Introduction
The increasing frequency of falls in healthcare institutions necessitates the implementation of effective measures aimed at limiting the occurrence of adverse events. The capstone project aims to accomplish this by proposing the creation of an interdisciplinary team run by a nurse leader. It will include the unit manager, registered nurses, ward unit assistants, patient care technologists, and hospitalists. The team will facilitate practice change by overseeing a quality enhancement initiative, implementing intentional rounding, and applying risk assessment tools. The capstone project’s main objective is to improve the welfare of patients admitted to the hospital’s surgical ward by reducing fall rates.
Background
Healthcare institutions must prioritize the identification and elimination of risks that predispose their clients to falls. These adverse events are responsible for a high number of accidents within these institutions. Falls cause both physical and psychological problems in the affected individuals. For instance, affected patients may suffer soft tissue injuries, fractures, and contusions. In addition, falls cause significant emotional distress for the patients, their caregivers, and relatives. The aforementioned factors reduce the affected individuals’ quality of life in addition to causing prolonged hospital stay.
Rationale
Hospital falls lead to prolonged hospital stays, which is costly to patients and leads to the consumption of scarce resources. Falls also cause injuries, heightened anxiety, and distress. It is worth noting that the fear of falling restricts mobility and limits patient autonomy. The mortality rate as a direct result of falls is particularly high among the elderly. Therefore, it is essential to apply evidence-based interventions to prevent falls in healthcare facilities. For instance, nurse-led fall-prevention toolkits are effective because they link evidence-based prevention initiatives to specific risk factors.
Filling the Gap
Elderly patients stand the highest risk of experiencing falls in hospital settings. This capstone project helps prioritize the adverse effects associate with falls by proposing an innovative and multidisciplinary solution that can be applied to the surgical department. Most of the current strategies in the surgical department seldom apply research evidence. In addition, they do not include the application of risk assessment tools and multidisciplinary teams to address patient falls. While the department applies standardized intentional rounding, it has not been streamlined to address the increasing frequency of patient falls.
Capstone Project Development
One of the most significant barriers encountered during the project was the lack of reliable cell service for contact with the preceptor. There were frequent interruptions to service that made communication strenuous. In addition, the increased cost of communication in view of the fact that certain aspects of the project required long conversations was problematic. This limited the amount of time available for constructive discussions, which in turn affected the quality of conversations. It is vital to note that increased dependence on the telephone slowed progress on the project leading to some delays.
Capstone Project Successes
The literature review was the foundation upon which the project was based. It facilitated the identification of the common causes of hospital falls and allowed for the classification of the negative effects associated with the adverse event. In addition, it was instrumental in the creation of a guideline that would help reduce the incidence of falls in hospitals. Kotter’s change theory informed the interdisciplinary team’s activities within the healthcare institution. It is worth noting that the effective use of available resources is vital if projects designed to offer solutions to prevalent challenges are to be successful.
How Successes inform Future Projects
Future projects stand to benefit from the successes witnessed in this project in a variety of ways. For instance, the literature review can be used to inform change and best practices that will benefit the patients by ensuring their risk of falling is reduced. In addition, the organization will benefit from improved fall prevention initiatives which will significantly reduce the cost of care by reducing hospital stay and avoiding lawsuits. It is worth noting that a successful nurse-driven change practice will encourage future nurses to engage in innovative projects designed to address critical patient issues. Healthcare practitioners will be encouraged to apply innovation to solve persistent organizational challenges.
Capstone Project Challenges
The one aspect of the project that did not go well was the lack of real-time feedback from nurses regarding the fall prevention initiatives in place at the facility. The lack of contact with the nursing staff limited access to their expertise and input with regard to the effectiveness of current strategies, the predisposing factors, and the potential solutions implemented in the unit. It is vital to note that while access to the preceptor and the library were invaluable, the absence of the nursing staff’s contributions made the project development process challenging.
How Challenges Inform Future Projects
Remote-access technology will allow meetings to be conducted in real-time regardless of the prevailing circumstances. In addition, wearable smart devices will facilitate the evaluation of physical as well as environmental factors that relate to a specific project. Ensuring that patients fill out questionnaires creates a database that can be accessed even when physical interviews are deemed impossible. Disaster mitigation initiatives must include project implementation protocols to ensure vital projects are completed successfully. Finally, understanding the impact of limited access to expertise in so far as project implementation is concerned will ensure that future projects avoid overlooking specific environmental and contextual factors by looking for alternative sources of reliable information.
Postimplementation Support (short Term)
In the short term, it is essential to appoint a project team leader whose roles will include ensuring continued project development, facilitating team collaboration, and resolving conflicts. Regular meetings and open communication channels are meant to ensure that any arising issues are addressed, and any changes are agreed upon prior to implementation. It is worth noting that keeping a file that outlines the project’s rationale, resources, and expectations at the nurses’ station is essential since it ensures all team members are kept abreast of the program’s goals.
Postimplementation Support (LongTerm)
Long-term measures such as organizing quarterly meetings to make recommendations on specific changes are critical. These meetings can also be used to evaluate failures and successes with regard to program implementation. Adapting the program for institution-wide implementation ensures that all patients in the institution benefit while maintaining the initiative’s longevity. Building a catalog of historic data creates valuable reference points for future project leaders who will use the information to create effective incidence response plans. Finally, a clear communication structure facilitates access to vital feedback that is crucial when addressing emergent issues.
Resources for Postimplementation Support
Staff time is a critical resource, seeing as it is essential to hold meetings, facilitate training, and address arising implementation challenges. Funding for the acquisition of training material is necessary, seeing as continuous medical education equips personnel with the skills required to apply evidence-based techniques and run the program effectively. Access to the facility’s data system facilitates the generation of incident reports that can be used to assess program effectiveness with regard to fall prevention. The institution’s amenities, such as conference rooms, are essential for holding meetings and conducting training. Finally, additional members of staff are necessary to facilitate smooth program implementation.
MSN Outcomes: Evidence-Based Practice
The application of research findings in clinical contexts is the foundation of evidence-based practice. The literature review guided problem identification in addition to playing a critical role in guideline formulation. Studies were used to support and propose the application of a multidisciplinary approach and the use of standardized intentional rounding. In addition, research findings were critical in the decision to use risk assessment tools to categorize patients prone to falls. Evidence showed that the application of the aforementioned strategies significantly reduced the frequency of falls in the institutions that were studied.
MSN Outcomes: Developing Innovative Nursing Practices
It is important to maintain the inherent dignity of all human beings when implementing a fall prevention program. Innovative nursing practices demonstrate the ability to plan, deliver and evaluate patient-centered initiatives. The use of standardized intentional rounding, risk assessment tools, and adopting a multidisciplinary approach was critical to the project’s success. The proposed solution comprehensively offered care to a diverse population. It is worth noting that advanced knowledge and insight were applied in the creation of a culturally competent guideline that caters to all age groups.
References
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