Instructions
1. Presume you are the quality manager in a hospital that conducted an improvement project to eliminate pulmonary complications in patients who develop dysphagia (difficulty swallow) following a stroke. This project was done because the medical staff found that 45 percent of patients hospitalized following a cerebrovascular accident (stroke) had some degree of dysphagia and 10 percent of these patients developed pulmonary complications due to aspiration. A team of physicians, nurses and physical therapists was convened to study the problem and implement changes for the purpose of eliminating all pulmonary complications for patients with dysphasia following a stroke. After studying how patients were managed, the team agrees that improving the completeness and timeliness of nursing assessments and interventions would reduce pulmonary complications for patients who have strokes and secondary dysphagia.
To achieve the goal of zero pulmonary complications in patients with dysphagia following a stroke, nurses caring for patients in the intensive care unit and on the medical ward and dietitians received in-service training in the following areas:
– How to conduct a complete and accurate assessment of patients to identify signs and symptoms of dysphagia.
– The importance of assessing stroke patients for gag reflex and swallowing on admission.
-The importance of promptly notifying the patient’s attending physician within two hours if dysphagia signs or symptoms are identified.
-The importance of promptly notifying dietary services within tow hours if dysphagia signs or symptoms are identified so the patient can be put on a special diet and a nutritional assessment conducted.
2. Identify four process measures and one outcomes measure that could be used to evaluate the effectiveness of the actions taken to reduce pulmonary complications in the target population.
Expert Solution Preview
Introduction:
This assignment involves identifying process and outcome measures to evaluate the effectiveness of interventions implemented to reduce pulmonary complications in patients with dysphagia following a stroke. The interventions included improving nursing assessments and interventions and providing in-service training to nurses and dietitians.
1. Answer:
As the quality manager of a hospital that conducted an improvement project to eliminate pulmonary complications in stroke patients with dysphagia, four process measures and one outcome measure that could be used to evaluate the effectiveness of the interventions are:
Process measures:
– Percentage of nursing assessments conducted within 2 hours of admission to identify signs and symptoms of dysphagia.
– Percentage of patients assessed for gag reflex and swallowing on admission.
– Percentage of attending physicians notified within 2 hours of identifying dysphagia signs or symptoms.
– Percentage of dietary services notified within 2 hours of identifying dysphagia signs or symptoms for special diet and nutritional assessment.
Outcome measure:
– Percentage of patients who did not develop pulmonary complications due to aspiration after the implementation of interventions.
These measures will help assess the effectiveness of the interventions and identify areas that require improvement for better outcomes.
End of Answer