822 / Nursing Instrument for Quality Assurance Tallaght (NIQAT)®

IRELAND
Classification of the PSP
Type of Patient Safety Practice Safe
 
Clinical Practice (CP)
Related practices from PaSQ database
"Best fit" category of the reported practice
Documentation
Other There is no specified text here
Topic of the reported practice
Quality indicators
Aim and the benefit of the Patient Safety Practice
 
The aim of this patient Safety Practice is the implementation of a robust mechanism to measure the contribution of nursing care to patient outcomes. The process known as the Nursing Instrument for Quality Assurance Tallaght (NIQAT) continuously audits practice in key areas to identify current practice, areas for improvement and impact on patient outcomes.
Description of the Patient Safety Practice
 
Background: Measuring outcomes in the past decade has increased in an attempt to identify the impact and value of interventions. In this instance this initiative measures the direct contribution, by measuring nurse sensitive outcomes, that nurses make to practice and patient outcomes. In developing this initiative, 10 indicators of nursing outcome are measured every 3 months through cyclical audit. These indicators are those sensitive to nursing care and important to patient safety and outcomes from nursing interventions.

Methods: A cyclical audit process is used every 3 months, whereby practice is audited in addition to measurement of impact on outcome. The audit was developed from local, national and international standards of good practice relevant to each of the indicators. The indicators were chosen on the basis of those most sensitive to nursing care, based upon a review of the literature on nursing outcome and those chosen by the organisation as most relevant to both patient safety, nursing care and organisational goals. The 10 indicators include: Medication Management, Documentation, Pain Management, Falls Prevention, Tissue Viability, Infection Prevention and Control, Nutritional Management, Discharge Planning, Patient Experience and Clinical Observations/Early Warning Score. A sample of 6 patients per in-patient ward is used as the sample each cycle. Data is collected via chart audit, direct observation and interviews.

Evaluation: The results of the audit are disseminated throughout the organisation every 3 months. The results demonstrate the overall performance of the clinical areas in each of the individual indicators, with additional detail and access to the data results, for each clinical area to assess their individual results and performance in each element (question) in each indicator. Additionally, falls figures are also tracked and presented as part of the results reporting to identify the correlation between good performance on the indicator on Falls Prevention and is impact on the number of patient falls. To date this correlation has been very positive. Similarly, the results are also presented in such a way so as to identify good performance levels. This is achieved by setting thresholds within each indicator along with a RAG dashboard (Red Amber and Green whereby Green indicates good performance and Red indicates poor performance with necessity to improve). Compliance of 80% and over is indicated as a Green, 70-80% indicated as Amber and below 69% is indicated as a Red. Whereby clinical areas have indicator results in red/amber, there is also an improvement plan template, specifically designed to target improvements.
Attachment of relevant written information and/or photos, as appropriate
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Effectiveness of the Patient Safety Practice
 
Degree of implementation of reported practice
Yes, fully
Level of implementation of reported practice
Institution level
Specific and measurable outcome for the reported practice were defined
Yes
A baseline measurement before implementation of the reported practice was obtained
Yes
A measurement after full implementation of the reported practice was obtained
Yes
Evaluation of a "positive" effect of the reported practice on Patient Safety
The evaluation showed improvements in Patient Safety outcomes
Type of before-and after evaluation
Quantitative
Enclosure of a reference or attachment in case of published evaluation's results
Yes. Published in the Health Service Executive (HSE) Health Matters Magazine Winter 2011 and Spring 2012. Available online at www.hse.ie
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Health care context where the Patient Safety Practices was implemented
 
Hospital
Transferability
 
Successful implementation of this Patient Safety Practice in other health care settings than above stated
Yes
Specification of implementation in another health care setting(s)
Hospital
Successful implementation's level  of this Patient Safety Practice across settings
Yes, across multiple specialities within the same setting
Involved health care staff
 
Nurses
Pharmacists
Clinical support
Quality manager
Risk manager
Patient Involvement
 
Direct service user's involvement as integral part of this Patient Safety Practice
Yes
Specification of the service users or their representatives' involvement in the implementation of this Patient Safety Practice
Patient(s)
Point of time in which service user or their reprasentatives' involvement takes place
During implementation of the Patient Safety Practices
Active seeking of service users' opinion, feedback, experience, etc. as integral part of this Patient Safety Practice
Yes
Short description of the service users' level of involvement
Consultation, such as asking for information
Public accessibility of information regarding this Patient Safety Practice to patients and citizens/service users
Yes
List of sources where public information is accessible
Communicated through our local newspaper and the Health Service Executive Health Matters magazine. It was also available on our hospital news letter and website (wwww.amnch.ie) previously.
Implementation of the Patient Safety Practice
 
Existing collaboration with other countries or international organisations related to implementation of this Patient Safety Practice
Yes
Problems encountering in the implememntation course of this Patient Safety Practice like lack of motivation, no management support, etc.
Yes
List of the most prevelent difficulties encuntered during implementation of this Patient Safety Practice
Not sufficient human resources available
List of the most prevalent drivers for a successful implemetation of this Patient Safety Practice
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Use of any specific incentives to enhance motivation while implementing this Patient Safety Practice
No
Description of used incentives, if any.
There is no specified text here
Existence of support or approval by the clinical or hospital management or any other hihg level authority in the implementation process of this Patient Safety Practice
Yes
Costs of the Patient Safety Practices
 
Completion of cost calculation related to this Patient Safety Practice
No
Total number of person days required to implement this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total number of person days required for training as preparation for implementation of this Patient Safety Practice
Clinical staff: There is no specified text here
External consultants: There is no specified text here
Support staff: There is no specified text here
Managerial staff: There is no specified text here
Others: There is no specified text here
Not relevant: There is no specified text here
Total cost in Euro of specific equipment (machines, software, communications supplies, etc.) needed to support implementation of this Patient Safety Practice
There is no specified text here
Associated cost with a work reduction or foregoing in order to deliver this Patient Safety Practice
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Contact information
 
Name: Philippa Ryan Withero
Country: IRELAND
Organisation: Tallaght Hospital
E-mail: philippa.ryanwithero@amnch.ie
Phone: 00 353 1 414 4130
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