Order from us for quality, customized work in due time of your choice.
Falls in the Elderly in the Hospital Setting: A Quality and Safety Issue
-
Falls are the second leading cause of accidental or unintentional injury deaths worldwide (WHO, 2012, para. 1).
-
In the US, 20-30% of falls in the elderly lead to injuries (WHO, 2012, para. 1).
-
Falls in hospitals remains a very common occurrence: up to 60% of all reported incidents (McDonnell & Kerr, 2014, p. 17).
-
Falls in hospitals lead to adverse psychological (primarily stress) and psychological outcomes for patients and healthcare professionals; they are costly for hospitals (Fitzpatrick et al., 2011).
-
Key reasons for hospital falls lack of observation and faulty risk assessment (McDonnell & Kerr, 2014, p. 17).
Proposed Change
-
Establishment of a continuous system of monitoring and improving safety with respect to falls in the elderly in the hospital environment.
-
Key areas: fall risk assessment practices, environment improvement, training, and patient education training (Boltz, 2012; CDC, 2016; Fitzpatrick et al., 2011; McDonnell & Kerr, 2014).
-
It is impossible to suggest a detailed plan without the involvement of the multidisciplinary team with their individual experiences and knowledge (Boltz, 2012, p. 291). The resulting program is to be customized.
Change Theory
-
Organizational change is typically required for healthcare safety and quality improvement (Sutherland, 2013).
-
The key aspect: managing the change (Cameron & Green, 2015; Sutherland, 2013).
-
Kotters Eight Steps Model: a very popular change model (King & Gerard, 2013).
Change Model to Be Applied: Justification and Application
-
The following steps constitute Kotters Eight Steps model (Cameron & Green, 2015, pp. 100-101).
-
Establish a sense of urgency.
-
A preliminary step.
-
Key role: allows realizing the need for change.
-
Involves the evaluation of the existing practices; defines if they are deficient.
-
It provides the basis for the rest of the change and thus is justified.
-
Tools: data gathering and its presentation in leaflets or posters; meetings.
-
Responsibility: volunteering members.
-
-
Form a powerful guiding coalition.
-
It provides the center for change management and thus is justified.
-
Tools: meetings of the interested members of the multidisciplinary community of the hospital, department, ward.
-
-
Create a vision.
-
Provides the vision, mission, and strategy for the change; aligns it with the hospitals mission, vision, and strategic goals.
-
It provides the plan for the change and thus is justified.
-
Tools: data gathering, knowledge development, meetings; surveys for stakeholder involvement is a possibility.
-
Responsibility: the coalition.
-
-
Communicate the vision.
-
Highlights the importance of communication between stakeholders.
-
Ensures the dissemination of the plan and thus is justified.
-
Tools: leaflets, posters, meetings.
-
Responsibility: the coalition, managers, supervisors; ultimately: everyone.
-
-
Empower others to act on the vision.
-
It requires providing tools and removing obstacles.
-
Involves communication with the stakeholders for ideas on implementation and complaints on obstacles.
-
Change cannot be carried out without empowerment. The step is justified.
-
Tools: a problem-reporting system; meetings, funding of the project.
-
Responsibility: the coalition (as decision-maker) and every stakeholder (reporting, suggesting, and implementing.
-
-
Plan for and create short-term wins.
-
Presupposes advertising noticeable improvements and rewarding successful workers.
-
Necessary for motivation and thus is justified.
-
Tools: data gathering; rewards (can be monetary).
-
Responsibility: the coalition.
-
-
Consolidate improvements and produce still more change.
-
Improvements are celebrated; problems are identified, reported, and eliminated.
-
Enables customization and sustainable improvement; thus, is justified.
-
Tools: a problem-reporting system; meetings, funding.
-
Responsibility: every stakeholder.
-
-
Solidify the change
-
Solidify the resulting practices as the hospitals policies.
-
Required for meaningful change. Justified.
-
Responsibility: coalition and management.
-
The Need for Change: Professional Collaboration
The first step establishes the need for change via professional communication and collaboration in data gathering, analysis, and dissemination.
Aligning the Model: Mission, Vision, and Values
-
Step three is specifically concerned with the hospitals mission, vision, and strategic goals.
-
Required to ensure the integrity of change and the appropriateness of outcomes.
Aligning the Model: Collaboration and Change Customization
-
The steps one and three are based on customization.
-
Steps four-seven involve further customization.
Applying the Model: Professional Collaboration of the Multidisciplinary Team
-
Communication and collaboration are required throughout the change.
-
Collaboration is needed between the disciplines: falls are affected by medications, environment, supervision, education, and training (Fitzpatrick et al., 2011).
Dissemination Strategy and Justification
-
Continuous dissemination of information is required for Kotters Model.
-
Dissemination is to be involved at different stages of the project, and the strategies can be multiple depending on the purpose.
-
For the final plan, awareness and understanding are to be raised with the help of meetings, discussions, and learning.
-
After the initial success, action research can be carried out, and an article about it can be published.
Proposed Budget
-
The plan requires minimum funding, but the majority of costs are unclear at the moment. The detailed budget is to be developed during stage three.
-
Posters and leaflets are likely to require funding. Internet research shows that it is possible to buy good-quality posters for $30 per unit; brochures can be purchased for $80. Depending on the quantity, store, and specifics of the order, the price can change.
-
Incentives. Depending on the efforts required of the coalition members, they can be working as volunteers or not.
-
Training. Depending on the training program chosen, funding may be needed.
-
Rewards. It can be monetary or not, token (for example, writing tools) or more significant and costly.
-
New equipment might be required for environmental improvement (Fitzpatrick et al., 2011). However, it is impossible to predict their costs at the moment.
Desired Outcomes
-
The desired outcome is a practically implemented model for a sustainable improvement of safety and quality in the field of falls in the elderly in hospital settings.
-
Key aspects: the practices of risk assessment, continuous improvement of the environment, and training and patient education training programs.
References
Boltz, M. (2012). Evidence-based geriatric nursing protocols for best practice. New York: Springer Publishing.
Cameron, E. & Green, M. (2015). Making sense of change management. London: Kogan Page.
CDC. (2016). Older Adult Falls. Web.
Fitzpatrick, M.A., Jorgensen, J., Forte, J., Kulik, C., Payson, C., Currier, A.,&Cardente, R. (2011). Special supplement to American Nurse Today best practices for falls reduction: A practical guide. American Nurse Today, 6(3). Web.
King, C. & Gerard, S. (2013). Clinical nurse leader certification review. New York, N.Y.: Springer Publishing.
McDonnell, T. & Kerr, A. (2014). Interventions to prevent falls in an inpatient hospital setting. Age And Ageing, 43(1), 17. Web.
Sutherland, K. (2013). Applying Lewins change management theory to the implementation of bar-coded medication administration. Canadian Journal of Nursing Informatics, 8(1-2), 1-6. Web.
WHO. (2012). Falls. Web.
Order from us for quality, customized work in due time of your choice.