Improving the Quality of Documentation about Patient Safety Attendant Care

Patient safety attendants (PSA) provide a critical service to ensure the safety of selected patients during their inpatient stay, but may incur high costs for a health care system. (Greeley et al., 2020, p. 317). One on one care is considered specialized treatment, which can be expensive for the patient and the hospital (Wood et al., 2018, p. 4). Patient falls are recognized as one of the top safety risks and result in more than 1 million adverse events in U.S. hospitals (Kowalski et al., 2018). The financial cost of patient injuries from a fall while in the care of the hospital are not reimbursed by Medicare & Medicaid services (Kowalski et al., 2018). In 2016, Melin (2018, p. 25) found that in the United States, there were 8.67 falls per 100 patient days in the hospital. In an attempt to reduce patient falls, a common strategy in any healthcare setting is the use of PSAs. Recently, there has been an effort to decrease usage of PSAs and increase the utilization of patient safety monitoring (PSM). Patient safety monitoring is accomplished through the use of technology that allows a technician to remotely monitor multiple patients at once. A PSM technician is able to see and talk to the patient remotely by the use of a camera and microphone located in the room. By utilizing a PSM system, a technician can alert the patients nurse if they are not able to redirect the patient remotely. In contrast, PSAs require a minimum of two caregivers per patient (e.g. nurse and PSA) and causes unnecessary cost to the patient and the hospital. Nursing leadership sought to better understand how attendants are used and how much of their time is spent directly at the bedside. To address this question, the Nursing Practice Council requested a report showing the actual time that PSAs spent with the patient. The hospital's EHR was researched and it was found there currently is no place for a PSA to input the information being requested by the Nursing Practice Council. Inaccurate or incomplete documentation impedes the monitoring of patient safety and their outcomes (Elkbuli et al., 2018, p. 289). Correct documentation is vital to understanding the needs of the patient and to develop a system to ensure care processes related to PSA care can be monitored for cost and quality improvement. It is expected that a new tracking system can be developed for PSAs to document start and stop times as well as their patient's status and interventions performed. To meet this goal, the objectives of this project were as follows:1.Assess the current workflow and identify where and when required data can be gathered to support information needs. 2.Define the documentation requirements of stakeholders and identify gaps relative to the data currently gathered. 3.Recommend a new workflow and information documentation strategy to meet the defined requirements.