STRATEGIES FOR CHANGE A documentation guideline was designed to allow wound dressers to tick, state and agree or disagree against set indicators for a more straightforward and consistent documentation process. Training on how to use the guideline was provided for the appropriate people (in the second PDSA cycle) to increase uptake of correct use of the guideline. The proposed aim of introducing the guideline was to reduce time on documenting, increase quality of care and provide a step by step approach in dressing changes. MEASURING THROUGHOUT Each week, the ward clerk collected information on the completeness and quality of all patient wound dressing documentation. This was then presented at the stakeholder meeting to provide information on the progress of the project. ANALYSE AND RESPOND On the first PDSA cycle there was no significant improvement in documentation, the rate changed to 45% from 44%. Investigation through collecting feedback from patient attendants found that this was mainly down to a gap in knowledge about how to correctly document, as well as time pressure. To tackle this, training was developed on how to properly document using the guideline. This was given to the staff on the unit, and there were numerous reorientations on documentation for the staff after this. Additionally, training on burn management and QI following dressing changes was given to 90 health workers, empowering the attendees to improve documentation for dressing changes. On the second PDSA cycle, correct documentation rate was 85%. SUSTAINING CHANGE Within the timeframe to ensure sustainability, Daniel ensured that resources were available at all times. He also organised weekly updates on the progress of the project to all the appropriate stakeholders and conducted close monitoring and evaluation of the project. Daniel also gave presentations about his project at his own hospital and other hospitals in the disctict.
SWOT analysis chart - Daniel’s project
Strengths All of the experts on wound dressing - nurses, doctors, and patient attendants - are all readily available. Opportunity There is high patient availability, there is unity surrounding the problem from the necessary stakeholders and the hospital is a referral unit.
Weaknesses Low support from administrative staff, and low budget to carry on the project Threats High workload of the stakeholders, multiple roles of the stakeholders, increasing the costs to carry out the project, resistance to change.
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