QAPI Program Utilization_Manual

PERFORMANCE IMPROVEMENT MONITORING/EVAL PLAN TRACKING SHEET Month: ___________ Year: _________ Priority Focus Area Performance Meassurance/Outcome Related Functions Benchmark Goals Data Collection BD Informed (Y/N) Date Weekly Data Total Month Significant finding Assessment and Care/Services Management of CHF Diuresing/Weight Response to diuretic Meds (Lab work) Lung sounds/Edema Understand Disease/Tx, response teaching D/C inst./level underst. Assessment and Care/Services Pain Management Pain level assessed in Adm.(scale) Effectiveness of pain Meds Effect. Of Pain management techniques Communication with MD, and other team members Assessment and Care/Services Open Wound Open wound assessed and measured in Admission Open wound assessed on each visit Wound care followed MD orders Asseptic/clean techn. Followed. Standard Prec. Documented patient/S.O. understanding wound care management Assessment and Care/Services Education, training nneds Patient/S.O. education needs and level of understanding assessed in each visit Education materials appropriate to the level of understanding Assessment and Care/Services Other: 133