Hourly rounds help keep patients from falling.
Explain how the gap was closed
Falls are the most common problem reported in hospitals, and they can be different based on the types of patients, the risk factors, and the ways to prevent them (Daniels, 2016). It was found that the problem of patients falling in the organization made it harder for nurses and other health care workers to give safe care. It was seen that each healthcare team was in charge of preventing falls instead of using a multidisciplinary method. For example, the nursing team didn’t want to follow the rules for preventing falls in the hospital because other workers thought it was their job to make sure patients were safe. The problem of falls had a big effect on older people and people in the medical/surgical units. A quality improvement project was made to help solve this problem by putting into place tactics that have been shown to work.
Today, using evidence-based practice has helped to improve both the standard of care and the safety of care for patients. In order to find the best way to stop patients from falling in the facility, a study of the literature was done. The most important way to stop people from falling was found to be to round up the hours on purpose. (Schuchman & Graziano, 2020) Most studies showed that falls in healthcare can be avoided if risk factors are found quickly and action is taken quickly. The use of hourly rounds was suggested because it could make it easier for patients and their families to be a part of various healthcare teams. Morris and Riordan’s (2017) study found that hourly rounds were the best way to find out what patients needed, which could have led to falls if they hadn’t been found. For example, the researchers said that hourly rounds could help unstable patients keep track of their movement, toileting, and continence needs. Making sure that older people and people who had just had surgery were stable was important, and planned rounding was the best way to do this.
Hospitals are under a lot of pressure to come up with guidelines or plans to keep patients from falling. Education and training were needed to make sure that the group could use the proposed strategy well. The nurses were taught why they should do hourly rounds and how to include the 4Ps (Pain, Potty, Positioning, and Possessions) into their new routine (Daniels, 2016). When the new change is fully put into place, the nurses will be expected to be busy and do their normal hourly rounds. During the rounding activity, the nurses will use the 4P’s method to check on the patient’s pain, position, placement, and potty. When the new plan is fully put into place, it should reduce the number of falls in all areas.
Getting behind the plan
Change management plans can help healthcare groups make smooth transitions by making sure employees know what to do during the change process. It has been shown that not having a plan for managing change leads to resistance to change and, finally, the failure of new organizational strategies. There are both short-term and long-term plans to help the new approach for preventing patient falls, so that there are fewer falls in the facility. The first step will be to get the nursing leadership and unit supporters involved in putting the new change into place. This short-term plan will help the staff follow the hourly rounding meetings and make them more effective. Goldsack et al. (2016) did a study to find out what makes hourly rounding measures work better. They found that when leaders are involved, they have an effect on staff and make sure that procedures are followed. As part of the long-term plan to support the new change, the staff, especially the new ones, will be educated and trained. This plan will help improve the facility’s attitude toward preventing falls and tell the nurses of their role in making sure patients are safe. Setting rules and giving helpful guidelines for hourly rounding will be needed to make the new approach even stronger.
Resources for Post-Implementation
After the project is finished, it will take both material and people resources to reach the goals. The first thing the group needs is a computer system that can collect and store information about patient falls. As part of the new project, nurses will be taught and trained to do hourly rounds. For education, there will be a room with seats for staff, extras like monitors and mics, notebooks for taking notes, and attendance sheets to make sure that everyone shows up. Because education and training are needed, money will help organize training classes and make it easier for stakeholders to meet. When it comes to the people who will help with the project after it has been put in place, the clinical nurse educator, unit leaders, and other important people will be there to help the nursing team.
Chapter 5: Looking back
Integration of Results
Results of Clinical Reasoning
The second goal of the MSN program is for the nurse to plan, perform, and evaluate evidence-based practice by combining clinical reasoning with organizational, patient-centered, and culturally appropriate strategies. To show that this goal was met, the project made sure that both the group and the patients liked the chosen intervention. During the early stages of the project, the hospital’s management helped decide if the new change would work to improve quality and patient safety. I also knew that the clinical nurse educator, nurse unit leaders, and managers were very important for the organization to accept the new change. These people helped get the nurses and other members of the healthcare team to agree to the new change. During the implementation phase, I realized that the staff needed education and training to help them understand the project and how the evidence-based solution could help reduce patient falls.
Result of Applied Research
The fifth goal of the MSN program is for the nurse to use the results of applied research in the practice setting, figuring out how to navigate and integrate care services across healthcare systems. During the whole process of putting the project into action, study results were used to help make decisions that kept people from falling in the facility. For example, a search of the literature was done to find fall prevention strategies, such as suggestions from professional groups. In the last section, I gave a summary of 30 trustworthy sources that had information about how to avoid falls. The hourly rounding approach was chosen to show how applied research can be used because it has been shown in the literature to reduce the number of patient falls in healthcare settings. Also, the choice to give nurses education and training before putting the new change into place showed how research results were used.
Patient safety is one of the most important parts of giving people good health care. When sick people fall, it’s a common and dangerous danger to their safety. The trouble with the organization was that people didn’t follow the rules for preventing falls. To deal with this problem, the nursing team was supposed to make a point of going around every hour to check on patients. The first step in putting the new change into place was to meet with the project managers to talk about the next steps. During the meeting, the stakeholders were told why the new change was important and how their power and influence could help make good things happen. In the second part, the planned strategy was shown to the administration, which then agreed to it. After the project was given the go-ahead, a thorough study of the literature showed that hourly rounds could help reduce patient falls in the organization. The last step in putting the plan into action was to educate and train nurses. The nurses were taught how to do hourly rounds and how important it was to keep people from falling. When assessing patients, the 4Ps (Pain, Potty, Positioning, and Possessions) were stressed. The project managers met once a week to talk about the new change process and find ways to get around imagined problems.
Daniels, J. (2016). Purposeful and timely nursing rounds: A best practice implementation project. JBI Database of Systematic Reviews and Implementation Reports, 14, 248-267. https://doi.org/10.11124/jbisrir-2016-2537
Goldsack, J., Bergey, M., Mascioli, S., & Cunningham, J. (2016). Hourly rounding and patient falls: What factors boost success?. Nursing Management, 45(2), 25–30. https://doi.org/10.1097/01.NURSE.0000459798.79840.95
Morris, R., & O'Riordan, S. (2017). Prevention of falls in hospital. Clinical Medicine (London, England), 17(4), 360–362.
Schuchman, M., & Graziano, J. (2020). Management of frequent falls. In Home-Based Medical Care for Older Adults (pp. 49-55). Springer, Cham. https://link.springer.com/chapter/10.1007/978-3-030-23483-6_8
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