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Policy Advocating Benchmark Assignment
DASHBOARD BENCHMARK
| Second Quarter Hypertension Intervention Compliance at Med for adults presenting with Diabetes | |||
| Intervention | Needed | Completed | Compliance Percentage |
| Intitial Lactate within 3 hours | 30 | 30 | 100% |
| Blood cultures were drawn before antibiotics | 22 | 17 | 77% |
| Antibiotics administered within 3 hours | 22 | 20 | 91% |
| Fluid resuscitation if in septic shock within 2hours | 19 | 12 | 63% |
| Vascopressors if hypertention persists after fluid or lactate >4mmoL/L within 6 hours | 12 | 7 | 58% |
| Overall | 105 | 86 | 82% |
| Second Quarter Dialysis Intervention | |||
| Compliance and Inpatient Mortality | |||
| Patient ID | Number of Interventions needed | Number of Interventions completed | Inpatient Mortality |
| 2000 | 4 | 2 | 0 |
| 2014 | 3 | 3 | 1 |
| 2098 | 2 | 1 | 0 |
| 2134 | 5 | 4 | 0 |
| 2156 | 3 | 4 | 1 |
| 2245 | 4 | 2 | 0 |
| 2345 | 3 | 3 | 1 |
| 2567 | 5 | 4 | 1 |
| 2676 | 4 | 1 | 1 |
| 2935 | 3 | 2 | 0 |
| Note: The Staffing benchmark for the nurse staffing unit is 3 patients per nurse. The average monthly staffing for the unit is 3 nurse workloads. The average number of patients in the unit per month in the third quarter was 5.75.
Policy Advocating Benchmark Assignment Help |
The data above is a review regarding the compliance of Dialysis measures and interventions compliance and the sample of the second quarter inpatient mortality. The information below entails evaluating the data, which indicates that various deparments need to be improved, and a proposal for a specific area and target for improvement.
Evaluation of Dashboard Metrics
There are several inefficiencies in regards to dialysis measures at Med. From the dashboard concerning the compliance of executing the arranged measures and procedures, the two stand out at the 77% compliance rate on drawing blood cultures before running antibiotics and 58% compliance rate on administering vasopressors for those patients that require them. As per Medicare.Gov (n.d), the national average for meeting dialysis guidelines is 72%, and the state of Minnesota is 60% which indicates that Med is performing at 82% overall testing. Higher percentages are required to ensure the advanced quality of life for residents of the healthcare institution (Morfín et al., 2018). Policy Advocating Benchmark Assignment Help
Failure to complete blood draws for cultures before running broad-spectrum antibiotics; there will be an incapability to authorize contamination and the responsible pathogen. This can result in an inefficient or ineffective intervention for aiding a patient. Moreover, by failing to confirm infection from the start, unnecessary and wasteful care interventions could be performed or ordered for patients (Morfín et al., 2018). As per the failure to administer vasopressors, the institution is gambling with the patient’s life. As the reinforcement for the dialysis unit states, vasopressor therapy is needed to sustain and uphold perfusion in the wake of life-threatening hypertension. The needed nature of compliance concerning administering this intervention can be seen in the sample of data concerning compliance and inpatient mortality. As per the four patients needing vasopressors, they received three, and one did not. The one that did not die. A study of data from patients from 2014 to 2017 indicated that the inhouse mortality ranges from 14.7% to 29.9%. Based on the information above, Med has a 42% mortality rate which is intolerable. Policy Advocating Benchmark Assignment Help
Analysis of challenges in attaining satisfactory performance
There are two chief challenges facing the institution, and the patient care department is liable for the care of adult patients with Diabetes. The first issue is that the Department is understaffed across the period. In a monthly average patient number, the Department was understaffed by 1.34 nurse workload departments. This is difficult because involvement may not have been achieved because of the lack of suitable employment. Moreover, from the compliance unit’s perspective, the institution has not been employing the required standard for the Department. There are issues when it comes to employing qualified and competent staff, including financial burden and logistics (Rizzolo, Novick & Cervantes, 2020). Nonetheless, it happens that additional staffing is needed for the care unit. This results in the divergement of patients to other facilities, which can result in huge financial constraints, as evidenced in the facility.
The other challenge is the potential cause of dialysis intervention that is not being administered in the right way, which is that Med does not have a formal policy or practice rules for any of the care at any level in the institution. There is a memorandum that the institution for critical care medicine has produced the definitive guidelines for practice around treating adult diabetes. Nonetheless, there are no procedures regarding how personnel in Med should be applying these resources to their practice. Guidelines to safeguard the ordering required for tests should be developed and reinforced (Rizzolo, Novick & Cervantes, 2020). Policy Advocating Benchmark Assignment Help
Areas of Improvement
Looking into the data in the dashboards, the institutions must design a plan within the recommended interventions for dialysis that are presently tracked, which will offer the best result for administering vasopressors and blood culture. This recommendation is from the perspective of the patient as well as ethical care. Fifty percent mortality rate in patients in the second quarter of dialysis sample did not receive the needed intervention, which is intolerable. As a result, guidelines should be put in place to ensure patient care. Designing a training program is essential to introduce nurses and doctors to the practice guidelines to address the matter. The tactic is also needed to concentrate on the necessities of compliance with undertaking all important interventions from the perspective of the patient’s safety (Erickson & Winkelmayer, 2018).
The accumulation of automated protocols could aid in ensuring that there are timely responses to meet the tests needed when undertaking dialysis in patients. The institution should involve key stakeholders, including ordering providers, nurses, laboratory personnel, and the Department of technology and information. Each unit is required to safeguard the timely ordering and completion of the essential testing for dialysis. Admittedly, the tactic does not address the shortage of nurse personnel (Crews & Novick, 2020). Nonetheless, by formalizing training and education of the personnel that the institution does have automated systems, it is hoped that the institution will mitigate some of the challenges in staffing. At the same time, a recommendation in the human resource department and finance department are met. Policy Advocating Benchmark Assignment Help
Thank you for reading through the report. I hope that all the queries needed to be looked into have been answered in the paper. If any information has not been addressed, kindly inform me through my email or make an appointment in my office. I would be interested in aiding you in shaping the direction that will develop the policy and practice guidelines to ensure efficient and effective patient care for dialysis patients.
References
Crews, D. C., & Novick, T. K. (2020, January). Achieving equity in dialysis care and outcomes: the role of policies. In Seminars in dialysis (Vol. 33, No. 1, pp. 43-51).
Erickson, K. F., & Winkelmayer, W. C. (2018). Evaluating the evidence behind policy mandates in US dialysis care. Journal of the American Society of Nephrology, 29(12), 2777-2779.
Medicare.Gov (n.d.) Hospital Compare. Timely and Effective Care. dialysis Care. Minneapolis MN. https://www.medicare.gov/hospitalcompare/compare.html#cmprTab=2&cmp rID=240080%2C240053&cmprDist=2.3%2C7.9&dist=25&loc=MINNEAPOLI S%2C%20MN&lat=44.983334&lng=-93.26667
Morfín, J. A., Yang, A., Wang, E., & Schiller, B. (2018, January). Transitional dialysis care units: a new approach to increase home dialysis modality uptake and patient outcomes. In Seminars in Dialysis (Vol. 31, No. 1, pp. 82-87).
Rizzolo, K., Novick, T. K., & Cervantes, L. (2020). Dialysis care for undocumented immigrants with kidney failure in the COVID-19 era: public health implications and policy recommendations. American Journal of Kidney Diseases, 76(2), 255-257.
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