Core measures to my core.

Published

I have accepted the fact that core measures are here to stay, and that they are best practice for our patients. Besides if 5 of my relatives were admitted to the hospital... and lets say one didn't get aspirin and the other didn't get VTE prophylaxsis then developed complications as a result... I would be highly upset. I would like to know what your hospitals are doing to help with compliance. We currently:

Place a core measure checklist on the chart which is to be addressed each shift and prior to discharge. We are suppose to check to make sure vaccines have been given or at least refusal documented, VTE assessment complete with intervention, and then the common AMI,CHF,PN,STROKE core measures. We also have core measure quality nurses that audit charts to help us fill in the gaps or note errors for example a patient may have previously refused a vacc on an admission months ago... the documentation stays in the system so when the nurse checks THIS admission it may appear as if the vaccine has been addressed (i love when they catch those!)

If there is a fallout then the data abstract is sent to the manager and the manager attends a montly core-measure meeting to address the issue and the staff nures are talked to.

Core measure data is communicated via e-mail to all employees.

Ive taken an interest in core measures as a staff and charge nurse... NOT as a quality coordinator. It is the expectation that core measures are ultimately the staff nurses responsibility so I'm looking for help as to how to help us OWN it. It's funny, there are hospitals with 0 fallouts... they are tiny 25 bed hospitals.... well, my unit only has 25beds so I know we can do it too. SUGGESTIONS?

Up Vote Up Vote ×

I have accepted the fact that core measures are here to stay, and that they are best practice for our patients. Besides if 5 of my relatives were admitted to the hospital... and lets say one didn't get aspirin and the other didn't get VTE prophylaxsis then developed complications as a result... I would be highly upset. I would like to know what your hospitals are doing to help with compliance. We currently:

Place a core measure checklist on the chart which is to be addressed each shift and prior to discharge. We are suppose to check to make sure vaccines have been given or at least refusal documented, VTE assessment complete with intervention, and then the common AMI,CHF,PN,STROKE core measures. We also have core measure quality nurses that audit charts to help us fill in the gaps or note errors for example a patient may have previously refused a vacc on an admission months ago... the documentation stays in the system so when the nurse checks THIS admission it may appear as if the vaccine has been addressed (i love when they catch those!)

If there is a fallout then the data abstract is sent to the manager and the manager attends a montly core-measure meeting to address the issue and the staff nures are talked to.

Core measure data is communicated via e-mail to all employees.

Ive taken an interest in core measures as a staff and charge nurse... NOT as a quality coordinator. It is the expectation that core measures are ultimately the staff nurses responsibility so I'm looking for help as to how to help us OWN it. It's funny, there are hospitals with 0 fallouts... they are tiny 25 bed hospitals.... well, my unit only has 25beds so I know we can do it too. SUGGESTIONS?

Up Vote Up Vote ×
Specializes in Emergency & Trauma/Adult ICU.

This has to be addressed from a multi-disciplinary standpoint. Order sets need to be standardized for admitting diagnoses that include core measures.

Up Vote Up Vote ×
Specializes in Complex pedi to LTC/SA & now a manager.

Duplicate threads merged as per site ToS

Up Vote Up Vote ×
Specializes in Hospital Education Coordinator.

we do what you outlined, but the case managers and quality analysts all have input as well. Documentation has to be aligned with core measures so you do not have to think about whether or not you missed anything.

Up Vote Up Vote ×
Specializes in Medical-Surgical/Float Pool/Stepdown.

Core measures are the bain of my existance right now!!!

I'm in a 46 bed surgical floor and it is now the floor nurses responsibility to make sure all core measures are done. It is hard to want to "OWN IT" because it is really the MD's job to do all of those things. I have my own kids at home to keep up with! Plus I don't understand why some of the people currently on light duty could not be putting their time to this instead of us...:mad:

Up Vote Up Vote ×
Specializes in Registered Nurse.

"It is hard to want to "OWN IT" because it is really the MD's job to do all of those things. I have my own kids at home to keep up with! Plus I don't understand why some of the people currently on light duty could not be putting their time to this instead of us...:mad:"

I could not have said it better! I don't want to "OWN IT" either. Hire some of the unemployed nurses before adding on more core measures.

Up Vote Up Vote ×
Specializes in Cath Lab & Interventional Radiology.

The pneumonia core measure is the one that really gets me. The RN is to determine whether the antibiotic choice is appropriate. Apparently there is a link on the intranet (not at all easy to find) what?

Up Vote Up Vote ×

I also do not want to own it. My patient's discharges are being delayed by up to an hour sometimes because I am trying to be sure core measures were addressed properly. And being a new nurse, I already struggle with time management. Then I have to dig back through the entire chart to see if the doctors have done their jobs all along. I understand that core measures are good in many ways, but I do not like that it is the floor nurses job to dig and investigate the charts. I feel like it is babysitting the doctors, and if we fall out, I will get the chewing because I didn't catch it.

Up Vote Up Vote ×

At my facility, the RNs are not penalized for core measures points that are clearly physician driven and not addressed by them.

Up Vote Up Vote ×

As a charge nurse on my med/surf nit, I get to check the core measures. Fun stuff! Not...

If something's left off, I have to leave a note for the MD/NP.

What's really fun is the ER admits. If the MD doesn't order the right antibiotics for a pneumonia patient or a morning echo, I have to go to the ED and get the order corrected.

Like I said, fun, fun.

Up Vote Up Vote ×

Nurses are a going to be hesitant to own anything more that is going to add to their workload.

As another poster suggested, responsibility without authority (making sure doctors do their jobs) adds stress.

This is going to be a tough sell. We are busy enough with all the Q1 hour reassessment and Q4 exact timing restraint charting, VAP protocols and everything else, that I don't think I could muster much enthusiasm for yet something else.

Unless of course, staffing is going to be increased to make this focus possible.

Up Vote Up Vote ×
+ Join the Discussion