Suggestions for improvement and Best Practices

National Database of Nursing Quality Indicators (NDNQI) data enables nurses as well as nursing leadership to assess and evaluate nursing performance in association to patient outcomes. Hospitals or medical institutions can employ the information to institute organizational goals and objectives for improvement at the unit level and take into account progress in enhancing patient care and the work setting. It can also aid the medical facility in evading costly complications. The data analysis for Nurse-Sensitive Quality Indicators for Adams 5 Inpatient Rehab Unit analyzed and measured four quarters of performance: Q2 FY09, Q3FY09, Q4FY09 and Q1 FY10. Also, it covers four different areas such as NDNQI (National Database of Nursing Quality Indicators) data, Nurse-Sensitive Service line/Unit Specific Indicators, Nurse-Sensitive General Indicators, and Nurse-Sensitive Patient Satisfaction Survey Indicators.

Based on the data presented in the dashboard, the selected NDNQI that needs improvement is pressure ulcer. The occurrence of pressure ulcers has been acknowledged as an indicator of health care quality as well as patient safety. This is linked to the fact that it is a prevalent clinical complication that impacts several patients in acute care. In this case, the pressure ulcer indicator is specifically selected owing to the poor outcomes that are perceptible. In the first quarter, it starts out with a negative variance of 17.16 percent. In the second quarter, there is slight improvement though there continues to be negative variance of 9.69 percent. In the third quarter, there are positive outcomes with a positive variance of 2.84 percent. However, in the last quarter, the indicator for pressure ulcers shows a negative variance of 5.86 percent.

Suggestions for improvement and Best Practices

There are best practices from evidence-based literature that supports the nursing plan delineated above. One of the best practices is comprehensive skin care assessment. In delineation this is a procedure in which the whole skin of every person is assessed for any kind of abnormalities. With respect to pressure ulcer, comprehensive skin assessment has different significant goals and functions that comprise of pinpointing pressure ulcers that might be existent, ascertaining whether there are lesions as well as skin-related factors inclining to pressure ulcer development. There is also the identification of other significant skin conditions and providing the data essential for the calculation of pressure ulcer incidence and prevalence (Anderson et al., 2008). Most of all, in order to improve the results, it is imperative to remember that comprehensive skin assessment is not a singular event that is restricted to admission. There is the need for incessant repetition on a regular basis to ascertain whether any changes in the condition of the skin have taken place. Taking into consideration that this is within the hospital environment, it is suggested that skin assessment ought to be undertaken by a unit nurse once the patient is admitted to the unit, on an everyday basis and during patient transfer or patient discharge. It is deemed that by undertaking a risk assessment within a period of six hours or so when a patient is admitted, the persons at risk or even high risk of developing pressure ulcers can be pinpointed early devoid of any kind of delay (Warner et al., 2017).

The second best practice is standardized pressure ulcer risk assessment. In particular, pressure ulcer risk assessment is a uniform and continuing process with the objective of ascertaining patients at risk for the development of a pressure ulcer in order for plans for targeted preventive care to deal with the recognized risk can be carried out. This process is multidimensional and comprises of numerous constituents, one of which is an authenticated risk assessment tool or scale. It is imperative to take into consideration other risk factors that are not quantified in the assessment tools. Notably, the risk assessment does not pinpoint who will experience the development of a pressure ulcer but rather it ascertains which patients have a greater likelihood of developing a pressure ulcer, especially if there is no inclusion of exceptional preventative interventions. What is more, the assessment might be employed to ascertain various risk levels and interventions that are progressively more intensive may be carried out to patients that face higher risk (Kottner and Balzer, 2010).

The third best practice is care planning and implementation to address areas of risk. In delineation, care planning offers guidance and direction for what should be done to prevent pressure ulcers. Subsequent to the identification of patient risk factors through risk assessment, it is imperative to ensure that such needs are matched with care planning. This takes into account planning for any risks that are obtained for instance, mobility, nutrition, and friction. Pressure ulcer care planning is a procedure by which the patient’s risk assessment information is interpreted into an action plan to take into consideration the recognized patient needs. Its particular purpose in this case is to carry out care practices in order to ensure that the patient does not develop a pressure ulcer in the course of the hospitalization. The care plan ought to point out distinct actions that ought to or not ought to be undertaken. All care planning necessitates personalization in order to fit the needs of the patient (Warner et al., 2017).


Anderson, J., Langemo, D., Hanson, D., Thompson, P., & Hunter, S. (2007). What you can learn from a comprehensive skin assessment. Nursing2018, 37(4), 65-66.

Kottner, J., & Balzer, K. (2010). Do pressure ulcer risk assessment scales improve clinical practice?. Journal of multidisciplinary healthcare, 3, 103.

Warner, J., Ann Raible, M., Hajduk, G., & Collavo, J. (2017). Best Practices for Pressure Ulcer Prevention in the Burn Center. Critical care nursing quarterly, 40(1), 41-48.

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