Quality Improvement Initiative: Reducing Patient Falls - Essay Example

? Quality Improvement Initiative: Reducing Patient Falls Quality Improvement Initiative: Reducing Patient Falls Many people in the American nursing facilities fall ever year. The research has shown that nearly half of all the residents of the nursing facilities fall ever single year. This has attracted concerns from many people including hospitals. There have been numerous efforts set in place so as to reduce number of falls in the hospitals. Falls are caused by both intrinsic and extrinsic factors. The intrinsic factors that cause falling include: acute medical condition, chronic diseases, effects of balance, age, and strength, side effects of the medications and unsafe behaviors among others. The extrinsic factors include: environmental hazards, unsafe personal care items and poor equipments. These factors may include things like unstable beds, poor lighting systems, improper foot wear, unstable furniture and poor conditioned floors among others. These factors have causes many falls resulting to serious injuries. In order to make sure that the falling among the patients is controlled, a team of people from various disciplines need to be composed so as to address the problem accordingly. This team will ensure that every discipline that is aimed to ensure the patients safety is wholly represented so as to make sure that the common objective of the team is achieved (Taylor et al 2005). The team will consist of falls nurse coordinator, fall nursing assistant, falls therapist, falls engineer, and director of nursing. This is a balanced team as every member plays an important part in the falls management. The falls nurse coordinator ensures the program is sufficiently implemented. He/ she oversees falls response steps and implementation of care plans. The coordinator also arranges for education and training of staff members, residents, and families. He/she should work with the medical director to in order to ensure that all care providers are aware of the program and the expected roles (Taylor et al 2005). There should be two coordinators in the team to ensure that there is continuity in services delivery during the periods of high demand and in case there is a change in staffing. The coordinator should be able to communicate effectively with all other members of the team so as to ensure the free flow of services and information. The falls nursing assistant should ensure that environment and equipment are inspected so as to ensure that they are in the good condition. He/she should be able to work with peers and other informal leaders within the unit. The nursing assistants should be two for small units and three to four for large units. The falls therapist should be at the front line in the assessment of mobility, wheelchair seating, and resident transfer. A member of rehabilitation department is best suited for this position because of his/her experience in occupational and physical therapy. The falls engineer is responsible for inspection, modification, and repair of equipment and the environment (Taylor et al 2005). A member of the maintenance staff is the best suited for this role. The director of nursing is not always active but should participate in different meetings of the team so as to make sure that he/she gives views concerning the progress of the team. These team members should be selected based on the merit. This requires that the most experienced are given first priority during the selection process (Pearson and Coburn 2011). The team should be able to collect the data on the ground so as to know what is required to be done at any given time. The team should be able to identify its strength and weaknesses so as to ensure that every time it is in the verge of improvement and not stagnation. The team should be able to coordinate its activities as well as the activities of the other employees within various units in fall control unit so as to ensure all the patients are cared for. The team should also devise a workable timetable that will facilitate service delivery to all patients (Taylor et al 2005). The team should be devoted in the service to all members of the society. This will make sure that services are delivered appropriately. The team should also give the lead to all other care providers by acting as the examples. This will make facilitate fast service delivery even under unfavorable conditions of terms and service. The team should also be focused to achieve its core objectives which are developing skills that will effectively solve of falling through facilitating intervention to the vulnerable residents. The patients who are at high risk of falling should be attended closely so as to ensure that they are safe. In doing this the team should encourage team work among all the members as well as among all other workers under them. This is a key toward achieving a common goal of reducing falls among the patients. The better communication system within this team is the one that will ensure that appropriate actions are taken at the right time (Pearson and Coburn 2011). This kind of communication allows each member to know what is expected of him or her. The service delivery is made very fast as there is no distortion of communication channel. All the channels of communication should be open for communication. These channels include both the vertical and horizontal communication. The communication systems within the team should be able to deliver both urgent and non-urgent information. The communication should also take place in all direction so as to allow response mechanism. This make the officers on ground to ask for back up in the event where they are being overwhelmed by the situation at hand. The team should have a main source of information where the orders are disseminated from and where that feedback is received and recorded (Healthcare Association 2006). The information about number of falls in the surgical division which shows that 5.0 falls are reported for each 1,000 patient days is much less compared to the data in the national benchmark. The national bench mark shows that half of the 1.6 million residents in nursing facilities in U.S report a fall. It also adds that every one person three who reports falls is likely to fall more than two times. As the falls become serious problem it is reported that every one person out of ten is seriously injured. In this case the study has shown that 65,000 patients experience hip fracture out of falling (Taylor et al 2005). Falls have adverse effects to people affected. These effects are both short time and long time effects. In the event where the patient reports a broken life, he/she may lack ability to function appropriately. This is because the part responsible for the right body positioning that facilitates bodies’ ability to function is ruined. Falling may lead to loss of self confidence. This is because people who once fell may live all their live in fear of falling. This makes them lack courage in day to day activities (Healthcare Association, 2006). The falls may lead to increased need for care. Individuals who break their crucial parts like hands or legs face a lot of problems if they fail to recover fully. This is because eating as well as walking may be a problem hence they will rely on other people so as to be able to perform such important tasks in life. These people my live their entire life being fed or being drugged around on wheel chairs. Through this way falls creates a need for dependence (Pearson and Coburn 2011). The reduced body activity may result to other health complication as the body functionality will be interfered with. Body activities such as body blood circulation and burning of the calories will not be effective hence paving way for many sophisticated health problems. The quality of life of the affected individuals may change. This is because the persons injured may find it difficult to engage themselves in any productive activities (Healthcare Association 2006). Through this their income may drastically decrease hence causing them to drain their investment and consequently be faced with problems later. As the quality of live is determined by the quality of life is determined by ones income, disability resulting from falling that can make person unable to raise money for his/her day to day expenses will definitely lead to changed standard of living. The team has set in place various strategies so as to make sure that it improves the state of the facilities available so as to avoid most of the falls. Some of the strategies in place include medication evaluation (Healthcare Association 2006). This tries to correct medications that are likely to make the patients fall and replace it with a more friendly medication which has less effect to the patients. The team is also conducting gait and balance training so as to ensure that the patients are equipped to protect themselves from falling. The team is also conducting thorough medication assessment that is crucial in identifying the problems associated with the behavior, mobility, gait vision and posture with an aim of correcting them so as to initiate a commendable action process which will evade all these problems. The team has initiated individualized wheel chair seating to ensure that those with walking problems do not fall while trying to walk (Healthcare Association, 2006). Hip protectors have also been designed and put in place to ensure that patients do not break their hips as it has been the case before. This protects the patients from being crippled out of falls. Low beds and mats are now taking over from high bed so as to ensure that the patients are as close to the floor as possible. This saves them from injuries even if they fall. With the beds close t the floor there will be no falling as the ones witnessed when the tries to climb a tall bed. The team is also aiming at fitting alarms and sensors that will alert them in the event where patients are about to fall. These will be very beneficial as they will call for attention of service providers even when they are far away (Clarke 2009). In addition to this the team start activities and exercise programs which are very crucial in energizing patients and hence strength them that they may not be falling so easily. This will be accompanied by effective behavioral counseling and changing strategies which will facilitate self management among the patients. In order to ensure that proposed changes will bring the desired changes, the team will be conducting regular surveys in all units so as to establish the new cases of falls reported as well as the severity of the injuries sustained. This will also be complemented with comparisons between the reported cases after the new measures have been put in place and the reported cases before the measures were in place (Clarke 2009). The factor of change that will determined through this process will always give the progress as well as providing most valid information that can be used in improving the measures in place. For the effective response to be realized, the available resources need to be suitably allocated. The team should ensure that the involved members of staff are fully trained and equipped so ads to ensure that they are ready to helps the patients at every time. The working basis of the workers also needs to be programmed so as to ensure that they are available at every time of need. The members of the team should have their duties fully defined to avoid confusion in the excursion of duties (Taylor et al 2005). The proposed changes in nursing facilities should also be enforced in order to ensure that conditions at hand are changed for better. This will act as a new dawn in the nursing units as the number of falls will be greatly reduced. The replacement of the high beds with the low beds and mats will ensure that the falling height is greatly reduced. Patients will not be injured as they have been in the before cases. A patient falling from six feet above the floor is likely to be injured more compared to one falling from one foot above the floor. Also the cost of putting in place lower beds is less expensive compared to high beds this is because fewer materials will be involved. The fixing of alarms is as well very beneficial to both the patients and the attendants. Although the cost of fixing these materials can be relatively high, the indirect cost of treating the fallen patient is increasingly very high. The proposed exercises will help in the strengthening of the patients hence making them more stable. This will enable them to perform various activities without risk of falling. Since the proposed response mechanisms are very beneficial, it is our duty of managers to adopt them. The provision of the above intervention mechanism should be done in the order f their priorities. This will ensure that the ones which are very crucial are provided first. For instance the introduction of low beds and mats should be done first because the application of the others may cope well if the patients are already near the floor (Clarke 2009). The workers to attend to the patients should thoroughly be trained in order to make sure that they are conversant with their services. The workability of the new changes can only be determined by effective data recording and comparison. This will enable the team to judge its progress toward solving falling problems. The behavior changes among the employees should also be noted so as to figure out the success of various services given to them. Fall has been one of the major causes of injuries to the patients in the hospitals. This has called for all stake holders to join hands in ensuring that these are not repeated every time. There are various strategies that have been put in place so as to make sure that these cases are minimized. Improvement of the available facilities and giving the right education are the main classes of the proposed changes. If they are improvised fully we will be having better hospitals with less injuries due to falls. References Clarke, J. (2009). The “how to” guide: Reducing harm from falls, NHS Institute for Innovation and Improvement. Retrieved 15 July 2013 http://www.patientsafetyfirst.nhs.uk/ashx/Asset.ashx?path=/Intervention-support/FALLSHow-to%20Guide%20v4.pdf Healthcare Association (2006). Profiles in quality improvement and Patient Safety. New York: Healthcare Association. Pearson, K. & Coburn, A. (2011). Evidence-based Falls Prevention in Critical Access Hospitals. Southern Maine: Maine Rural Health Research Center, University of Southern Maine Taylor, R., Patricia P., Holly, B. & Ouslander, J. (2005). The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities. Agency for Healthcare Research and Quality (AHRQ), Department of Medicine 1841 Clifton Road, Atlanta, Georgia, 30329 (404): 728-6900 Read More