NURS FPX 6085 Assessment 5 Evaluation Plan Design

Evaluation Plan Design

The improvement of patient safety and the correct and timely documentation is one of the main focuses of contemporary quality enhancement in healthcare (Mistri et al., 2023). The assessment studies an intervention of a formal audit and feedback procedure to improve pressure injury risk documentation on adult medical-surgical patients within 24 hours of admission.

It brings together strategies from leadership, interprofessional, and combining technology and policy alignment by closing the gaps in practice. The plan includes an implementation timeline, assessment methods, and improvement opportunities that aim to reduce pressures acquired in hospitals, improve compliance, and promote a culture of quality care.   

Evaluation of Plan

• Outcomes that are the Goal of an Intervention Plan

The principal results of the proposed intervention plan are the improvement in the timeliness, accuracy, and completeness of pressure injury risk documentation of adult patients on the first 24 hours of admission. It will be evaluated by the desirable results in terms of a higher compliance rate with standard documentation procedures, which is supported by the evidence-based tools such as the Braden Scale (Huang et al., 2021). The secondary outcomes include reductions in the incidence of hospital-acquired pressure injuries, improved interprofessional collaboration regarding the risk status of patients, and improved continuity of care.

The intervention also aims at strengthening the adherence of the staff to assessment guidelines, which will be supported by regular audits and feedback. It is expected that the use of technology, such as electronic health records (EHR) alerts and computerized reminders, is going to automate the process of documentation (Tsai et al., 2020). This will be achieved not only by quantitative improvements in documentation measures, but also by qualitative measures, such as staff satisfaction and perceived usability. The combination of these results aims at furthering patient safety, optimizing resource utilization, and aligning the practice with the national quality standards.

• Evaluation Plan to Determine the Impact of the Intervention

The evaluation plan of the structured audit and feedback intervention will be based on a mixed-method design to measure the effectiveness of the intervention in improving the pressure injury risk-documentation compliance during the first 24 hours of admission. Pre- and post-intervention compliance rates will be measured using EHR reports and secondary outcomes like pressure injury rates, scores on the audit, and the time spent on documentation completion (Bunting and Klerk, 2022).

The data will be collected on a weekly basis during the 12-week implementation process and will be compared with the baseline data collected at the end of the previous quarter. Qualitative measures will consist of the staff feedback obtained through the post-implementation surveys and focus groups to understand the usability perceptions, the effect on the workload, and the feedback effectiveness.

Process evaluation will monitor the compliance with the intervention elements such as attendance of education sessions, frequency of EHR timely use, and timely feedback. The measurement of outcomes will determine the statistically significant and clinically significant improvements. Economic factors, including the reduction in the treatment cost of pressure injuries and resource utilization, will also be measured. The plan-do-study act (PDSA) cycle will allow quick modification once regular monitoring during rollout is performed (Abuzied et al., 2023). The final report will inform the decision on whether or not to scale up the intervention, amend it, or integrate it into regular policy in a long-term implementation.

Discussion

Advocacy

• Nurse’s Role in Leading Change and Driving Improvements

Nurses play a central role in influencing change and quality improvement and experience of care, particularly in interventions like structured audit and feedback of pressure injury risk documentation. They are the closest to caregivers and have the direct opportunity to address an area with a problem, speak out in defense of evidence-based practice, and demonstrate their adherence to documentation standards (Flaubert et al., 2021). Transformational leadership strategies allow nurse leaders to inspire and engage teams and develop a shared dedication to patient safety and quality outcomes.

During this intervention, nurses act as agents of change by promoting compliance with the 24-hour documentation requirement, positive feedback, and interdisciplinary cooperation in order to address barriers. Nurses ensure education programs are practical, relevant, and staff-focused. Bedside teams, quality improvement experts, and information technology (IT) personnel can further communicate and be facilitated by nurses to integrate their workflow (Baloyi, 2022). Nurses can achieve involvement and reduce resistance by promoting accountability and creating a psychologically safe environment. The changes to processes eventually lead to results in the form of observable improvements in quality of care, patient outcomes, and patient experience as a result of their leadership.

• Effect of Intervention Plan on Nursing and Interprofessional Collaboration

The risk documentation of pressure injury through the structured audit and feedback intervention enhances the nursing and interprofessional practice in a direct manner, as it establishes a shared accountability to assess properly and in a timely manner. Wound care experts, quality improvement teams, and IT support work closely with nurses as primary users and are required to get an efficient workflow, ensure EHR prompts are functional, and the feedback is actionable (Baloyi, 2022). Interdisciplinary leaders, such as nurse educators and unit managers, facilitate communication whereby everyone on the team has expectations and is able to contribute to the solution of problems.

This process encourages the practice of respect because both practices will lead to the attainment of compliance and patient safety improvement. Regular audit review and huddles offer the chance of discussing the practices in real-time, enabling teams to alter the practice in real-time and resolve the barriers without blaming (Sarkies et al., 2023).

The plan has practical benefits to the greater health care community: Reduced pressure injuries acquired in hospitals, lower treatment expenses, better adherence to regulations, and enhanced data to report on quality. The plan also creates a culture of continuous improvement whereby disciplined processes, technology, and teamwork can drive ongoing patient care improvement and safety.

Future Steps

Targeting the achieved outcomes is one potential aspect for deepening the impact of the project. Integrating analytics into the documentation system could sketch compliance within risk compliance frameworks regarding longitudinal stratification of high-risk patients. A cross-walking stratification of evidence-based bed and borden scores with other clinical indicators of mobility and nutrition, as well as comorbidities (Moorman, 2021), will inform the electronic health record (EHR) editions. Consider nurse and interprofessional teams who will be able to deploy preventive measures to mitigate needless escalations in risk.

In the context of sustaining skin risk assessment and real-time recording, adjunct wear that monitors under pressure within deep tissue and under sub-epidermal moisture (SEM) scanning units within nurse-led care is are adjunct. Assessment accuracy will be streamlined through the Ousey et al. (2022) real-time skin monitoring framework, which enhances skin care record amendments for prompt action. These include nurse-led mobile health bedside systems that include reminders, compliance supervision, and nurse-led mobile systems with educational modules for ease of integration into practice.

Addressing innovation in patient care, for example, through team rounds with wound care and quality improvement (QI) leaders, would ensure that risk mitigation strategies are embedded in daily activities. Moreover, including patients and families in the process of feedback through repositioning education and skin checks would create shared accountability for prevention. By combining technology-enabled early detection with interdisciplinary care, the intervention would greatly improve patient outcomes (Gala et al., 2024). The integrated approach would further reinforce the safety culture and reduce the hospital-acquired injuries.

Reflection on Leading Change and Improvement

• Impact of Project on My Ability to Lead Change

By enhancing my understanding of the greatly advanced evidence-based, structured interventions, this project improved my leadership skills in effecting transformational change. ‘Preparation to lead the designing of an audit and feedback process for risk documentation of pressure injury reaffirmed the need to marry evidence-based decision-making with data-driven, supportive leadership’ (Foy et al., 2020). I have acquired practical skills in stakeholder engagement, intervention alignment to organizational priorities, and the integration of technology into workflow processes. 

Encouraging feedback by engaging psychological safety and constructive resistance, and owning the results, also taught me how to anticipate and circumvent resistance. Also, the experience underscored the value of flexible change and the ability to alter focus strategy and focus on the long-term objective, using what objectives to measure. As a future leader, I will find myself in a much better situation to tackle quality improvement initiatives that will require both clinical and interprofessional collaboration. This project taught me that the ability to effect change does not arise from a list of mandates, but a desire to foster a culture that encourages each member of the team to feel included, aware, and proactive in advocating for safer, quality care.

• Ways to Transfer Completed Intervention, Implementation, and Evaluation into my Personal Practice

The last intervention, illustrated with its implementation and evaluation, will be the last part that fulfills the requirement of detailing the evaluation methodology and logic sustaining quality improvement. In my vicinity of practice, the deliberate, customized audit-and-feedback approach with its accompanying support and seamless linking of EHR workflows and educational material affords a versatile and highly scalable solution for sustaining improvement across a range of clinical challenges, be it pressure injury prevention, medication safety, infection control, or optimized discharge planning.

With the implementation plan, I have gained the appreciation of stakeholders’ engagement, broader staggered rollout, and customizing work routines to enhance the adoption and sustainability of the integrated approaches. Using real-time data monitoring and the continuous refining process of the PDSA cycle has application in other projects to sustain attentiveness to frontline issues.

Moreover, the combination of quantitative and qualitative appraisal in the evaluation plan serves as a model for both tangible results and staff feedback vis-à-vis their constructive and actionable opinions. The application of these approaches allows me to develop precise compliance and organizational driven interventions that work to optimize patient outcomes and staff satisfaction in varying care environments. This process ensures that improvement activities in the future will continue to be evidence-informed, collaborative, and attentive.

Conclusion

Based on compliance as well as patient and quality care safety, the issue of documenting the risk of developing a pressure injury is best solved by the formal audit and feedback method. The approach incorporates the leadership and participation of members of other professions as well as communication and technology to resolve the imbalances of the current state and drive genuine improvement.. In order to achieve goals that are long-lasting, the evaluation and improvement process will need to happen often.

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