Create a 500‐750-word comprehensive outline that communicates the following about your
chosen topic: Some areas need support and citations. Each section needs support. These sections are
not opinion based.
1. Introduction:
1. Identify the risk management topic you have chosen to address (Part of your thesis
is a stat that needs a citation. Please rewrite.) (Be sure to include a thesis in the next
work, solid intro and conclusion for any presentation.)
1. 2019 increased number Youroftext
HAPI’s.
hereIn 1 particular those missed on
admission and the following 48-hours.
2. There is a current policy and procedure (P&P), Pressure Ulcer Prevention
and Treatment, that covers the necessity of a thorough skin assessment at
admission to establish baseline which should be done by two registered
nurses (RN’s).
3. Thesis: in spite of a PI prevention & treatment policy & procedure HAPI’s
have increased by 100% in 2019 from 2018, 20% of which are PI being
missed on admission skin assessments and subsequent 48 hours making
the condition hospital acquired, costing the hospital money, putting the
patient in danger, and the hospital at risk for lawsuits.
2. Why it is important within your health care sector.
1. The statistics: 2015-2018 number of HAPI’s dropped from 31 to 15
(LeMieux, 2017). 2019 had a total of 25. 5 of the 25 were due to poor
admission skin assessments that missed a community acquired (already
present) pressure injury (PI). It was then missed multiple shifts, for 48
hours from admission, which then classifies it as hospital acquired.
2. Patient: PI not cared for leads to increased area damage, pain, possible
infection, sepsis, and even death.
3. Hospital: ethical and legal duty to do no harm. Financial penalty since
Medicare doesn’t cover hospital acquired conditions, including stage 3 &
4 PI (CMS, n.d.)
4. Community & nursing profession: Nurses not doing the basics does not
make for a profession that is trusted.
2. Rationale:
1. Illustrate how this risk management strategy is lacking within your selected
organization's current risk management plan
1. Having a lot of travelers and new nurses the current P&P doesn’t have a
checks and balance to whether these nurses are doing a proper head to toe
assessment. Nurses have orientation for a handful of shifts, but who’s to
say the orienting nurses are setting a good example.
2. Assistant Nurse Managers (ANM’s) must play an active role in decreasing
HAPI’s. Admission skin assessments should be done with a RN and the
ANM, not 2 staff RN’s
1. Greater responsibility
2. Accountability
3. Skill check for new nurses
4. Support
5. Team effort – leaders part of the team, not just on the side lines
This study source was downloaded by 100000829725281 from CourseHero.com on 12-13-2021 04:54:30 GMT -06:00
https://www.coursehero.com/file/57306588/Eleonora-Reznikova-Week-2-Educational-Program-on-Risk-Management-Part-One-Outline-of-Topicdocx/
, 2. Explain how its implementation will better meet local, state, and federal
compliance standards.
1. Developing competent nurses and increasing responsibility at admission
skin assessment will:
2. local: good perception of nurses, patients/community taken care of,
organization is properly reimbursed. Maintain licensure & getting paid
from Medicare by complying with joint commission
3. state: help the state achieve overall goal of protecting the patients (CDPH,
n.d.)
4. federal: no federal tracking exists (There are no federal standards for State
reporting systems (West, Eng, Lyda-McDonald, McCall, 2010)
3. Support:
1. Provide data that indicate the need for this proposed risk management initiative
1. In 2008 the Centers for Medicare & Medicaid Services (CMS) started
denying claims for stage 3-4 HAPI’s & penalize with 1% reduction in
reimbursement for hospitals with the highest HAPI rates (Black, 2019).
2. Stage 3 PI average cost $4,546, stage 4 $13,138 (surgical treatments,
medications, wound dressings, legal/investigation expenditures (Lim &
Ang, 2017).
3. Untreated PI result in: increased length of hospital stay, hospital costs,
increased nursing care time, chance of cellulitis, osteomyelitis, sepsis and
mortality (Agostini, Baker, & Bogardus, 2001)
2. Demonstrate how it falls under the organization's legal responsibility to provide a
safe health care facility and work environment.
1. Nonmaleficence: nurses follow a code of ethics. Proper assessment and
prevention of further damage is an ethical and moral responsibility of the
healthcare team.
2. Keeping the patient safe from harm is a legal issue, and the hospital can be
sued for outcomes from poor treatment, or poor result of an untreated PI.
4. Implementation:
1. Describe the steps to implement the proposed strategy in your selected health care
organization.
1. Stakeholders: ANM’s, nurses, house supervisors, upper management,
HAPI committee, community.
2. Proposal of P&P change first brought to HAPI committee (RN’s,
physician, ANM, patient care technicians). Information gathered. Process
of shooting holes through proposition in order to make argument stronger.
1. EBP identified on quality improvement when management is
hands on. (multiple current articles found – see reference section)
3. House supervisor considered the proposition
4. P&P committee
5. Brought to ANM’s, teaching for ANM’s regarding the reasons for the
change, as well as refresher on proper skin assessments.
6. Informing the nurses via start of shift huddles
5. Challenges: (Challenges and Opportunities: Ideas or suggestions about areas of focus
regarding risk management the organization could or should address moving forward into the
This study source was downloaded by 100000829725281 from CourseHero.com on 12-13-2021 04:54:30 GMT -06:00
https://www.coursehero.com/file/57306588/Eleonora-Reznikova-Week-2-Educational-Program-on-Risk-Management-Part-One-Outline-of-Topicdocx/
chosen topic: Some areas need support and citations. Each section needs support. These sections are
not opinion based.
1. Introduction:
1. Identify the risk management topic you have chosen to address (Part of your thesis
is a stat that needs a citation. Please rewrite.) (Be sure to include a thesis in the next
work, solid intro and conclusion for any presentation.)
1. 2019 increased number Youroftext
HAPI’s.
hereIn 1 particular those missed on
admission and the following 48-hours.
2. There is a current policy and procedure (P&P), Pressure Ulcer Prevention
and Treatment, that covers the necessity of a thorough skin assessment at
admission to establish baseline which should be done by two registered
nurses (RN’s).
3. Thesis: in spite of a PI prevention & treatment policy & procedure HAPI’s
have increased by 100% in 2019 from 2018, 20% of which are PI being
missed on admission skin assessments and subsequent 48 hours making
the condition hospital acquired, costing the hospital money, putting the
patient in danger, and the hospital at risk for lawsuits.
2. Why it is important within your health care sector.
1. The statistics: 2015-2018 number of HAPI’s dropped from 31 to 15
(LeMieux, 2017). 2019 had a total of 25. 5 of the 25 were due to poor
admission skin assessments that missed a community acquired (already
present) pressure injury (PI). It was then missed multiple shifts, for 48
hours from admission, which then classifies it as hospital acquired.
2. Patient: PI not cared for leads to increased area damage, pain, possible
infection, sepsis, and even death.
3. Hospital: ethical and legal duty to do no harm. Financial penalty since
Medicare doesn’t cover hospital acquired conditions, including stage 3 &
4 PI (CMS, n.d.)
4. Community & nursing profession: Nurses not doing the basics does not
make for a profession that is trusted.
2. Rationale:
1. Illustrate how this risk management strategy is lacking within your selected
organization's current risk management plan
1. Having a lot of travelers and new nurses the current P&P doesn’t have a
checks and balance to whether these nurses are doing a proper head to toe
assessment. Nurses have orientation for a handful of shifts, but who’s to
say the orienting nurses are setting a good example.
2. Assistant Nurse Managers (ANM’s) must play an active role in decreasing
HAPI’s. Admission skin assessments should be done with a RN and the
ANM, not 2 staff RN’s
1. Greater responsibility
2. Accountability
3. Skill check for new nurses
4. Support
5. Team effort – leaders part of the team, not just on the side lines
This study source was downloaded by 100000829725281 from CourseHero.com on 12-13-2021 04:54:30 GMT -06:00
https://www.coursehero.com/file/57306588/Eleonora-Reznikova-Week-2-Educational-Program-on-Risk-Management-Part-One-Outline-of-Topicdocx/
, 2. Explain how its implementation will better meet local, state, and federal
compliance standards.
1. Developing competent nurses and increasing responsibility at admission
skin assessment will:
2. local: good perception of nurses, patients/community taken care of,
organization is properly reimbursed. Maintain licensure & getting paid
from Medicare by complying with joint commission
3. state: help the state achieve overall goal of protecting the patients (CDPH,
n.d.)
4. federal: no federal tracking exists (There are no federal standards for State
reporting systems (West, Eng, Lyda-McDonald, McCall, 2010)
3. Support:
1. Provide data that indicate the need for this proposed risk management initiative
1. In 2008 the Centers for Medicare & Medicaid Services (CMS) started
denying claims for stage 3-4 HAPI’s & penalize with 1% reduction in
reimbursement for hospitals with the highest HAPI rates (Black, 2019).
2. Stage 3 PI average cost $4,546, stage 4 $13,138 (surgical treatments,
medications, wound dressings, legal/investigation expenditures (Lim &
Ang, 2017).
3. Untreated PI result in: increased length of hospital stay, hospital costs,
increased nursing care time, chance of cellulitis, osteomyelitis, sepsis and
mortality (Agostini, Baker, & Bogardus, 2001)
2. Demonstrate how it falls under the organization's legal responsibility to provide a
safe health care facility and work environment.
1. Nonmaleficence: nurses follow a code of ethics. Proper assessment and
prevention of further damage is an ethical and moral responsibility of the
healthcare team.
2. Keeping the patient safe from harm is a legal issue, and the hospital can be
sued for outcomes from poor treatment, or poor result of an untreated PI.
4. Implementation:
1. Describe the steps to implement the proposed strategy in your selected health care
organization.
1. Stakeholders: ANM’s, nurses, house supervisors, upper management,
HAPI committee, community.
2. Proposal of P&P change first brought to HAPI committee (RN’s,
physician, ANM, patient care technicians). Information gathered. Process
of shooting holes through proposition in order to make argument stronger.
1. EBP identified on quality improvement when management is
hands on. (multiple current articles found – see reference section)
3. House supervisor considered the proposition
4. P&P committee
5. Brought to ANM’s, teaching for ANM’s regarding the reasons for the
change, as well as refresher on proper skin assessments.
6. Informing the nurses via start of shift huddles
5. Challenges: (Challenges and Opportunities: Ideas or suggestions about areas of focus
regarding risk management the organization could or should address moving forward into the
This study source was downloaded by 100000829725281 from CourseHero.com on 12-13-2021 04:54:30 GMT -06:00
https://www.coursehero.com/file/57306588/Eleonora-Reznikova-Week-2-Educational-Program-on-Risk-Management-Part-One-Outline-of-Topicdocx/
