NRS 451 Topic 3 Assignment Executive Summary

Executive Summary

Grand Canyon University

NRS-451V

Patient safety is a priority in the healthcare industry. Falls resulting in injury are a current patient problem. The elderly and confused patients are not the only patients at risk for falls. Post- anesthesia patients are at a higher risk for fall without regards to their age. Although they may communicate effectively and physically demonstrate full recovery, their cognition and balance may still be affected. Every year in the United States, hundreds of thousands of patients fall in hospitals, with 30-50 percent resulting in injury (“Preventing falls,” 2015). According to the Center for Disease Control (CDC), one out of five falls cause a serious injury such as broken bones or head injury (CDC, 2017).A fall prevention checklist such as the Morse Fall Scale, which is used to identify fall risk factors upon the initial assessment and as needed throughout the patient visit (“Preventing Falls,” 2013). This tool may help predict future falls and put a plan in place to prevent falls. According to the statistical reports from national accredited agencies such as the CDC and Joint Commission, falls is a serious event that can not only put a patient’s life at risk but can also be costly.

Purpose

The purpose of this initiative is to properly assess, identify and safely care for patients that are at risk for falls and injury factors in an effort to reduce the probability of future falls. By putting in plan in place, the patient’s needs will be addressed at the first person contact and culminating with the last healthcare provider. Fall prevention is interdisciplinary, meaning all healthcare providers from nurses, physicians, patients and families need to cooperate to increase safety and prevent falls. How should the right information about a patient’s fall risk get to the right members of the team? When a patient arrives for services, if the reception notices that the patient has unsteady gate or ambulates with assistive device, she must make a notation on patient’s chart so that the nurse can provide a wheelchair. Upon arrival to pre-operative department, the nurse will perform a fall risk assessment utilizing Morse Fall Scale. A systematic report and analysis will be set in place by having the assessment tool stay with the patient’s chart and continued re-assessment of the patient as he/she is moved to each unit. When the patient arrives to post-anesthesia care, report will include fall assessment score. Once the patient has met discharge criteria, as per currently used Aldrete Score, the patient will be instructed to dress in the stretcher with both side rails up and in the presence of either a family member or a staff nurse. All patients will be transported or mobilized via wheelchair by a staff member upon discharged from facility. The proposed plan also includes hiring a nurse assistant to aid with transportation and sanitizing stretchers after each use. With currently having only two recovery nurses, the proper staffing levels will increase patient safety. This initiative will address inadequate/incomplete assessments, communication failures, lack of safety practices and inadequate staffing. To create a more consistent program, copies should be included in orientation programs for new employees (Huber, 2014).

Audience

The strategic plan should be communicated to stakeholders: board members, management, and staff. Emphasis would be placed on board members as they are responsible for setting and revising policies and making sure they are in compliance with federal and state regulations. I would not exclude patients, they can be provided with a condensed summary of the strategic plan on admission, particularly those sections related to their care (Huber, 2014).

Benefits

Planning and prevention increases quality care. With coordinated efforts to apply a fall prevention program, the problem of falls might be managed more effectively (Hughes, 2008). The fall risk prevention implementation will also assist the staff in delivering safe care while meeting patient’s needs. It may also increase patient satisfaction survey scores as they will notice that their safety is our priority.

Budget Justification

While hiring a nurse assistant may be an additional cost to the facility, it will prove in the long run to be a positive action as it will assist in decreasing and over time eliminating patient falls. It is more cost effective to hire a nurse assistant than it is to employ a registered nurse. Nurse education and updates can be done during staff meeting to reduce education expenses. The ultimate goal is to deliver safe care and preventing falls/injuries. Overall, the program will reduce costs that may be attributed to a fall. The average hospital cost for a fall injury is over $30,000 (CDC, 2017)

Basis Upon Which the Program Will be Evaluated

The facility has a quarterly monitoring system for falls and injuries. Upon initiation of the proposed program, the monitoring and data will be recorded and after assessing the effectiveness, adjustments can and will be made accordingly. The effectiveness can also be evaluated through patient feedback as their survey includes questions about safety.

Feedback

The proposed program was shared with my director at North Houston Endoscopy and Surgery. He believes that the proposal can be incorporated as we want to decrease patient falls/injuries. Some challenges that might arise are having patients dress in the stretcher with both side rails up, but with proper patient teaching and reiterating patient safety it can be done. With budget, another challenge may be employing a nurse assistant, but the importance is noted. The strengths that were focused on was the implementation of Morse Fall Scale, as we do not have one in place and a systematic nurse report (Burke, 2018).

References

Burke, M. (2018, March 22). Personal Interview.

Centers for Disease Control and Prevention. (2017, February 10). Costs of Falls Among Older

Adults. Retrieved from

http://www.cdc.gov/homeandrecreationalsafety/falls/fallcost.html

Fall Prevention. (n.d.) Retrieved from

https://www.americannursetoday.com/wp-content/uploads/2015/…/ant7-Falls-630_FULL.

Pd…

Huber, D. (2014) Leadership and Nursing Care Management, 5th Edition. [ Pageburstl].

Retrieved from https://pageburstls.elsevier.com/#/books/97814557407

Hughes, R. (2008). Patient Safety and quality: An evidence-based handbook for nurses.

Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK2653/.