Supporting the Quality of Measurement and Evaluation in Education.

The impetus for the development of a measurement and evaluation team for Robert Morris University, School of Nursing and Health Sciences (SNHS), was to foster faculty and administration commitment in enhancing the quality of measurement and evaluation processes. Many of the SNHS faculty members had experienced incidents of academic inconsistencies with student exam protocols. The measurement and evaluation team was charged to define the goals for faculty to use evidence-based assessment and evaluation strategies that are appropriate for the learner and learning goals, support use of evaluation data to measure the achievement of designated outcomes, and promote curricular excellence through the use of assessment and evaluation data and policies to enhance the teaching and learning process. This paper examines the results of surveys of undergraduate students, proctors, and faculty within the SNHS regarding new exam protocols, the implementation of the protocols, and their success.

Accurate Identification of Infection Source in Burn Trauma Patients With Central Line Infection to Determine Appropriate Treatment Option As Well As Proper Public Reporting.

With the advent of the Patient Safety Movement in the late 1990s and the CMS (Centers for Medicare & Medicaid Services) nonreimbursement program for never events, there has been much focus on the prevention and accurate identification of health care-associated infections such as central line-associated bloodstream infections (CLABSIs). There has certainly been a national effort to decrease the occurrence of these infections. With the implementation of patient safety initiatives such as the central line prevention bundle, there has been a considerable reduction in the number of CLABSIs except for patients with burn trauma. Because of the compromised nature of these patients, the number of CLABSIs has not decreased similarly to other types of patients. In addition, these patients may have a secondary infection that was not accurately or timely identified. With CLABSIs, proper identification of primary and secondary infections is very important, particularly when identifying treatment options and ensuring accurate public reporting of health care-associated infection information.

Impacting Care and Treatment of the Burn Patient Conversion to Electronic Documentation.

Improving patient care through enhanced electronic communication among health care providers is aimed at reducing the number of medication and medical errors. The American Reinvestment and Recovery Act (ARRA) was signed into law in 2009, supporting the federal government's commitment to the improvement of health care quality, safety, and efficiency through requirements to implement an electronic health record by October 2015 or hospitals and eligible providers potentially realizing penalties or reduced reimbursement rates. In addition to ARRA, Congress presented another initiative to further advance the delivery of high-quality health care, the Health Information Technology for Economic and Clinical Health Act (HITECH), leading to the authorization of $27 billion to encourage health care providers to achieve meaningful use of the electronic health record. However, the conversion of the paper medical records to an electronic version has been challenging, particularly in specialty departments. The burn unit of a tertiary hospital located in the Pittsburgh area experienced such challenges. A project plan, developed in 2009 prior to the electronic medical record going live, involved a multidisciplinary team, consisting of providers, nurses, and information system builders who came together to determine how to capture the totality of the burn unit documentation. The goal of the project was to develop an electronic documentation tool and provide a system to accurately and efficiently evaluate documentation compliance with the staff. The Lund Browder documentation tool, used with the paper medical record, was the selected tool for the electronic conversion. This tool has been regarded by most health care organizations as being the most accurate in measuring the extent and degree of the burn. With the paper documentation tool, the staff was, on average, 74% compliant with the Lund Browder tool. The electronic version and availability of the tool increased compliance to 100% in the fourth quarter of 2015.

Physician-led sepsis quality improvement team.

Over the last decade, hospitalizations for sepsis have more than doubled and the incidence of postsurgical sepsis tripled between 1997 and 2006. This upward trend is expected to continue for several reasons, including population-specific characteristics (e.g., age, chronic disease status) and health care-specific characteristics (eg, lack of understanding of sepsis, medical treatments that leave patients susceptible). Highly effective, focused, quality improvement teams need to be established in order to successfully manage this condition. Quality improvement, and specifically quality improvement in health care, has evolved substantially over the past few decades. This evolution has been pushed by government initiatives and private accrediting bodies that have exposed concerns regarding quality of care. Hospitals have responded with not only corrective actions but also actions that improve quality despite a lack of noted deficiencies (i.e., taking quality from "good" to "better"). Key components of a successful quality improvement program have been identified, as have components of successful quality improvement teams. By applying these components to a physician-led sepsis quality improvement team, hospitals can successfully decrease sepsis mortality and increase compliance with the application of sepsis best practice in the emergency department, intensive care unit, or non-intensive care unit nursing units.