NUR 630 Topic 1 Discussion Question
DQ You are assigned to a quality team on a rehabilitation floor where patient falls are on the rise
According to Silva & Hain (2017), falls are caused by a variety of reasons and each patient should be evaluated individually. The best strategy for preventing falls is quality improvement initiatives. Quality improvement is most effective at preventing avoidable harm and has proven effectiveness in reducing falls with injury. However, quality improvement initiatives are best supported by evidence-based practice and research which provides a standardized approach to care (Tricco et al., 2019).
Quality improvement strategies focus on identifying and implementing interventions which significantly impact problem areas, such as falls. It’s necessary to obtain data regarding the problem and investigate the root cause. After the cause is identified, further direction will be provided to obtain the appropriate research and intervention. Once the appropriate supporting evidence and best practices are identified the implementation of the quality improvement process can begin. Although, quality improvement is an ongoing process of identifying innovative strategies for further development (Silva & Hain, 2017).
References
Silva, K. B. & Hain, P. (2017). Fall prevention: Breaking apart the cookie cutter approach. MEDSURG Nursing, 26(3), 198–213.
Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., Khan, P. A., Sibley, K. M., Robson, R., MacDonald, H., Riva, J. J., Thavorn, K., Wilson, C., Holroyd-Leduc, J., Kerr, G. D., Feldman, F., Majumdar, S. R., Jaglal, S. B., Hui, W., & Straus, S. E. (2019). Quality improvement strategies to prevent falls in older adults: A systematic review and network meta-analysis. Age & Ageing, 48(3), 337–346. https://doi.org/10.1093/ageing/afy219
RESPOND HERE
Crystal it is true that various reasons can cause falls. Therefore, evaluation becomes an important step towards avoiding more falls to
be witnessed in the facility. However, quality improvement programs are the more suitable strategy for avoiding falls (Parker et al., 2020). Quality improvement initiatives may be reliable when the programs are supported by evidence-based practice and research. Some improvement programs may fail to achieve the purpose due to incorrect strategies deployed in the process (Keuseman & Miller, 2020). As a result, factual information obtained from research and EBP is significant. Continuous falls may cause accidents in the facility (Stoeckle et al., 2019). Therefore, the intervention process should identify the cause of falls and the best strategies to prevent more falls. Research provides data that can be used in developing a reliable intervention mechanism.
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References
Keuseman, R., & Miller, D. (2020). A hospitalist’s role in preventing patient falls. Hospital Practice, 48(sup1), 63-67. https://doi.org/10.1080/21548331.2020.1724473
Parker, C., Kellaway, J., & Stockton, K. (2020). Analysis of falls within pediatric hospital and community healthcare settings. Journal of pediatric nursing, 50, 31-36. https://doi.org/10.1016/j.pedn.2019.09.026
Stoeckle, A., Iseler, J. I., Havey, R., & Aebersold, C. (2019). Catching quality before it falls: preventing falls and injuries in the adult emergency department. Journal of emergency nursing, 45(3), 257-264. https://doi.org/10.1016/j.jen.2018.08.001
DEANNA
Patient falls are one of the most common events that occur in healthcare organizations every year costing an estimate of $14,000 on each fall (Quigley, 2019). As a leader in healthcare, one must be aware of clinical and financial complications falls have on an organization can utilize programs to minimize and prevent falls. Researching the best current quality or evidence-based processes is the first step to reduction of falls and improving outcomes.
Evidence based practice it the proof of a process that has been tried and produces improving results based on a practice and is a clinical decision-making tool based on the latest evidence in clinical areas.
Quality improvement strategies are systematic action of process and steps that lead to a measurable outcome (Fowler, 2021)
Research is a diligent investigation of studies, and literature to gain knew knowledge on the process (Fowler, 2021).
The chosen path of how to reduce falls depends on the question you are trying to answer, in the situation of reducing falls in a specific area such as rehabilitation, choosing Evidence Based Practice would be the path I would choose in this situation (Quigley, 2019). Health care is slow to adopt EBP practices, yet much can be gained by implementing a practice based on the current research in fall prevention. EPB has clinical evidence by the clinical experts in the field, yet it has quality metrics and measure tied to it for improvement of outcomes. EBP has the ability to be specific on clinical driven findings yet gives a broad base of knowledge to help reduce falls. EPB also has a variety of models based on the start of a question enabling one to specifically tailor the process to a specific area compared to a quality improvement metric that has more rigidity to the process.
EPB, quality improvement, or research can all be useful in the process, yet it is helpful to choose a process that best fits the question and solution to be desired.
Fowler, S. B. (2021). Quality improvement, evidence-based practice, and research. Home Healthcare Now, 39(3), 178–178. https://doi.org/10.1097/nhh.0000000000000941
Quigley, P. A. (2019). Building clinical capacity and competency: fall and fall injury prevention [White Paper]. https://doi.org/file:///C:/Users/deann/Downloads/10_White_Paper_Pat_Quigley_Jun19.pdf
REPLY
Deanna, I agree with you that patient falls are common events in healthcare settings. Statistics reveal that annually hospitals spend a lot in handling and preventing these falls. Therefore, nursing leaders are aware of the financial and clinical consequences associated with patient falls. Quality improvement initiatives are suitable for preventing patient falls (Pirzadeh & Embree, 2021). Unfortunately, the programs may fail if the leader ignores the right protocols. Introducing research in the quality improvement initiatives makes the process more accurate (Watson et al., 2019). The research seeks to give information that will determine the cause and strategies to improve outcomes. Evidence-based practice is another routine that will enable hospitals to determine the cause of patient falls (LeLaurin & Shorr, 2019). The evidence-based practice provides factual details that hospital management wishes to have. The high costs of responding to patient fall trigger desperation among other leaders. Hence, having accurate intervention mechanisms for these patient falls is an idea that most leaders will welcome.
References
LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in geriatric medicine, 35(2), 273-283.
Pirzadeh, I., & Embree, J. L. (2021). Using Participatory Design to Mitigate Hospital Patient Falls. The Journal of Continuing Education in Nursing, 52(8), 359-361. https://doi.org/10.3928/00220124-20210714-04
Watson, B., Salmoni, A., & Zecevic, A. (2019). Case analysis of factors contributing to patient falls. Clinical nursing research, 28(8), 911-930. https://doi.org/10.1177/1054773818754450