1. Prioritize targets for quality improvement measures to maximize resource efficiency.
2. Measure effectiveness of quality improvement efforts.

Purpose: This presentation describes the use of NDNQI reports in quality improvement efforts to reduce the incidence of nosocomial pressure ulcers in selected patient populations at one midwestern hospital through implementation of the PUPPY (Pressure Ulcer Prevention Project, Y’all) project.

Relevant and Current Knowledge: This session describes the process used by a group of advanced practice nurses to maximize their impact on patient outcomes through the combined utilization of NDNQI reports and evidence-based practice. The session provides an opportunity for the nurses to share what they learned.

Summary: NDNQI reports were used to create a priority list of patient care areas (PCAs) upon which to focus organizational resources. The criteria used to stratify the list were based on a comparison of the PCAs quartile ranks for prevalence of nosocomial pressure ulcers and hours of care. Two units were selected for implementation of an evidence-based intervention that included staff testing and education, clinical expert consultation, initiation of intervention algorithms, daily rounding, and resource manuals. Post-intervention prevalence rates for nosocomial pressure ulcers have decreased and remained at zero for both PCAs for five quarters, with the exception of one patient of special circumstances.

Implications: The outcomes of this project demonstrate that NDNQI reports can be successfully used to focus the use of health care resources to maximize efficacy and demonstrate the effectiveness of quality improvement efforts. In addition, nurses can begin to quantify the impact their knowledge and skill has on healthcare costs and patient outcomes.