How implementation of NDNQI has created an environment of change in pressure ulcers rates in a Saudi Arabian Hospital

Purpose:
Benchmarking is a tool that enables health care professionals to identify and measure inconsistencies in patient care outcomes and practices. NDNQI benchmarking has had a huge impact on both pressure ulcer (PU) patient outcome as well as organizational wide practices.

Significance:
Overall prevalence is reported to range from 3.5% to 29.5% in acute and long-term care facilities with an estimated 2.5 million people affected annually. The associated cost for the average hospital is between $400,000 and $700,000 annually. The prevalence of PUs is a significant health care concern

Strategy and Implementation:
The first NDNQI Combined Pressure Ulcer & Restraint Survey was conducted in June 2010. To date we have trained over 270 champions & facilators, consisting of front line nurses, head nurses wound care specialists, performance improvement specialists accreditation specialists quality coordinators & program directors. All of our inpatient and a number of our outpatient & procedural units are involved in the survey, both in providing the workforce and in the interpretation and action planning of the data that is produced. The Nursing Quality Department, Wound Care Team and the Nursing Education & Saudization Department are key departments involved in this indicator. It is through NDNQI's data and benchmarking that we have been able to effect serious structural changes to the way in which KFSH&RC:- Riyadh practices in respect to PUs. The strengthening of the wound care team and the implementation of a validated evidence based tool are just two examples as a direct outcome from this data.

Evaluation:
Hospital wide PUs have decreased since the implementation of NDNQI. The decrease in total % of PUs in our institute ranges from 1.75% to 36.61%. The ability to be able to benchmark quarterly has been a crucial key in this drive towards better practice and patient outcomes.

Implications for Practice:
The implementation of NDNQI for change in structure and practice proved paramount for: Accountability of data at both a grassroot level as well as an executive level: Improved Physical assessment on admission: Improved documentation: The implementation and enculturation of the validated PU tool.