Initial evaluation of a technologyenabled change in delivery of the dementia service during COVID-19 in North Warwickshire.

BACKGROUND: Remote monitoring technologies show potential to help health professionals deliver preventative interventions which can avoid hospital admissions and allow patients to remain in a home setting. AIMS: To assess whether an Internet of Things (IoT) driven remote monitoring technology, used in the care pathway of community dementia patients in North Warwickshire improved access to care for patients and cost effectiveness. METHOD: Patient level changes to anonymised retrospective healthcare utilisation data were analysed alongside costs. RESULTS: Urgent care decreased following use of an IoT driven remote monitoring technology; one preventative intervention avoided an average of three urgent interventions. A Chi-Square test showing this change as significant. Estimates show annualised service activity avoidance of £201,583 for the cohort; £8764 per patient. CONCLUSIONS: IoT driven remote monitoring had a positive impact on health utilisation and cost avoidance. Future expansion of the cohort will allow for validation of the results and consider the impact of the technology on patient health outcomes and staff workflows.

Challenges in defining and categorizing falls on diverse unit types: lessons from expansion of the NDNQI Falls Indicator.

In 2012, the National Database of Nursing Quality Indicators launched a project to expand its falls indicator for use on pediatric, neonatal, and psychiatric units. We discuss challenges encountered, argue that schemes for categorizing falls by cause or supposed preventability are not suitable for large-scale efforts to track and prevent falls, express concern about the growing burden of collecting increasingly granular quality data, and discuss limitations of total and injurious fall rates as quality measures.

Evaluation of the National Database of Nursing Quality Indicators (NDNQI) Training Program on Pressure Ulcers.

The National Database of Nursing Quality Indicators (NDNQI) Pressure Ulcer Training Program was developed to improve nursing accuracy and reliability in identifying and staging pressure ulcers and differentiating hospital- and unit-acquired from community-acquired pressure ulcers. Of 5,200 individuals who completed the training program within 5 months of release, 937 provided written evaluation comments. Four major themes emerged from content analysis of the evaluation remarks: pressure ulcer and other wound pictures; accuracy and clarity of content; program design and technology; and the educational/informational experience. Reviewers most frequently commented on their positive learning experience. Program components that enhanced the educational experience included the array of pressure ulcer pictures at each stage and pictures of other wounds. Clarity of content, program design, and technological problems were barriers to reviewer satisfaction. Findings suggest the NDNQI Pressure Ulcer Training Program was effective for educating staff nurses on pressure ulcer identification and staging.