A Dashboard on the Break Room Screen: Extracting Pressure Injury Prevention Data From the Record and Designing a Unit Display That Nurses Will Actually Look At
[Student Name]
University of Phoenix
DNP/715: Information Systems and Health Care Delivery Technology
Week 5 Assignment
[Instructor Name]
[Date]
The unit and figures are composites written for a model paper.
My DNP project aims to reduce hospital-acquired pressure injuries on a 20-bed surgical intensive care unit, where our rate of stage 2 or worse injuries was 4.1 per 1,000 patient days last year. The intervention bundles a two-hourly repositioning prompt, a heel offloading protocol and a daily skin check documented in a structured field. To know whether the bundle is used and whether it works, nurses and leaders need to see data frequently. This paper plans the extraction and the dashboard.
Defining What to Extract
Every dashboard begins with precise definitions. Outcome: new stage 2 or worse pressure injuries per 1,000 patient days, from the wound documentation field, confirmed by the wound nurse. Process: the proportion of patient shifts with a documented skin check, the proportion of two-hour intervals with a documented turn and the proportion of eligible patients with heels offloaded. Balancing: staff time for documentation, measured by periodic sampling, and device-related injuries, which could rise if attention shifts.
Extraction Logic
With our analyst, I wrote the query logic: patients on the unit for at least 12 hours, excluding those admitted with existing injuries; a turn counted if documented within 150 minutes of the previous turn; a skin check counted if completed once per 12-hour shift. The query runs nightly and loads a table that feeds the dashboard. We validated it by comparing 40 patient-days against manual chart review, achieving 95% agreement for turns and 100% for skin checks.
What the Evidence Says About Dashboards
Dowding et al. (2015) reviewed the literature on dashboards for improving patient care and included 11 studies with considerable variation in settings, users and indicators. They found evidence that where dashboards were easily accessible to clinicians, for example as a screen saver, their use was associated with improved care processes and patient outcomes, but they called for better-quality research and design guidance.
A dashboard that lives three clicks deep in a reporting portal is a report; one on the break room screen is a conversation.
Placement
Where a display lives decides whether anyone sees it.
Taking the lesson from the dashboard review (Dowding et al., 2015), the display will appear on the break room screen and as the unit's workstation screen saver, not only in the hospital's reporting portal. Accessibility was the feature most associated with benefit.
Design
The dashboard has four panels. The top left shows days since the last hospital-acquired pressure injury, a simple, motivating number. The top right shows this week's turning compliance with a target line at 90%. The bottom left shows a run chart of the monthly injury rate. The bottom right shows skin check and heel offloading compliance by shift. Colors are limited to two, with red reserved for values below target.
Run Charts
Perla et al. (2011) make the case that a plain chart of weekly or monthly points around a center line, read with a handful of rules, tells an improvement team more than any average that throws away the order in which results arrived. The monthly injury rate and weekly compliance are shown as run charts so that nurses can see whether changes are real, not only whether this week was good or bad.
Feedback, Not Just Display
Ivers et al. (2012), in a Cochrane review of 140 studies, found that audit and feedback generally led to small but potentially important improvements in professional practice, with a median absolute increase in desired practice of 4.3%. Effects were larger when baseline performance was low, the source was a supervisor or colleague, feedback was provided more than once, was delivered both verbally and in writing and included explicit targets and an action plan. A screen alone meets only some of these conditions.
Adding the Missing Features
To meet the conditions Ivers et al. (2012) identified, the charge nurse will review the dashboard at the start-of-shift huddle twice a week, targets are displayed explicitly, and each huddle ends with one action, such as focusing on heel offloading for patients on vasopressors. Monthly, I will send a written summary to staff with the run charts and a brief interpretation.
Choosing Few Measures
It is tempting to put every available number on a dashboard. Our first draft had 11 measures, and nurses in a feedback session said they could not tell what mattered. We reduced it to four, each tied directly to the bundle. Fewer measures, clearly linked to action, make a display easier to read at a glance during a short break.
Making Data Actionable
Each panel answers a question a nurse can act on. If turning compliance drops on nights, the charge nurse can ask what is different on nights. If heel offloading lags for patients on vasopressors, the huddle can focus on that group. A number without an obvious action tends to be ignored.
Individual Versus Unit Feedback
We considered showing compliance by individual nurse but chose unit and shift levels. Individual displays in a shared space could shame rather than motivate. Individual data will be available privately to each nurse through the education coordinator.
Data Refresh and Trust
Nurses will not act on numbers they doubt.
The dashboard updates nightly. A small note shows the date of the last refresh and a contact for questions. When nurses find a discrepancy, they can report it, and I will investigate. Trust in the numbers determines whether nurses act on them.
Evaluation of the Dashboard Itself
A dashboard is itself an intervention that needs evaluation.
I will survey nurses at one and three months about whether they look at the dashboard, understand it and have changed practice because of it, and I will log huddle discussions. If the dashboard is ignored, the design or placement will change, because an unread display costs analyst time and gives nothing back.
Sustaining the Dashboard
Dashboards often fade after a project ends. To sustain it, the unit's quality council will own the display after my project, with the analyst maintaining the query and the nurse manager reviewing it monthly. Ownership assigned in advance keeps the display alive.
Accessibility for All Staff
Night-shift nurses rarely attend daytime meetings. Placing the display in the break room and on screen savers reaches every shift equally, and the monthly written summary is emailed to all staff, including per diem nurses.
Privacy
The dashboard shows only aggregate unit data, with no patient names or identifiers, so it can be displayed in the break room without privacy concerns.
Conclusion
Precise measure definitions and validated extraction logic produce trustworthy data for the pressure injury project. Evidence on dashboards supports placing the display where nurses see it without effort, and run charts show change over time. Because audit and feedback work best with targets, repeated delivery, verbal discussion and action plans, the dashboard is paired with huddles and monthly written summaries.
References
Dowding, D., Randell, R., Gardner, P., Fitzpatrick, G., Dykes, P., Favela, J., Hamer, S., Whitewood-Moores, Z., Hardiker, N., Borycki, E., & Currie, L. (2015). Dashboards for improving patient care: Review of the literature. International Journal of Medical Informatics, 84(2), 87-100. https://doi.org/10.1016/j.ijmedinf.2014.10.001
Ivers, N., Jamtvedt, G., Flottorp, S., Young, J. M., Odgaard-Jensen, J., French, S. D., O'Brien, M. A., Johansen, M., Grimshaw, J., & Oxman, A. D. (2012). Audit and feedback: Effects on professional practice and healthcare outcomes. Cochrane Database of Systematic Reviews, 2012(6), Article CD000259. https://doi.org/10.1002/14651858.CD000259.pub3
Perla, R. J., Provost, L. P., & Murray, S. K. (2011). The run chart: A simple analytical tool for learning from variation in healthcare processes. BMJ Quality and Safety, 20(1), 46-51. https://doi.org/10.1136/bmjqs.2009.037895
How this DNP 715 Week 5 example is structured
The DNP/715 Week 5 work usually addresses data extraction and dashboards for project outcomes. This paper moves from measure definitions to extraction logic, then to display design and feedback, with each design choice tied to evidence about what makes dashboards and feedback change practice. Students search this week as DNP 715 Week 5, DNP715 Wk 5 or DNP/715 Wk 5; all three are the same assignment.
DNP/715 Week 5 questions, answered
What does DNP/715 Week 5 usually ask for?
Many sections ask students to plan how project data will be extracted from information systems and displayed in dashboards that support monitoring and decision making.
Do clinical dashboards improve care?
A review found some evidence that dashboards giving clinicians immediate access to information, for example as a screen saver, were associated with improved care processes and outcomes, though high-quality studies were few.
What makes audit and feedback more effective?
A Cochrane review found audit and feedback produces small to moderate improvements, with larger effects when baseline performance is low, feedback comes from a supervisor or colleague, is given more than once, in both verbal and written form, and includes explicit targets and an action plan.
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