V. Rabiola-Thomas, D. Miller, C. Troia, P. Moffatt, Burn, HBO, Wound &amp; Ostomy Services, The Nebraska Medical Center, Omaha, NE;</td></tr><tr><td colspan="2" class="item-abstract">Pressure ulcer prevention plans are usually triggered by total scores on risk assessment scales; interventions tend to be general. The purpose of this study was to examine outcomes of an evidence-based matrix of interventions targeted to the type and level of risks identified by Braden Scale subscores. These interventions were integrated into a hospital computerized care planning system and all staff received mandatory education. The Braden-Bergstrom Conceptual Schema was used as a conceptual framework for identifying pressure ulcer risk. The Plan-Do-Study-Act Model of continuous quality improvement was used as a framework for implementation. Pressure ulcer outcomes, compliance with careplanning and preventive care were measured in patients hospitalized in an acute care facility during a series of sixteen, one-day, cross-sectional surveys of all hospitalized patients. Average census for each of the surveys was 325. All patients were examined by certified wound care nurses. Ten percent of patients were re-examined with 95-100% test-retest reliability. Facility and community acquired ulcers were differentiated using methods established by the National Database of Nursing Quality Indicators (NDNQI). Compliance with care planning for at-risk patients increased from a low of 52% pre-matrix implementation to a high of 94% post-matrix implementation. Hospital acquired pressure ulcer rates decreased from a high of 9.6% pre-matrix to a low of 1.4% post-matrix. Correlations between risk status on a given subscale and interventions specific to that subscale were examined. The contingency coefficients for the six subscales ranged between .158 and .380 with p &lt; .01 for all subscales. Targeting interventions to the level and type of patient risk factors may result in more efficient use of limited resources. These strategies have yielded sustained positive patient outcomes in one large teaching hospital and can be tested in other settings.</td></tr></table>en_GB
dc.date.available2011-10-26T23:10:32Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-26T23:10:32Z-
dc.description.sponsorshipMidwest Nursing Research Societyen_GB
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