2.50
Hdl Handle:
http://hdl.handle.net/10755/162952
Type:
Presentation
Title:
Clinical Benchmarking Project: Adult Asthma
Abstract:
Clinical Benchmarking Project: Adult Asthma
Conference Sponsor:Emergency Nurses Association
Conference Year:2001
Author:Abel, Cynthia, RN, MSN, CEN
Contact Address:920 Watson Street, Aurora, IL, 60505, USA
Contact Telephone:(630) 954-1289
Purpose: The purpose of this multi-institutional project was to identify benchmarks and overall "better performers" for the care of the admitted adult asthma patient by linking defined measures of patient characteristics and key clinical processes with patient outcomes. Design/Setting/Sample: This was a retrospective medical record review of 689 adult asthmatic patients from 26 academic health center institutions. Records of 30 patients, ages 18 to 54 years and with an ICD-9 code of 493, consecutively admitted at each hospital between October 1, 1999, through April 1, 2000, were selected. Methodology: The key performance indicators of asthma care in the emergency department, inpatient unit, and at discharge were identified from the NIH Asthma Care Guidelines. The UHC benchmark, or standard for performance, was identified as the percentage of compliance for a performance indicator that was achieved by at least 25% of the participants. Descriptive statistics indicating the highest and lowest levels of performance, and the median were also identified for each indicator. Results: There were no overall better performers identified in this project. One institution was identified as the "better performer" for emergency department aspects of care measured. Key emergency department performance indicators for asthma care measured in this project included: (1) Administration of inhaled beta agonist within 15 minutes of presentation: highest performer 93.3%, lowest performer 13.3%, median 43.5%, with the UHC benchmark 54.5% or better; (2) Administration of peak flow prior to admission for patients who were able; highest performer 96.6%, lowest performer 10.0%, median 71.0%, and the UHC benchmark 83.3% or better; and (3) Administration of systemic steroids prior to admission and within 2 hours of presentation; highest performer 92.3%, lowest performer 35.7%, median 65.2%, and the UHC benchmark 72.7% or better. In addition, while 93.0% of all cases submitted had a documented measurement of oxygen saturation in the emergency department, only 26.0% of all cases submitted had documentation of a full physical examination in the emergency department; auscultation, use of accessory muscles and respiratory rate. Conclusions: There are many opportunities for emergency nurses to improve the care of asthmatic patients admitted to the hospital via the emergency department; documentation of a full physical examination, measurement and documentation of peak flow when the patient is able and anticipating the rapid administration of an inhaled beta agonist and systemic steroids when appropriate. Emergency personnel at the institution identified as a "better performer" in the emergency care aspects of asthma care identified the following factors contributing to success: (1) staff familiarity and support of NIH asthma care guidelines, (2) interdepartmental and interdisciplinary collaboration in providing prompt care to asthma patients, (3) use of ED asthma practice guidelines and an algorithm (4) a standardized "asthma" documentation form and (5) ongoing monitoring of asthma patient care for performance improvement initiatives. [Research Poster Presentation]
Repository Posting Date:
27-Oct-2011
Date of Publication:
17-Oct-2011
Sponsors:
Emergency Nurses Association

Full metadata record

DC FieldValue Language
dc.typePresentationen_GB
dc.titleClinical Benchmarking Project: Adult Asthmaen_GB
dc.identifier.urihttp://hdl.handle.net/10755/162952-
dc.description.abstract<table><tr><td colspan="2" class="item-title">Clinical Benchmarking Project: Adult Asthma</td></tr><tr class="item-sponsor"><td class="label">Conference Sponsor:</td><td class="value">Emergency Nurses Association</td></tr><tr class="item-year"><td class="label">Conference Year:</td><td class="value">2001</td></tr><tr class="item-author"><td class="label">Author:</td><td class="value">Abel, Cynthia, RN, MSN, CEN</td></tr><tr class="item-address"><td class="label">Contact Address:</td><td class="value">920 Watson Street, Aurora, IL, 60505, USA</td></tr><tr class="item-phone"><td class="label">Contact Telephone:</td><td class="value">(630) 954-1289</td></tr><tr class="item-email"><td class="label">Email:</td><td class="value">wndnonwtr@aol.com</td></tr><tr><td colspan="2" class="item-abstract">Purpose: The purpose of this multi-institutional project was to identify benchmarks and overall &quot;better performers&quot; for the care of the admitted adult asthma patient by linking defined measures of patient characteristics and key clinical processes with patient outcomes. Design/Setting/Sample: This was a retrospective medical record review of 689 adult asthmatic patients from 26 academic health center institutions. Records of 30 patients, ages 18 to 54 years and with an ICD-9 code of 493, consecutively admitted at each hospital between October 1, 1999, through April 1, 2000, were selected. Methodology: The key performance indicators of asthma care in the emergency department, inpatient unit, and at discharge were identified from the NIH Asthma Care Guidelines. The UHC benchmark, or standard for performance, was identified as the percentage of compliance for a performance indicator that was achieved by at least 25% of the participants. Descriptive statistics indicating the highest and lowest levels of performance, and the median were also identified for each indicator. Results: There were no overall better performers identified in this project. One institution was identified as the &quot;better performer&quot; for emergency department aspects of care measured. Key emergency department performance indicators for asthma care measured in this project included: (1) Administration of inhaled beta agonist within 15 minutes of presentation: highest performer 93.3%, lowest performer 13.3%, median 43.5%, with the UHC benchmark 54.5% or better; (2) Administration of peak flow prior to admission for patients who were able; highest performer 96.6%, lowest performer 10.0%, median 71.0%, and the UHC benchmark 83.3% or better; and (3) Administration of systemic steroids prior to admission and within 2 hours of presentation; highest performer 92.3%, lowest performer 35.7%, median 65.2%, and the UHC benchmark 72.7% or better. In addition, while 93.0% of all cases submitted had a documented measurement of oxygen saturation in the emergency department, only 26.0% of all cases submitted had documentation of a full physical examination in the emergency department; auscultation, use of accessory muscles and respiratory rate. Conclusions: There are many opportunities for emergency nurses to improve the care of asthmatic patients admitted to the hospital via the emergency department; documentation of a full physical examination, measurement and documentation of peak flow when the patient is able and anticipating the rapid administration of an inhaled beta agonist and systemic steroids when appropriate. Emergency personnel at the institution identified as a &quot;better performer&quot; in the emergency care aspects of asthma care identified the following factors contributing to success: (1) staff familiarity and support of NIH asthma care guidelines, (2) interdepartmental and interdisciplinary collaboration in providing prompt care to asthma patients, (3) use of ED asthma practice guidelines and an algorithm (4) a standardized &quot;asthma&quot; documentation form and (5) ongoing monitoring of asthma patient care for performance improvement initiatives. [Research Poster Presentation]</td></tr></table>en_GB
dc.date.available2011-10-27T10:36:58Z-
dc.date.issued2011-10-17en_GB
dc.date.accessioned2011-10-27T10:36:58Z-
dc.description.sponsorshipEmergency Nurses Associationen_GB
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