WOCN and Quality/IT collaboration: Designing and implementing an electronic process for pressure ulcer data management, real-time feedback for quality improvement and direct upload of PU reports

Health care organizations submit pressure ulcer (PU) quality data to a variety of internal and external groups including hospital quality committees, hospital boards of directors, National Database for Nursing Quality Improvement (NDNQI), and CMS.   Hospital PU surveys are time intensive and require extensive resources and personnel.  Accuracy of the data is paramount.  Feedback of real-time PU data to hospital administrators, nurse managers and unit-based nurses facilitates opportunities to celebrate positive outcomes or initiate timely corrections that can impact quality care.

WOCNs within our organization initiated a collaborative effort with an IT physician to develop and implement an electronic PU survey that creates the opportunity to systematically extract EMR data.   This electronic tool provides a two-fold advantage.  First, it generates a paperless streamlined method that allows members within the organization to view hospital-wide, unit-based or patient specific PU information at any point in time.  Trends and allocation of resources can be examined.  Second, the electronic system is used for NDNQI surveys.  The NDNQI survey is a lengthy process that uses paper data collection tools which may result in problematic transcription errors.   The manual submission process could take several days to complete and obtaining results could take months.  With the electronic extraction of data from the EMR to the PU tool, RN surveyors save time and improve accuracy by using desktop and/or mobile devices to input validated information. Surveyors also input patient-centered and unit-based comments for real-time feedback to nursing units and final results including pressure ulcer rates are immediately available for viewing by nurse managers and nursing staff.  This survey method allows a direct XML upload of data for submission to NDNQI. 

WOCNs beta tested the process in Beth Israel Medical Center, an inner-city 800 bed acute care facility. This process is now utilized by the entire four-hospital system.