Clinical Practice Improvement Project Report

Additionally, the project addresses the nurses pivotal contribution especially during communication (information focus), and also emphasize the benefits of multidisciplinary and friendly working environment (quality improvement). The project will also emphasize the value of effective leadership skills in reducing patient-falls. The proposed project will ensure that patient hospital stays, and the healthcare costs are reduced considerably. The proposed project will ensure that patient access more integrated care, care that will ensure that people meets the demands and the priorities of the community the healthcare community demands. The overall consequence is low patient –fall rates, readmission rate, cost of care, lengthened hospital stays and improve patient satisfaction and quality of life (Haines et al., 2013).

Patient falls among the elderly are the main source of non fatal injuries as well as trauma. Research indicates that patient-falls rates correlate with the staffing ratio and organization safety culture.   The healthcare providers, especially the nurses are responsible for patient safety (Hutchings, Ward, and Bloodworth, 2013).  It is estimated that integration of evidence based practice in the healthcare will reduce approximately, 1000 falls every month. In some nations, the concept of safe and quality care is being emphasized  too an extent that the  public medical  insurance  fails to cater for hospital costs associated with patient safety, claiming that these costs are  preventable if the healthcare staff practice EBP  (Hicks, 2015).

Literature indicates that a lot of resources are wasted   during the treatment of the hospital falls rather than identifying the approaches that will strategize on minimizing the rates of hospital falls (Rowe, 2012).This calls for a change of approaches by the healthcare providers, and to embrace the innovative strategies that are identified by evidence based strategies to prevent patient falls. This includes the use of assistance during toileting, use of fall assessment risks during admission and integration of the healthcare providers in refresher training programs that are geared towards reduction of patient falls in hospital setting (Kieke, 2014).

The internal stakeholders who will be involved in this project include clinical staff in the orthopaedic department including the physician, general practitioners and the orthopaedic manager, whereas the external stakeholders include the customers and the healthcare organizations that support safe and quality care. The internal stakeholders in this project will be involved in funding, coordination and resourcing of the proposed project (Olrich, Kalman, & Nigolian, 2012). The role of the external stakeholders will be informed of advises based on their experiences and their views in addressing the issue of patient falls. The engagement of these stakeholders is important as it facilitates in decision making. This is because the stakeholders have values that important in the health care facility. The integration the stakeholder addresses the negative perceptions and any source of doubts regarding the policy changes (Lowel and Hudgson, 2012).

From this framework, the planning stage will involve intensive research to identify the healthcare facility safety measures to identify the underlying gap that is causes increase in patient –fall rates. This framework will facilitate in the process of identifying the conditions that precipitate the project, the areas affected, and the people affected by the poor safety measures in the orthopaedic department. This framework guides the exploration of the causes of this critical issue and the characterization of the problem. The framework helps in the establishment of the baseline that will be used to evaluate the outcome (Falls free, 2014). In this context, the number of injuries associated with fall rates will be recorded before and after the implementation of the program. This data will be used to examine the rates of readmission rates due to issues associated with patient-fall incidences, and the additional cost of care due to lengthened hospital stays. This is proposed to take place for six months. This short term project is aimed at providing conclusive decisions that can be applied in long term strategies (Zephir, Minel, and Chapotot, 2011).

PEPPA refers to “participatory, evidence-informed, patient centred process for project development, implementation and evaluation processes.” This framework outlines nine key steps that will be used in this project.  The first stage is to define the population and describe the present patient safety measures in the organization. The next step will be to identify the relevant stakeholders and the recruitment processes. The recruited stakeholders will participate in discussions to identify the critical issues, which need to be addressed to improve the quality of care (Trepanier, 2014). The fifth step is to define the strategic interventions that will address the critical interventions that will fit within the healthcare facility goals and mission. The next step is planning of the strategic implementation, including the identification of outcomes and the evaluation plan. The facilitators and barriers of the project will also be identified. The plan (hourly rounding) will be identified, evaluated and monitored (Graham, 2012).

Healthcare quality improvement requires a broad range of activities with varying level of complexity in their methodological as well as the statistical rigor, which involves developing, implementation and the assessment of the interventions proposed.  All processes of improving quality in the health care is geared towards achieving effective, safe, timely, efficient , patient centred and equitable healthcare services (Trepanier, 2014).

Prior to the implementation process, the nurses and assistive nurses will undergo training on the relevance of the proposed intervention. As stated previously, the hourly rounding will begin at 6.00 am to 11 pm. After every rounding, the nurses in charge will fill in the log book provided. The logbook will indicate the patient admission date, reason for admission,   patient fall incidence and any other information relevant to hospital stays. The rounding will be routinely monitored by managers and will be supplemented by questionnaires filled by patients (Dykes et al., 2010).

After every two weeks, a formal meeting will be conducted. This will form the platform for the nurses’ dilemmas and challenges during the implementation process are addressed. At the end of the proposed project, 45 minutes focus group interview will be conducted.  Data collected included semi-structured interview as well as the use of questionnaires. This will ensure that the data is explored holistically (Graham, 2012).

The evaluation process will be conducted using questionnaire and patient’s feedback. The questionnaires will be structured in a way that it appraises the patient’s perceptions on threats and vulnerability associated with patient falls.  It will also assess the patient healthcare relation and interaction to evaluate on how it impacts patient falls.