Pressure Ulcer Prevalence; Out from under Paper Checksheets through the use of Electronic Forms and Existing EMR Data

Purpose:
Converting a paperbased checklist to an electronic data collection format requires planning, troubleshooting and the cooperation of many disparate parties. An interdisciplinary team at YNHH created a a new process that improved and streamlined data collection and NDNQI submission processes for YNHH

Significance:
The pressure ulcer prevalance study is a huge undertaking involving hours of staff time for data collection, requiring hours of data entry once collection is complete. The YNHH team developed electronic forms for collection integrating existing EMR data, and auto formatting for NDNQI submission.

Strategy and Implementation:
Prior to the intervention, our hospital conducted a paper based quarterly data collection for pressure ulcer prevalence. The process was labor intensive requiring chart review as well as physical assessment of every inpatient. An interdisciplinary team comprised of IT professionals, nursing infomaticists, the Clinical Nurse Specialist, and staff RNs developed a new process for data collection. The manual rekeying of data was eliminated and collected data could be accessed in nearly "real time". The EMR contained many of the data elements required for the NDNQI submission such as Braden score, patient demographics, and pressure ulcer prevention interventions employed. By pulling the information from the EMR into an "electronic" form the data collection process was made more effective and efficient. The use of electronic forms made the physical assessment at the bedside more efficient. Through the use of the XML upload option, manual rekeying in to the NDNQI web tool was eliminated.

Evaluation:
Results of analysis of staff hours utilized will be presented: Paper based survey vs. electronic process. It is expected that with increased use of the process and incremental adjustments, the learning curve will diminish and even greater efficiency will be realized

Implications for Practice:
Very often old methods are employed for data collection because they seem "easier". Setting aside IT staff time and clinical staff time to think through requirements to complete electronic solutions is worth the effort. The groundwork completed here can be applied to additional NDNQI measures.