PowerPoint format with 2 slides only, choosing the most pertinent information
Quality Improvement (QI) Plan: [Insert the QI Model selected e.g. PDSA, FADE,]
[Insert the title of the Capstone Project here] Note: Adjust font size as needed
Quality Improvement Problem Provide a Brief Overview/background of the QI problem
Data to support QI Problem:
Provide the data used to justify why the QI problem was selected; answers the question how many? How often?; How does the data show that a problem exists? Cite sources
Analysis of the Evidence to Support QI Problem:
Discuss the important evidence from research, clinical guidelines, expert opinions with a brief description of important findings. This is the evidence that you used in the project/paper to develop your QI plan include in-text citations in APA format
[Citation fonts may be smaller in size]
List or summarize the quality improvement plan using the Quality model selected – PDSA, FOCUS PDCA, FADE etc.
Resources to Support the QI Plan:
What materials, who are the persons/department(s) or the title of the persons) needed or used in planning and implementing the QI plan?
Place your reference list here, use APA formatting
Quality improvement plan for fall management in the emergency room is one of the most important initiatives in hospitals and healthcare organizations. There are almost 1.6 billion nursing residents in USA healthcare, and half of them fall in the hospital and especially in the emergency rooms annually. The nurses are the cooperative and essential staff without which the things and operations cannot be the same, so it is necessary to guide them for their care, patient care and avoid falls. The quality management program will help provide the guidelines to nurses to prevent falls in emergency rooms.
The first parameter that needs to be developed in a quality management program is the culture of safety. The term is used when there is a safe culture and when the nurses are free to discuss their queries, and there are several other factors included in this term. Communication is the key to success, and it guarantees that the organization is moving in the right direction. Communication should be implemented in the hospitals. For example, if the nurses are given a chance to communicate with the management after regular intervals, they may report the falls, and the actions can be done accordingly (Singh, 2018).
The next factor is the change in staff beliefs and attitudes. In other words, it is said that the nurses are given specific training because, without training, they cannot be good enough. They should be told that everything should be managed in proper time and if they try to be in a hurry, falls occur. To avoid the situations, it is necessary for them to be on time and to be punctual. If everything goes according to the schedule, things will be appropriate, and the falls will be reduced (Dedhia, 2009).
The next important thing is communication with the patients. The nurses do the duty while talking to the patients, and sometimes they are frustrated enough that they do not care about the falls and it occurs. The patients usually do not respond to them as they want, and sometimes they do not understand the nurses. So, the quality improvement plans ensure that the nurses do a thing or a task properly before starting the next. If they listen to the patient, they should do it calmly before getting busy with other activities (Nebreda, 2018).
Strong and effective leadership is also included in the quality improvement plan because the senior managers have an eye on everyone. The nurses do not come late, and they remain busy in their tasks because they know if they are late, the different consequences can occur as they will need to answer to the leadership. Effective leadership is necessary because it is seen that the nurses often do the different activities in negligence, and sometimes they are busy talking with other friends and colleagues. Hence, the situation occurs, and falls are often seen in hospitals (Enns, 2014).
In the end, there should be different sign boards, and if there are slippery floors, it should be mentioned. The nurses are not the ones who fall, but some patients fall as well. Their family members are also in a hurry, and they are tense so they can feel. All these things should be considered, and the signboards should be available to the nurses, and they should be guided to read them and follow them. The patients should also be guided according to the signboards. The demonstration of hospitals and their rooms should be done in LEDs of big size.
There are different resources needed to change hospital management and culture and implement the quality improvement plan. First, the floor tiles should be changed. If the hospital management is reported to frequent falls and there are no reduction incidents reported, the management should arrange the new tiles. It is seen that the hospital floors have different instruments and machines that are pulled and pushed throughout the day, and there are thousands of people on them, so they lose the friction and become slippery. The new floor tiles can help in the reduction of incidents (Berian, 2018).
The next important thing is fall risks bands that should be stocked in the hospitals, which are high cost. The hospital should arrange them for the nurses because they have to walk throughout the day. They can use the fall risk band whenever they have to go to an area that is risky for falls. For example, the nurses and other staff have to take the patients upstairs or to the emergency rooms to use these bands at these times. They should be stocked and can be used in time of need.
The bed alarms should be used so the nurses can go only to the bed that needs assistance. Sometimes, the patients and families call in a hurry even when nothing is serious, becoming worried. As a result, the nurses also become worried, and they rush towards the emergency rooms. If the alarms are installed, the families will ring the alarm, and nurses will reach the bed calmly. They are of minimum cost and they can be easily used for the patients. At least, they should be present in the emergency room of the hospital (Engelhardt, 2018).
Another resource to be used in the quality improvement plan is the demonstration of posters and signboards. LED is also one of the resources to be used. They all are costly options so that the hospital can choose one according to the budget allotted for the purpose. The signboards can be more effective because they guide the nurses and patients to where they have to go. There is already a trend of charts in the hospitals, so some charts for fall management should also be made and pasted in the different areas of hospitals (Hempel, 2019).
Concluding the discussion, it is seen that the quality improvement plan and the different resources are necessary for the change. If positive change is not brought, the incidents of falls will be increased, and the safety of nurses will be at stake. There are different stakeholders of the hospital, and they all should be involved in it. They all should communicate about the issue and should try to find out the solution. Otherwise, the things may go harmful, and the people will keep on falling. It should be controlled, and resources should be used to avoid falls.
Alvarez-Nebreda, M. L., Bentov, N., Urman, R. D., Setia, S., Huang, J. C. S., Pfeifer, K., … & Javedan, H. (2018). Recommendations for preoperative management of frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI). Perioperative Care and Operating Room Management, 10, 1-9.
Brian, J. R., Zhou, L., Russell, M. M., Hornor, M. A., Cohen, M. E., Finlayson, E., … & Robinson, T. N. (2018). Postoperative delirium as a target for surgical quality improvement. Annals of Surgery, 268(1), 93-99.
Dedhia, P., Kravet, S., Bulger, J., Hinson, T., Sridharan, A., Kolodner, K., … & Howell, E. (2009). A quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes. Journal of the American Geriatrics Society, 57(9), 1540-1546.
Engelhardt, K. E., Reuter, Q., Liu, J., Bean, J. F., Barnum, J., Shapiro, M. B., … & Posluszny Jr, J. A. (2018). Frailty screening and a frailty pathway decrease length of stay, loss of independence, and 30-day readmission rates in frail geriatric trauma and emergency general surgery patients. Journal of Trauma and Acute Care Surgery, 85(1), 167-173.
Enns, E., Rhemtulla, R., Ewa, V., Fruetel, K., & Holroyd‐Leduc, J. M. (2014). A controlled quality improvement trial to reduce the use of physical restraints in older hospitalized adults. Journal of the American Geriatrics Society, 62(3), 541-545.
Hempel, S., O’Hanlon, C., Lim, Y. W., Danz, M., Larkin, J., & Rubenstein, L. (2019). Spread tools: a systematic review of components, uptake, and effectiveness of quality improvement toolkits. Implementation Science, 14(1), 1-46.
Singh, I., & Aithal, S. (2018). Selecting best-suited “patient-related outcomes” in older people admitted to an acute geriatric or emergency frailty unit and applying quality improvement research to improve patient care: patient-related outcome measures, 9, 309.
Running Head: QUALITY IMPROVEMENT: FALLS IN THE EMERGENCY ROOM
QUALITY IMPROVEMENT: FALLS IN THE EMERGENCY ROOM
QUALITY IMPROVEMENT: FALLS IN THE EMERGENCY ROOM
NURS-4220 Leadership Competencies in Nursing and Healthcare
September 19, 2021
Emergency rooms should have the entire associated technologies essential for the patient’s treatment in their hour of need. This fact needs to be kept in mind that there is a need to take rapid action in emergency cases rather than focusing on the detailed analysis. In this way, several falls have occurred in the emergency department that negatively affected the patients. The emergency room nurses must focus on overcoming the falls to improve the quality of services (Gray-Miceli, 2017). Nevertheless, it becomes a challenge to reduce the entire falls suddenly, so this report is made to reduce the falls in the emergency room by 10% in the next six months.
The emergency room is in charge of providing emergency care to patients in an emergency situation. There is a need for advanced technology, beds, active management participation, and leadership planning in this context. When the emergency room is compromise on any single factor, then it has a direct impact on increasing the fall. For instance, if the fall rate is 2.7% per 1000 beds in one year, but the leadership is working, it can manage the fall rate (Goldsack, 2015). On the other hand, if the fall rate is 1.6% per 1000 beds in one year, but the leadership is not focusing on fall rates, it is considered a challenging situation for the emergency rooms. It is worthy to say that the active participation of the management and leadership is essential to overcome the fall rates from emergency rooms (Goldsack, 2015).
The purpose of this paper is to see if there is a way of reducing falls in the emergency room by 10% in a time frame of six months. The purpose is comprehensive, so it becomes easy to plan by focusing on the fall rate in the given time.
It is analysed that the concentration on the fall rates is essential for improving the services in the emergency room. This fact needs to be kept in mind that the emergency room consists of nurses who have experience dealing with emergency patients. It is found that the emergency room nurses ignored several falls for the rapid treatment of the patients. They argued that the focus on the falls might require more time and resources that are challenging for treating in an emergency (Morris, 2017). In this way, there is a need to plan for the leadership and the ER nurses to quickly adapt the planned factors to reduce falls in emergency rooms.
The falls in the emergency room produced negative consequences for the services of the health care department. In this way, there is a need to overcome the falls that can be possible with the help of measuring the falls along with preventive practices by the ER nurses (Preventive falls in hospitals, 2013). It is found that the advancement of technology and improvement in nursing practices is considered to be beneficial to prevent falls in the emergency rooms (Gray-Miceli, 2017). There is a need for statistical information to highlight the fall rates that influence the treatment plan in the emergency department. In this context, it is found that the fall rate varies from 1.3 to 8.9.
Meanwhile, the active participation of the employees is essential to overcome the fall rate and its severity from emergency rooms (Goldsack, 2015). It is reported that the ratio of falls is increased in inpatients, whereas the percentage of falls is less in injured patients. This fact needs to be kept in mind that there is a need to make a plan to prevent falls rather than focusing on the ratio (Morris, 2017). It is found that the percentage of falls is less in injured patients, but the falls in injured patients create a severe problem for the patient. It is the responsibility of the ER nurses to treat critically all of the patients, especially the patient with injuries. It is considered the best way to reduce the severity of falls (Alert, 2015).
When it comes to talking about the quality improvement process, it is referred to as the plan essential to overcome the associated problems to improve the quality. Firstly, there is a need to overcome the target the falls that influence the treatment plan. Meanwhile, the management has to evaluate the problems along with associated consequences (Silver, 2016). The next step is the improvement plan for overcoming the problem. In the end, the project should implement for the sake of improving the quality of emergency services.
There is a need to focus on the fall rate that directly impacts the quality of services in the emergency room. In this way, Mobility Interaction Fall and Berg Balance Scale are used for focusing on the level of fall. When the fall rate is determined, then it becomes easy to make a suitable improvement plan according to the hour of need (Lundin‐Olsson, 2000). The discussion is mainly about the emergency rooms in the US that are a developed country. In this way, the emergency rooms have enough resources and appropriate teams to serve the patients better. The problem is found because of irresponsible leadership that influences the fall rate. Therefore, the quality can quickly improve because of focusing on the adoption of appropriate leadership styles.
When it comes to talking about the emergency room nurses, they provide an essential role in regulating emergency room falls. It is found that the nurses are ignored the critical cases that have a direct impact on increasing the fall rate. In this way, Mobility interaction fall is selected to improve the quality because it is critically focused on the elderly that are the suspects for falls in the emergency room (Lundin‐Olsson, 2000). On the other hand, there is also a need for statistics for the patients, so it becomes easy for the medical department to arrange the facilities. In this context, Berg Balance Scale is useful for improving quality.
It is concluded that the improvement of quality for preventing falls in the emergency room is essential. In this context, the emergency room has enough resources to regulate the way the fall risks are done and monitored, but there is a problem because of planning and ignorance of the fall rate. Therefore, the department has to make a plan for the progress by focusing on the entire associated factors. In this way, it becomes easy to improve the quality along with overcoming the fall rates.
Alert, S. E. (2015). Preventing falls and fall-related injuries in health care facilities. The Joint Commission, 55, 1-55.
Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2015). Hourly rounding and patient falls: what factors boost success?. Nursing2020, 45(2), 25-30.
Gray-Miceli, D., Mazzia, L., & Crane, G. (2017). Advanced practice nurse-led statewide collaborative to reduce falls in hospitals. Journal of nursing care quality, 32(2), 120-125.
Lundin‐Olsson, L., Nyberg, L., & Gustafson, Y. (2000). The mobility interaction fall chart. Physiotherapy research international, 5(3), 190-201.
Morris, R., & O’Riordan, S. (2017). Prevention of falls in hospital: clinical Medicine, 17(4), 360.
Preventive falls in hospitals (2013). 5. How do you measure fall rates and fall prevention practices?. Agency for Healthcare Research and Quality. https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/measure-fall-rates.html
Silver, S. A., Harel, Z., McQuillan, R., Weizman, A. V., Thomas, A., Chertow, G. M., … & Chan, C. T. (2016). How to begin a quality improvement project. Clinical Journal of the American Society of Nephrology, 11(5), 893-900.
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