Quality Improvement for Patient Falls Term Paper

Pages: 15 (4493 words)  ·  Bibliography Sources: 10  ·  File: .docx  ·  Level: Doctorate  ·  Topic: Leadership

Nursing-sensitive indicators produced by NDQF are indicators that reflect the quality of nursing care provided to the patient that represents competence, devotion, and level of education / certification of nurse and organization. All indicators are based on empirical evidence. The indicator would be the number of patients falls (ANA)

State the problem and mission in measurable terms; clearly state the unit of analysis.

Explain why your selected nursing indicator is a priority for your organization and support your selection with data.

Identify which quality improvement model best fits your nursing indicator and justify your selection with evidence from the research literature.

Detail the primary measurement that you will be utilizing, and the goal, in comparison to an external source (i.e. scores received by other similar health care organizations on your nursing indicator).

Synthesize strategies for managing any ethical dilemmas presented by the initiative.

Falls are a major problem amongst the elderly, particularly amongst the 656+ population and can lead to so many related problems, occasionally to fatal results, that this essay considers it a crucial topic for nurses and caregivers to look into and investigate.

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Approximately, a third to one-half of individuals fall each year (Downton, 1991), whilst in the United States, alone, one in three people, who are over 65, fall at least once a year, and this incidence increases to one into two people for those who are over 80 (Rosendahl, et al. (2003). The severity of fall complications also increases over age, particularly with females, resulting in more mortality and morbidity related to fall with individuals whose age exceeds 70 than with those who are younger (Gillespie, et al., 2009).

TOPIC: Term Paper on Quality Improvement for Patient Falls Assignment

Consequences of falling can include post-fall anxiety, fractures, head injuries and loss of independence through falling, each of which has far wider ramifications impacting physical, social, meant, emotional, and behavioral spheres of the patient's life. The ramification of falling, therefore, for the elder person has a wider and far-reaching impact that touches virtually every segment of his or her life. Falling can, accordingly, result in premature death. In the United States alone, the economic cost procured through fall-related injuries is predicted to total $32.4b by 2020 (Brown 2012)).

There is an extensive literature on the best methods to prevent falls, but the literature is so extensive that some of these methods are sometimes contradictory, and not all of the research has been scientifically conducted.

The Model for Improvement, developed by Associates in Process Improvement, is the tool that will be used in connection with these indicators as means for investigating and accelerating improvement. This model has been used successfully by many health care organizations in many countries to improve many different health care processes and outcomes.

It has three parts:

1. The Plan-Do-Study-Act (PDSA) cycle to test and implement changes in real work settings. The PDSA cycle guides the test of a change to determine if the change is an improvement. Team needs to know what they wish to accomplish

2. Team plots and assesses change

3. Teams decides whether more improvement is needed (Langley et al. (2009)

The importance of this essay is evident: prevention of falls among the elderly population can prevent so many of the complications form occuring. Life can be extended, negative ramifications (in all spheres of the individual's life) be prevented; cost can be reduced; the terrific burden of care caused by providing care to the patient can be ameliorated; and quality of life -- amongst other factors -- can be enhanced. Furthermore, both primary health care and long-term nursing care would benefit from a comprehensive assessment of the methods most effective for preventing falls. As Brown (2012) pointed out the responsibility of nurses obligates them to expand their knowledge and skills on evidence-based interventions that are most effective in reducing frequency of falls for the individuals who are under their care.

Brown (2012) argued that in order for falls to be most effectively treated, causes of falls among the elderly population had to be analyzed, and their literature investigation led them to believe that cause could be categorized into two dynamics: (I) falls related to intrinsic factors (such as to medication or illness (such as Parkinson or hypertension; dizziness; depression; inadequate exercise; visual and/or hearing problems; anxiety of falling; diabetes; emotional and so forth)), and (ii) falls related to extrinsic factors (such as to environmental hazards; new and unfamiliar environment; footwear). It has been found for instance that the unexpected hospital environment or introduction t the unfamiliar setting of a nursing home can encourage falls.

Of concern and limitation to the literature on falling is that the construct is itself inadequately defined. Methods used for recording falls vary (Wolf, 1996) and consequent definition of falling can alter results of studies used to analysis the phenomena on and devise intervention. A consensus definition of falling, therefore, needs to be adopted in order to facilitate comparison and better theoretical and practical treatment of the subject. The Preventions of Falls network Europe (PROFANE) is in the midst of putting together such a package.

Part 2: Describe the team: membership, roles, facilitators, background/experience, and motivation within, followed with an analysis of the leadership role of the sponsor for this project.

Document the team process: determine meeting frequency, ability to fulfill roles on the team, etc. As this is a simulation exercise, you will create this information using best practices as a guide.

What leadership qualities should this "senior leader" or sponsor possess?

Do you believe this sponsor to be a transactional leader or a transformational leader?

What managerial attributes and actions would this senior leader need to employ to ensure that the staff will buy into workplace changes?

Predict how the senior leader role will evolve throughout the quality improvement journey.

Nurses may be student nurses, at least second year, compassionate, familiar with patients and hospital routine and acquainted with conducting experiments. Each of the participants will be motivated to reduce the amount of times patients fall and will be interested in patient's welfare. The nurses will be working in medical institution or in a nursing home. All of the them will belong to the same institution.

There will be 2 to 3 meetings to discuss literature on research and ways of putting it into effect into following 9 months program as well as ways of evaluating it. The leader can use PowerPoint to delineate and may hold a training session if participants think it necessary. Handouts that outline main points will be distributed. Part of the session can involve role-modeling so that nurses understand all details. Nurses will be given opportunity to ask question following session.

The leader leading the program will have the qualities of transformational leadership

Transformational leadership is a term that was coined in the 1980s by Bass (2005). He uses it to distinguish between what he calls 'transactional leadership' where one simply 'manages' an organization or leads the other in a certain way so that employees achieve what the organization wishes them to. A transformational leader goes beyond that in that he actually transforms the follower: changes him, has an impact on his life, motivates him in an extraordinary way so that he work towards the good of meaningful and substantial goal in a passionate and, frequently, self-sacrificing manner. Transformational leadership may possibly be the highest level of leadership that one can attain and its responsibility is enormous given the huge impact that transformational leadership can make on the lives of followers and on those connected with followers. Ramifications are therefore enduring and trans-generational as well as, sometimes, global. Examples of models of transformational leadership are clergy, teachers, nurses, social workers -- in fact anyone involved in the helping profession. Transformational leadership often involves taking a stance even though by so doing one may place one's position in jeopardy.

Transformational leadership is distinguished by four different characteristics:

1. Transformational leaders have the ability to create visions and employ charismatic behaviors

2. Bass described transforming leaders as purposeful leaders who seek to understand the motivation and needs of their followers.

3. Transformational leadership generates collective purpose and can be judged effective if actual social change results.

4. When on or more persons engage others in such a way that leaders and followers raise one another to higher levels of motivation and morality, true transformational leadership is present.

.Although supposedly effecting employee burnout, Bass (2005) propose that the opposite is the case. By influencing and motivating followers, transformational leaders only increase efficacy of the other. Similarly and counter-intuitively, transformational leadership may be more effective than so called passive leadership in influencing others. It is to that end, therefore, that transformational leadership may be the best paradigm for the type of leadership that nurses should adopt and would be ideal in this case for leading a discussion/workshop group.

The entire process will be conducted according to the nurse ethics delineated in the ANA code (2001). These are essentially nine moral provision that are nonnegotiable in regards to nurse practice. Although not explicitly proscribing… [END OF PREVIEW] . . . READ MORE

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