Aim Statement
The project aims at lowering the occurrence of inpatient falls in the Neurology Medical-Surgical unit by 25% within a timeframe of three months.
Chosen Change
Proposed Change
The change will involve the implementation of a purposeful hourly rounding by nursing staff to proactively assess patient needs, offer assistance, and address potential fall risks. The change will be specific to the departments with the highest incidences of patient falls. The staffing nurse making hourly rounds will be given a checklist, which will be used to measure the outcome of their activities.
The achievability of the change has anchored the fact that the majority of the nurses in the unit are well-trained to understand and identify patients’ needs. Moreover, the change is relevant since the majority of the factors contributing to inpatient falls are within the control of nurses. The rounding activities are expected to be conducted thrice per day, and reports are made every month for appropriate administrative action.
How the Change Will Be Done
Implementing purposeful hourly rounding by staffing nurses will involve two key activities. The head of the Neurology Med Surg will recruit a team of six nurses who will work on shifts. The team will be subjected to the basic checks to be done during the rounding. A list of nurses on duty will be shared among other nurses to allow them to raise concerns to the selected team. After every check, the appointed nurses will write a report to the department head, which will be analyzed later.
What Will Be Changed
The nurses’ schedules and routines will be changed to accommodate the newly introduced rounding activities. Additionally, the number of hours worked by appointed nurses will be changed to allow them to conduct effective checks in the unit.
Resources Needed
To implement the change, the organization will need finances to compensate the nurses who will be taking part in the rounding activity. Moreover, an electronic record-keeping and management system will be needed to store the collected information. The recorded data can be subjected to various analysis processes to determine the improvement needed.
Change Duration and Staff Involved
The purposeful hourly rounding activities will take place for three months, after which the outcome will be determined. The activities will start at the beginning of August 2023 in the Neurology Med Surg, which is the affected department. If the aim is achieved, the organization can consider integrating it into its routine activities.
Various stakeholders will be involved in implementing the proposed change. Nurses will be involved in making the purposeful hourly roundings three times a day. The department heads will be writing weekly reports based on observations made during the hourly rounding. Furthermore, the firm’s technology department will help in developing and maintaining the electronic records system.
Change Rationale
Incidents of inpatient falls in the unit are caused by multiple factors that are beyond the conditions of the beds and patients. Research by Di Massimo et al. (2022) shows that purposeful hourly rounds significantly reduce the falling rates in hospitals. The change will address the problem at hand and its associated causes, which lower the quality of healthcare services. Unlike other changes, such as the use of bed alarms, hourly rounding considers all contributory factors of many incidences of falling by patients in the unit.
Measurements
Interdisciplinary Team
Physical Therapist Roles and Nurse Interaction
A physical therapist is an interdisciplinary professional who will be recruited to be part of the team. The therapist’s role in the quality improvement project will be evaluating patients’ physical abilities, assessing their risk of falling, and customizing exercises and mobility plans. The nurses and the therapist interactions will be crucial in improving patients’ strength and physical mobility which is important to the project quality improvement. The interaction will involve the therapist assisting the nurses in understanding patients’ needs and developing hourly rounding reports. Therefore collaboration between the nurses on duty and the physical therapist will help in the development of patient-specific fall-prevention strategies.
Contribution to Quality and Safety of Patient Care
According to American Physical Therapy Association (APTA) (2023), physical therapists contribute to the quality and safety of patient care. The therapists address physical impairments while implementing evidence-based interventions (APTA, 2023). Moreover, they help in educating and empowering patients who are under physical care in hospitals (APTA, 2023). The physical therapist will help the team understand unique patients’ needs. Therefore, including a physical therapist in the project’s teams will be beneficial.
Nurse Role
Bachelor-Prepared Nurses’ Roles and BSN Knowledge
Bachelor-prepared nurses will play various roles during the implementation of the program. They will actively participate in the purposeful hourly rounding activities by helping the nurses appointed for the role. The bachelor-prepared nurses will help in summarizing the assessment reports weekly subject to department heads’ scrutiny and supervision. During my BSN studies, I gained knowledge of evidence-based practice and healthcare quality improvement principles. Moreover, during the studies, I learned about research methods and data analysis concepts. Consequently, my collaboration with the project’s team will help in reducing the incidences of inpatient falls by 25% within three months.
References
APTA. (2023). Physical therapists roles across the continuum. In Guide to Physical Therapist Practice 4.0. Web.
Di Massimo, D. S., Catania, G., Crespi, A., Fontanella, A., Manfellotto, D., La Regina, M., De Carli, S., Rasero, L., Gatta, C., Pentella, G., Bordin, G., Croso, A., Bagnasco, A., Gussoni, G., Campani, D., Busca, E., Azzolina, D., & Dal Molin, A. (2022). Intentional rounding versus standard of care for patients hospitalised in internal medicine wards: Results from a cluster-randomised nation-based study. Journal of Clinical Medicine, 11(14), 3976. Web.