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Contributing Factors to Hospital-Acquired Pressure Injury Development

This report will be prepared on the basis of the case study related to the National safety and quality health service (NSQHS) second edition for the comprehensive care standard. It will identify the contributing factors with Mrs. Parker with hospital-acquired pressure injury development using the NSQHS guide. The report is implementing the prevention strategies with identifying the pressure injury prevention risk assessment tool with analyzing the effectiveness with the supporting evidence.

The second edition of NSQHS for the comprehensive care of standard is related to the requirements of the comprehensive care of the patients with enhancing the end-of-life care for the Aboriginal and Torres people in Australia. Mrs. Parker's current hospital acquires the comprehensive care standard which focuses on identifying the need and requirements of the patient through delivering the patient care process. The system establishes and manages specific risk that harms the patients during the delivery of health care. The contributing factor of comprehensive care standard is combined with the preferred health care for physical, mental, and cognitive health needs with delivering patient comprehensive and compassionate care to deliver quality services (Safeandquality, 2021). The contribution is combined with the integrated screening and identification of different types of risk with developing the individual care plan to minimize the risk in the identified area. Patients with poor nutrition have a higher risk of pressure injury and it is a significantly increased risk of complications of pressure injuries. NSQHS comprehensive standard care for pressure injury development is a combined approach for increasing the quality of services and extending the number of beds in the hospital and it is a major contributor for the patients in handling pressure injuries. The contribution factor for preventing the pressure injury is combined with the national list of Hospital-acquired complications with reviewing the injury (Ritchie et al., 2018). A pressure injury is diagnosed with the stage 3 ulcer, stage 4 ulcer, and unspecified decubitus ulcer. The NSQHS developed the high prevalence of adverse events, healthcare, infections, medication safety, prevention is the prevention fall of pressure injury. The pressure injury is related to the patient harm and care of the skincare diseases and its prevention.

The NSQHS standard guide for the prevention strategies and evidence-based strategies for comprehensive care is an individual guideline for the hospitals to develop the assistance health care service and patient safety using the standards and frameworks of the NSQHS (Safeandquality, 2022). The major purpose of the NSQHS standard is to protect the population from harm and improve the quality of the health service provision of the country. The NSQHS provides an advanced assurance system test that is relevant to ensuring the standard of safety of the patients in the hospitals.

NSQHS clearly defines the eights standard for the healthcare and safety of the patient. The evidence-based approach of NSQHS is a well-defined structure that has been clearly defined the evidence-based prevention strategy which has been as follows-

  • Partnering with the customers.
  • Governance in clinical services.
  • Healthcare prevention and control with associated infection
  • Safety of medication
  • Comprehensive care
  • Safety communication with the patients.
  • Management of blood.
  • Identification and response to the acute deterioration (Fortnum & Bradshaw, 2019).   

In the case of Mrs. Parker during her hospital stay her disease is related to chest pain and purulent cough and she has also past medical history of Chronic obstructive pulmonary disease (COPD) which is a chronic lung disease and the four-evidence based prevention strategy that has been implemented during the hospital stay of Mrs. Parker is as following-

  • Clinical governance or communication- Clinical governance or communication is related to the health and safety of Mrs. Parker in the hospital. It ensures that the treatment of disease of Mrs. Parker is combined is executed with maintaining the safety and quality of health care and improving the health of the patient through the best medical attention (Banks, 2016). The NSQHS defines the set of governance to the hospital with executing the governing body of the management. Clinical governance is categorized into four main aspects which have been as follows-
  • Governance and leadership.
  • Security of the patient.
  • Patient effectiveness performance.
  • Quality delivery of care
  • Medication safety-Medication safety is another evidence-based strategy for the patient comprehensive care and it is related to the safe medical treatment of the patient. Medication safety provides safe and prescribed medical treatment to Mrs. Parker by prescribing quality medicine for her disease (Patietsafetyinstitute, 2022). It also monitors the use of the medicine by the patient during the treatment. Medication safety helps Mrs. Parker in the effective treatment of her disease because she has a long-time medical history.
  • Comprehensive care- Comprehensive care is a critical risk assessment process that has been used to develop a healthcare plan for the patient. It ensures that the health care with providing clinical and personal needs and preferences. The delivery of patient care for Mrs. Parker in the hospital is combined with the mental, physical, and cognitive health of the patient (Jessup et al., 2020). Mrs. Parke is diagnosed with chest pain and she has also been infected with chronic lung disease so comprehensive healthcare treatment for Mrs. Parker is clinical based evidence.
  • Safety communication with a patient- Safety communication with the patient is defined to establish positive communication between the patient and the hospital. It describes the clear and accurate exchange of information between the training clinical and patient with the family of patients (Psnet, 2021). Mrs. Parker has serious health issues and treatment of this issue is only possible if an effective communication process is established between them. 

NSQHS Comprehensive Care Standard for Pressure Injury Prevention

The other term is related to available evidence, clinical expertise, values of patients, and patient circumstances. The above term is related to the patient health and practice management of the health policy in the hospital.

A pressure injury is a critical injury in which injury happens because of different types of force applied on the surface of the skin. It is very important to prevent the cause of the infection during the injury (Mayoclinic, 2022). The most common reason for pressure injury is impaired mobility which is a disability. A pressure injury is an underling on the skin and in the inner layer of the skin especially on tissues and it occurs on the sacrum and prevents the treatment of the disease. It is combined with the stage ulcer.

Pressure injury prevention risk assessment tool is used for analyzing the impact of disease on an individual and it also provides the solution for the disease to an individual by minimizing the risk factors. It identifies the risk based on localized tissue destruction into the infected area. NSQHS mainly provides three risk assessment tools for the prevention of pressure injury used in the intensive care unit which has been Waterlow score assessment tool, Norton scale, and Braden scale

Waterlow risk assessment tool is an interdisciplinary tool that has been used to determine the individual risk of developing a PI. It is an assessment that has been used for analyzing the client's condition in the case of special risk and it analyzes the risk assessment based on heigh, body index, weight, mobility, and special risk factors of the body (Aci.health, 2022). The risk analysis is identified with the scale rating between three categories which have been as follows-

  • 10-14 at risk
  • 15-19 at high risk
  • 20 and above at very high risk

The effectiveness is combined with the evidence is that it is used in the hospitals for analyzing the risk of ulcer pressure injury in the patient.

Norton risk assessment tool is a risk analysis tool which has been developed in the year 1960 and analyzes the patient risk level of a pressure ulcer from the patient on five scale analysis between the range of 5 to 20(Aci.health, 2022). The lower risk assessment tool score shows the lower risk with higher-level risk. The effectiveness of supporting evidence with the risk assessment tool is related to the risk analysis of the patient.

Conclusion

Based on the above study, it is concluded that NSQHS second edition provides comprehensive care standards for improving the healthcare services for the patients in the hospitals for the treatment of the diseases. It aims at the physical, mental, and cognitive health needs of the patient with Mrs. Parker's current injury development. NSQHS standards guide Clinical governance or communication, Medication safety, Comprehensive Care, and Safety communication with the patient in the implementation of the prevention strategy. Waterlow and Norton are the two-risk assessment tool applicable in supporting the evidence.

References

Aci.health. (2022). Pressure injury prevention risk assessment. https://aci.health.nsw.gov.au/networks/icnsw/intensive-care-manual/statewide-guidelines/pip/pressure-injury-risk-assessment#:~:text=There%20are%20three%20main%20risk,pressure%20injury%E2%80%9D%20(4).

Banks, M. (2016). ISQUA16-2476 Improving The Safety and Quality Of Health Care For Aboriginal And Torres Strait Islander People Using The Australian National Safety And Quality Health Service Standards. International Journal for Quality in Health Care, 28(suppl_1), 55-55.

Fortnum, D., & Bradshaw, W. (2019). KHA-CARI guidelines: Infection control for haemodialysis units-a summary review. Renal Society of Australasia Journal, 15(2), 47-52.

Jessup, R. L., Tacey, M., Glynn, M., Kirk, M., & McKeown, L. (2020). Evaluation of the effectiveness of a comprehensive care plan to reduce hospital acquired complications in an Australian hospital: protocol for a mixed-method preimplementation and postimplementation study. BMJ open, 10(7), e034121.

Mayoclinic. (2022). Bedsores (pressure ulcers).https://www.mayoclinic.org/diseases-conditions/bed-sores/symptoms-causes/syc-20355893

Patientsafetyinstitute. (2022). Improving Medication Safety  https://www.patientsafetyinstitute.ca/en/Topic/Pages/Improving-Medication-Safety.aspx

Psnet. (2021). Approach to Improving Patient Safety: Communication. https://psnet.ahrq.gov/perspective/approach-improving-patient-safety-communication

Ritchie, A., Gaca, M., Siemensma, G., Taylor, J., & Gilbert, C. (2018). Australian health libraries’ contributions to hospital accreditation and the National Safety and Quality Health Services (NSQHS) Standards: results of the Health Libraries for National Standards (HeLiNS) research project. 

Safetyandquality. (2021). National Safety and Quality Health Service Standards (second edition).https://www.safetyandquality.gov.au/publications-and-resources/resource-library/national-safety-and-quality-health-service-standards-second-edition

Safetyandquality. (2022). National Safety and Quality Health Service Standards. https://www.safetyandquality.gov.au/sites/default/files/migrated/National-Safety-and-Quality-Health-Service-Standards-second-edition.pdf

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