Background: Every year patients experience harm from hospital-acquired conditions (HAC) such as catheter-associated urinary tract infections, central line-associated bloodstream infections, falls, pressure injuries, and clostridioides difficile. Our facilities goal is to do no harm; therefore, it was essential for us to identify a way to detect our patients that were at highest risks for acquiring these conditions. Patients’ risk factors were previously documented by nurses and scattered throughout their medical record. Our objective was to develop one place where nurses and leaders could go to look at patients in our facility and their risk factors. It was decided that a real-time snapshot dashboard that was able to pull risk factors from nurses’ documentation was necessary to initiate prevention strategies early and consistently. By working with nursing informatics and the IT department, we were able to create a dashboard that draws certain risk factors from nursing documentation to a centralized dashboard. The dashboard focuses on five major risks for harm and self-updates every two minutes. It is comprehensive of central lines, indwelling urinary catheters (foleys), fall risk, pressure injuries, and loose stool. Proper use alerts staff and leaders to high-risk patients for HAC so that proper prevention strategies can be implemented and ensure that protocol for things such as dressing changes and weekly measurements are completed. By allowing the board to evolve to fit the needs of the hospital we have been able to add features that make it easier for the staff, one example would be ability for the cursor to hover over the room number of the patient and it will provide details such as name, central line dressing, location, if the patient has diarrhea, and if the patient has fallen or is a high risk for falls based on our fall scale, etc.
Method: A collaborated effort among the nursing department, nursing informatics and the IT department to develop a real time dashboard which automatically updates pulling data from key nursing documentation for high risk factors. The dashboard does not require any manual entry by staff, which is key. It simply provides a one-stop-shop place for staff to quickly view patient risk factors for the five HAC we choose to focus on.
Results: The dashboard has been instrumental in the identification of risk factors to assist in implementation of prevention strategies to decrease hospital-acquired conditions. Leaders are able to round and ensure that all prevention strategies are in place. By increasing staff awareness to the conditions and patients at higher risk we have been able to show a decline in the number of these HAC.
Conclusions: This dashboard is a resource utilized by all staff to improve the awareness of patients at high risk for hospital-acquired conditions. The dashboard has helped engage and empower nurses to provide a higher level of care for patients. The dashboard is able to change and evolve to fit the organization’s need.
Evidence-based references 1. Dowding, D, Randell, R Gardner, P et al (8 more authors) (2015) Dashboards or improving patient care: Review of the literature. International Journal of Medical Informatics, 84 (2). 87 - 100. ISSN 1386 - 5056 2. Murphy DR, Savoy A, Satterly T, et al. Dashboards for visual display of patient safety data: a systematic review. BMJ Health Care Inform 2021; 28:e100437. doi:10.1136/bmjhci-2021-100437