HealthInsight, the Medicare Quality Improvement Organization for Nevada, is working with nursing homes across the state to improve the quality of life for residents by reducing the occurrence of pressure ulcers and the use of physical restraints.
Pressure ulcers are a serious concern for nursing homes as they cause pain, are difficult to heal, and increase the risk of infection and death. In early 2011, HealthInsight partnered with an expert consultant in the prevention and treatment of pressure ulcers to offer customized intervention strategies for six recruited nursing homes. The consultant conducted site visits and provided information regarding appropriate coding of risk factors, current best practices regarding wound treatment, and suggestions for optimizing outcomes in treatment.
HealthInsight also has worked with a consultant to help six recruited nursing homes reduce the use of physical restraints. Studies show that the use of restraints negatively impacts the health of residents, contributing to lower cognitive performance, increasing reliance on walking aids, and decreasing the ability to perform activities of daily living such as dressing and bathing. In addition, the use of restraints has been shown to increase the risk for physical injury.
As a result of these targeted interventions, HealthInsight Nevada observed a downward trend in the percentage of pressure ulcers and use of physical restraints among participating nursing homes.
Results showed an improvement in pressure ulcer rates from 15.08 percent at the beginning of 2011 to 12.29 percent at the beginning of 2013. Physicial restraint use decreased from 9.22 percent over the same time period.
HealthInsight is committed to sustaining these improvements through ongoing technical assistance and access to best practices. In May 2013, nursing homes from across the state had the opportunity to interact face-to-face with a national expert on treatment and prevention of pressure ulcers. In addition, ongoing collaborative learning sessions provided in partnership with the Nevada Health Care Association promote an “all teach, all learn” environment addressing staff engagement in quality improvement initiatives, including reduction in pressure ulcers and the use of physical restraints.