Electronic White Boards and Nursing Support Tools: Innovative Approaches for Advancing Nurse Sensitive Quality Measures

Purpose:
Nurse Sensitive Indicators focus on process and practice, however, the abstraction and analysis of data can be difficult and time consuming. Electronic Facility Boards, Daily Reports and Monthly Scorecards use innovative technology to provide information in a timely, concise format.

Significance:
The ability to utilize electronic facility boards with nursing dashboards and daily rounding reports allows timely outcome analysis for nurse indicator performance. Nurses can utilize technology during hospitalization to assist in clinical decision making to improve nurse indicator outcomes.

Strategy and Implementation:
The strategy of electronic boards, daily reports, and monthly dashboards was to support analysis of nursing indicators and provide data to support clinical outcome improvement. Facility Boards were initially piloted in August 2010 within critical care and incorporated throughout the enterprise in May 2011. The electronic boards provide real time data for the following indicators: restraints, pressure ulcers, Braden scores, fall risk scores, vent status, line status and urinary catheters. Daily Rounding reports were implemented initially in October 2010 and revised and re-implemented enterprise wide in February 2011. As with the status boards, the rounding reports provide a timely solution for reviewing indicators during rounds. The daily reports complement the status boards, reinforce indicators and support clinical evaluation. Finally the dashboard aggregated daily data to provide a monthly unit Dashboard that compares outcomes to benchmarks, unit outcomes and other departments.

Evaluation:
Preliminary review of an indicator's numerator and denominator positively support innovative technology to improve outcomes. Pre-implementation restraint data reflected that 78 percent of patients had appropriate documentation and orders, while Post-implementation showed 100 percent compliance.

Implications for Practice:
Electronic boards and nursing tools can assist in supporting timely evaluation,nursing processes, and improved understanding of indicators on clinical care. By creating a structure that provides electronic tools to simplify analysis, information can analyzed and compared to improve outcomes.