Question description

Two part:

Part A. Discussion question -Your initial post to the given topic of discussion should contain minimum 250 -300 max word count. APA format and minimum of 2–3 peer-reviewed references..

Part B. respond to two Class mate. Please keep answer 150 max word count.

Please keep response separated.

Part A.

Assume that two nursing units are experiencing higher rates of patient falls than the other six nursing units in a rehabilitation hospital. In a minimum of 250 words, create a theoretical reason this is occurring. Provide a brief synopsis of what is occurring and the reason you have established it is occurring. In addition, using the plan-do-check-act process, describe how the issue will be addressed.

Part B

Student (KC)

Generic Rehabilitation Facility has eight units, (A, B, C, D, E, F, G, H). The facility was having a falls problem. A nurse representative was chosen from each unit and that nurse along with the unit manager formed a Falls Committee. This committee met every other week for two months and developed a falls risk assessment and each unit was evaluated on the risk assessment. The group then started to meet monthly. One thing that was discovered was that this was just not a nursing problem it was a whole unit problem. A physician champion was a assigned for each unit along with a nursing assistant to attend the meetings.

The groups used Plan-Do-Check-Act (PDCA) process for developing a falls prevention program for the facility. In the Plan portion the group analyzed and defined the plan for falls prevention. The group set goals and made plans for how to meet those goals. Next the group went on to Do which they used to devise the plan and implement the plan. Next they moved into the Check phase where the group analyzed the data on the falls. The group was disappointed that the number of falls had not decreased as they planned and then one of the physicians spoke up and asked where the representatives for Units A and b were because he had not seen them at the meeetings lately and looking at the data the falls had increased in those two units and did decrease in the other units. That physician champion was assigned to go to Units A and B and find out what they were doing and why they had stopped attending the group meeting. Units A and B both said they felt they did not need the stuff the group was working on they were fine. When this physician showed Units A and B the data and how the falls dropped in all the other units but went up in their unit they decided they should start attending again. This lead back to step Act where they process needed to start again for Units A and B and after six months of working with everyone else all units had a decrease.

Hiroko, K. (2017). Fall Prevention Practice Gap Analysis: Aiming for Targeted Improvements. MEDSURG Nursing, 26(5), 332-335.

Morgan, S. D., & Stewart, A. C. (2017). Continuous Improvement of Team Assignments: Using a Web-based Tool and the Plan-Do-Check-Act Cycle in Design and Redesign. Decision Sciences Journal of Innovative Education, 15(3), 303-324.

Student (AH)

Patient falls represents a standard of quality care given by nurses. Repeated falls can result in a patient paranoia and an overall avoidance of movement which leads to a loss in functionality and reduced mobility. Patient falls within a hospital represent not only a legal risk but also a monetary one due to the fact that reimbursements will not be made if hospitalization is prolonged due to a fall (Dykes, Carroll, Hurley, Benoit & Middleton, 2009). If there is an increase in the amount of patient falls it is imperative that the healthcare organization review its policy and police the actions of all medical personnel that interact with patients on a daily basis to see whether or not there is a common characteristic resulting in the falls.

The falls that occur are potentially occurring due to the lack of support from medical personnel. This includes medical personnel being preoccupied from patients, lack of attention or just all around not being there when patients need assistance. Patients need to be attended to at different intervals however, it is the job of medical personnel to ensure that any needs of the patient are met. For example, if an individual needs to use the restroom and has pressed their assistance button several times and no one has provided assistance they may try to walk to where they are going by themselves resulting in a fall. This fall could inadvertently extend their stay and may or may not be covered under their medical insurance (Hitcho, Krauss, Birge, Dunagan, Fischer, Johnson & Fraser, 2004).

This issue will be corrected by creating a checklist for all individuals aligned with treating medical personnel. There will be a guideline that will dictate how fast medical personnel must attend to patients when they call out for help or when they request assistance. They will actively check in on patients and ensure that their needs are met in addition to helping them get to whatever activities you need to. This will be checked by monitoring the number of individuals responded to and having each medical person signing their initials to ensure that patients needs are being met. Lastly, after understanding how the process has been implemented actions will be taken to instill a fool proof plan has been given to all employees so they understand how to proceed for patient care.

Reference:

Dykes, P. C., Carroll, D. L., Hurley, A. C., Benoit, A., & Middleton, B. (2009). Why Do Patients in Acute Care Hospitals Fall? Can Falls Be Prevented? The Journal of Nursing Administration, 39(6), 299–304. http://doi.org/10.1097/NNA.0b013e3181a7788a

Hitcho, E. B., Krauss, M. J., Birge, S., Dunagan, W. C., Fischer, I., Johnson, S., Fraser, V. J. (2004). Characteristics and Circumstances of Falls in a Hospital Setting: A Prospective Analysis. Journal of General Internal Medicine, 19(7), 732–739. http://doi.org/10.1111/j.1525-1497.2004.30387.x

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