NRS 451 Executive Summary

Sample Answer

Nurses are essential components of healthcare delivery and can propose quality improvement initiatives in their workplace to enhance the quality of care by solving problems and challenges faced by their organizations. Quality improvement (QI) initiatives offer nurses that chance to develop innovative solutions to healthcare issues like falls that have devastating effects on patients and the quality of care delivered.

Evidence shows that falls significantly contribute to injuries that include fractures, laceration and in some cases, death, especially among the elderly patients (AHRQ, 2021). The purpose of this paper is to propose a fall prevention program or initiative aimed at providing sufficient education to prevent and reduce the prevalence of falls in the facility among elderly patients.

Purpose of the Quality Improvement Initiative

While hospital falls continue to decline over the past years, they still constitute a critical problem that requires interventions, especially among the elderly patients in skilled facilities. Patient falls are the most prevalent adverse events occurring and reported in hospitals. Each year, close to 800,000 falls occur in hospitals across the United States with about a quarter a million of these cases ending up in serious injuries while over 11,000 die.

The Centers for Disease Control and Prevention (CDC) (2021) asserts that one out of five falls leads to serious injuries like broken bones and head injury. The implication is that having a quality improvement initiative will be critical in helping the facility reverse these trends. The purpose of the project is to implement measures aimed at preventing and reducing falls in the facility. The initiative aims at increasing awareness and providing sufficient knowledge and information about falls in the healthcare (Heng et al., 2020).

The proposed quality initiative entails a fall care bundles intervention and education based on the following aspects;

• Conducing fall-risk assessment for patients on their admission
• Active hourly rounding
• Having suitable footwear for patients based on their condition
• Giving new opportunities for nurses to learn, unlearn, and relearn the issue of falls and ways of preventing it through a collaborative effort and having patient-centered approach.

Target Population

The proposed initiative targets three main stakeholders who include nurses, patients and their families, and the physiotherapists in the facility. The targeted patients are mainly those who require hourly rounding, are elderly and need support, and those in high dependence unit (HDU). Ensuring that nurses have sufficient knowledge about falls is essential as they will develop better and innovative ways to implement the proposed activities.

Falls, especially among the elderly patients, remain a leading cause of death and serious injuries like head fractures that can lead to permanent disabilities and even death. Fall incidences are highest among the elderly patients, especially those over 80 years (LeLaurin & Shorr, 2019). Therefore, the bundle of care interventions will address all stakeholders and offer sufficient information and education on falls’ prevention.

Benefits of the Initiative

A core part of this project or initiative is to increase awareness and information availability among nurses and other healthcare providers on falls and how to prevent them. The initiative primary benefits would be to reduce the prevalence of falls, especially among hospitalized older patients. The initiative will reduce and prevent harm as well as other complication like fractures and disabilities linked to falls. The CDC (2021) asserts that falls cost close to $50 billion each year. This implies that by implementing this project, the facility will reduce the cost of falls internally and across the healthcare sector at the macro level.

These costs are related to longer stays in hospitals that lead to more bills, cost of caring for the comorbidities caused by the issue, and the cost associated to the demise of those affected (Pop et al., 2020). Therefore, this project will offer a host of benefits not just to the organization but also the community since it will allow individuals and their families to mitigate the occurrence of falls.

Inter-professional Collaboration

The implementation of the initiative will require having a team led by the nurse leader and those serving in different areas where patients are susceptible to falls. The team will comprise of physiotherapists, occupational therapists, nurses, nurse leaders, and their respective physicians handling such patients. Through the inter-professional approach, the team will develop a common model for implementation of all the suggested interventions

Cost and Budget Justification

Healthcare costs associated with the treatment and management of falls in any facility are significant. As observed, falls constitute a critical economic burden on the healthcare system. However, implementation of fall prevention initiatives like this one guarantees organizations reduced cost of care and lowering the overall burden related to comorbidities and even mortality. Therefore, implementing this initiative will lower the cost of caring for patients suffering from falls.

The proposed interventions will cost the organization about $40,000. Studies show that hospitals can save up to $110,000 monthly when they initiate such programs in their care settings (Haddad et al., 2019). This implies that the cost of falls’ prevention is comparatively lower compared to the overall treatment costs and the lost time. As such, implementing this initiative will offer enhanced benefits for the organization compared to non-implementation.

Evaluation of the Quality Initiative

The evaluation of the initiative will be key to ensuring that it meets its objectives and allows the organization to mitigate and prevent falls. This implies that data and information will be collected before the implementation to create the basis of the evaluation aimed at ascertaining the efficacy of the initiative (Shaw et al., 2020). The next set of data will arise during the implementation for three months to capture any changes. Based on these sets of data, the evaluation team will determine the overall effects of the interventions on falls, especially if there is a decline of the incidences and if providers have sufficient information on prevention.

Conclusion

Quality improvement initiatives are a critical component of enhancing the overall patient outcomes in healthcare settings. The proposed initiative to reduce falls, especially among elderly patients, would lead to better outcomes and reduced cost of care for patients. The initiative will also reduce the cost burden associated with diverse components of the healthcare delivery system.

References

• Agency for Healthcare Research & Quality (AHRQ) (2021). Preventing Falls in Hospitals.
  https //www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/index.html
• Centers for Disease Control and Prevention (CDC) (2021 August 6). Facts About Falls.
  https //www.cdc.gov/falls/facts.html
• Haddad, Y. K., Bergen, G., & Florence, C. S. (2019). Estimating the Economic Burden Related to Older Adult Falls by State. Journal of public health management and practice
  JPHMP, 25(2), E17–E24. https //doi.org/10.1097/PHH.0000000000000816.
• Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A. M., & Morris, M. E. (2020). Hospital falls prevention with patient education a scoping review. BMC geriatrics, 20(1), 1-12.
  DOI 10.1186/s12877-020-01515-w
• LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients state of the science. Clinics in geriatric medicine, 35(2), 273-283. DOI 10.1016/j.cger.2019.01.007
• Pop, H., Lamb, K., Livesay, S., Altman, P., Sanchez, A., & Nora, M. E. (2020). Tailoring a comprehensive bundled intervention for ED fall prevention. Journal of emergency nursing, 46(2), 225-232. https //doi.org/10.1016/j.jen.2019.11.010
• Shaw, L., Kiegaldie, D., & Farlie, M. K. (2020). Education interventions for health professionals on falls prevention in health care settings a 10-year scoping review. BMC geriatrics,
  20(1), 1-13. DOI https //doi.org/10.1186/s12877-020-01819-x