On Sat, Oct 15, 2016 at 2:01 AM, Ultimate essays <ultimatessays1@gmail.com> wrote:
Order #157305047 Writer's choice (3 pages, 0 slides)
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Type of service: |
Writing from scratch |
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Work type: |
Essay (any type) |
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Deadline: |
(20h) |
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Academic level: |
College (1-2 years: Freshman, Sophomore) |
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Subject or Discipline: |
Health Care |
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Title: |
Writer's choice |
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Number of sources: |
5 |
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Provide digital sources used: |
No |
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Paper format: |
APA |
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# of pages: |
3 |
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Spacing: |
Double spaced |
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# of words: |
825 |
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ppt icon 0 |
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0 |
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Paper details: |
the directions are in the uploaded files. This paper has to do with MFI guidelines and square guidelines. Below i will send an MFI template i did in class before and another assignment i did that has to do with square guidelines. I want you to pull information from these two previous assignments in addition to what you write. MFI( model for improvement) guidelines addresses three questions which you will see below. MFI Template Model For Improvement (MFI) Template Problem you will address and why you chose it (2 paragraphs) Since I work in healthcare and with geriatrics, I have been a witness to one of the leading problems in our healthcare system which is falls. “A fall is defined as an event which results in a person coming to rest inadvertently on the ground or floor or other lower level”( Falls, n.d.)). Falls is the leading cause of death of people over the age of 65. Most adults over the age of 65 who had a fall usually end up passing away within a year. Falls is not just an American problem but a worldwide problem and is usually fatal for our elderly population. Falls are one of the most frequent injuries that older people experience. “The average hospital cost for a fall injury is over $30,000 U.S. dollars”( Cost of falls among older adults, 2016). They can results in fractures, hip dislocations, head trauma etc. They also result in an increased risk for morbidity, mortality and decrease in mobility and functionality. There have been many improvements and intervention, which include: leaving beds in the lowest position, having call light in reach, adequate lighting having a bed pad next to the bed for someone at risk for fall, having a bed alarms and chair alarm, having fall risk identification as well as moving an individual who is at risk for fall near the nurses’ station. While all of these interventions have been quite beneficial research still shows that falls are still a detrimental problem that affects adults over the age of 65. The reason I choose this topic, is because I work in a facility that claims falls is the patients right. We are not allowed to put seatbelts or tray tables to prevent clients from falling because it is their right to fall. This was implemented about a year ago and the falls since then have tripled. We have falls at least every day or every other day. Consequently it is vital for us healthcare professionals to implement falls and risks assessment to prevent falls, which is a requirement as a nurse to protect your patients from injuries. The facility I work at is also a psych facility. Some clients fall for attention or they either cannot comprehend what they are doing. Nursing interventions can only go far if our facility and the state are not supporting their employees to prevent falls, which means more fatalities lie ahead. MFI Questions: 1. What are you trying to accomplish? (Goal/Aim) The Aim of this project will be to raise awareness and to reduce the fall rate in Care One nursing home by at least 50% by six months period. The Care One facility consists of 160 beds and the whole nursing home is a psychiatric nursing home. I would like to improve fall precautions throughout the facility. The goal of this project is a reduction of fall rate and for the nursing staff to review, learn and apply fall prevention techniques and interventions for patients who are at risk of falls. We will pass out brochures to educate staff on fall prevention strategies as well as have monthly meetings that looks at data of the previous month as well as other interventions we need to improve such as answering call lights on time. By implementing these interventions we will be able to reduce falls by 50% from October 2016 to April 2017. This Project will be run throughout the course of one year and by October 2017 the fallss during this facility will have reduced by 90% 2. How will you know the change is an improvement? (Measures) Measurement is important to any study because it determines if any improvements were made according to the newly implemented interventions. One of the problems I have with the facility I am employed at is that some patient’s behaviors include pretending that they fell so that they receive attention. As a facility we will have to look at what is it that constitutes as a fall. The falls at care one will be tracked on a monthly basis throughout the facility. We will look at amount of falls per 160 beds, which are the number of beds currently at the facility. By looking at the measurements month to month we will be able to see if the problem is improving or getting worse. This project will use outcome measures and process measures. The outcome measures will measure the number of falls within a given period. The outcome measure will also measure events that were avoidable such as problems with their care as well as patients utilizing their care measures that were added to prevent falls. 3. What change will you make that will result in an improvement? (Intervention) Fall prevention needs to be addressed on the first day of admissions by identifying various factors that predispose a patient to fall. Care one is a facility that highly respects patient’s rights and wants. Even though we implement basic interventions, there needs to be more done for these patients who are a high risk fall patient. Currently the interventions that are implemented include having call light in reach, having adequate lighting in their rooms, having grab bars in the bathroom and for other clients who are at risk and wanderers they are put on a one to one. I believe that for clients who are disoriented, we should add other interventions such as seatbelts and tray tables for some clients who fall out of their chairs or are wanderers. Even though this might be considered a restriction, I believe it will reduce fall rates by a half. My goal is to be one of the facilities with the lowest fall rate in the state. I will also implement quarterly classes on the importance of fall prevention to keep fall rates gradually improving. Reference Costs of Falls Among Older Adults. (2016, August 19). Retrieved October 04, 2016, from http://www.cdc.gov/homeandrecreationalsafety/falls/fallcost.html Falls. (n.d.). Retrieved October 04, 2016, from http://www.who.int/mediacentre/factsheets/fs344/en/ Write a paragraph reflecting on your understanding of the Model For Improvement as the basis for the development of a quality project and the use of the Squire guideline as a mechanism/template to create a manuscript to share your Quality project proposal with others. The Model for improvement is not only a tool that is used in healthcare organization to accelerate improvement, but also a framework that is used to improve a quality initiative. It is a "powerful tool that is used for accelerating improvement"(Institute for healthcare improvement). It focuses on every part of the team that may affect initiating the new movement into action. It focuses on aspects such as personalities, resistance to change; cultures that make it difficult for change, building of run charts, data collection etc. In the healthcare world we live in today to incorporate evidence based knowledge to our work place can and does take a long time. I think reason for this is that if nurse implements evidenced based research immediately throughout her facility then she might be putting her facility, colleagues and patients at risk. The Squire guideline is a template that talks about a quality initiative and how it was studied and implemented. The Quality initiative that I am focusing on is falls within my facility. This is an issue that has affected every nurse personally in my facility. As a nurse, I feel it is my responsibility to care for the well being of my patients and to protect them where I can be able to. Recently in facilities within Massachusetts there have been claims that these fall intervention that are implemented all through healthcare facilities are considered a restraint. These interventions include having side rails up, having seat belts on patients at risk for falls, as well as tray tables to prevent them from falling. Having the state of Massachusetts voice this concern has caused many facilities to go restraint free which has caused falls to triple and has brought more debilities to the patient due to them falling. Squire Manuscript Does having adequate fall interventions prevent injuries and improve quality of healthcare even if some are considered a restraint? Background: Hospitals nursing homes as well as other health care facilities are moving away from some fall preventions which are considered restraints. By healthcare facilities implementing the no restraint rule, they have put patients at high risk for injuries including death. These falls also cost the health insurance a lot of money knowing that it could have been prevented. Local Problem: In Massachusetts, here has been a no restraint movement in healthcare facilities including the one I work at. I have seen the no restraint rule before I was working as a nurse at a local group home where clients who are a high risk of seizures cannot be strapped in their wheel chair with their seatbelt because it is considered a restraint. The problem with this idea is that most patients who have so called “restraints” to prevent them from falling also have other mental problems. Most likely these patient’s don’t know what they are doing and if they don’t have a restraint they end up wondering throughout the floor and sometimes even wonder out of the building. The problem with such patients is that the nurses and nursing assistants at times can be too busy to keep watching one patient, which puts the patient at risk for falls, getting lost, killed etc. If any of this happens the person that will most likely take the fall is the nurse. I believe the facilities should be willing to hire one on ones for such patients. In my facility falls are a huge problem. In one shift I can have three falls which could have been preventable. When these falls happen my work is behind, my medications are behind and there are times where there is no one helping you with giving out medications. The problem with these is at times you may be late to give insulin to some of your patients and they will go to lunch or dinner and end up having a very high blood sugar and present symptoms of hyperglycemia. When this happens these patients also have to be attended to. Intended Improvement: A.) Pass a law that will allow certain restraints for patients who are at risk for falling and are also mentally disabled. There are patients who are wanderers but are not at risk for falling for these patients they don’t need restraints. I believe these fall interventions rules should be clear as to who it can be implemented on because they don’t apply to everyone. By passing this law that clearly outlines fall prevention strategies, our patients will be getting better care, fall prevention will reduce drastically and we will save the health insurance money for not sending someone out. B.) Since i work in Massachusetts, I have seen some facilities incorporating the no restraint rule for patient who are a fall risk and heavily confused. After a while the facilities realize that the patient has fallen too many times so they assign him a one on one. I want to reduce falls where they could have been prevented. Even though falling may be a patient right our right as healthcare providers is to protect them from falling. I believe facilities should be making their own rules since they know the patients better than the state or JCAHO( an accrediting organization for healthcare facilities). Study Question: Why do facilities only hire a one on one after patient has fallen to many times? Methods Ethical Issues: Conducting this study, I would want to talk to patients who have stayed at Care One nursing homes including the one I currently work at. I would want to ask them about the care they received from their nurses and CNA’S. Did they feel that nurses did the best job to protect the clients from any injuries as well as other patient’s injuries. Did the nurses respect client’s rights? How do they prevent falls and reduce injury when falls do happen? Were the nurses always watching the resident? Were clients who were at risk for fall moved near the nurse’s stations? Were the nurses always there when a resident asked for help to go to the bathroom. Setting: This study will take place at care one nursing homes including the one I work at. It will include other nursing staff, some patients as well as the quality assurance nurses. Planning the intervention: Since my facility is all psych patients I will only be able to use a few patients on questions about the facility. To collect data for my study I will question the patient’s family as well as the nursing staff. I will ask patient’s families if they would like to take a survey that speaks about their loved ones stay at the nursing home. I will ask the family on what they think about the interventions that are currently in place to prevent a fall. I would also ask them if they believe in the no restraint rule even for their loved ones. Also how they think is best to handle this situation. In my study I want to ask other patients and nurses from other Care one facilities about the no restraint rule. I will also set up interviews which can be done right at the nursing homes or I can arrange with patients families or other nursing staff from other Care One facilities to meet them at their houses and collect my data. Pre- work Meet with the quality assurance nurse in CareOne Contact other facilities in the areas as well as nursing homes and rehabs and obtain the fall prevention protocols as well as interventions. Pre work -Education Provide education to the healthcare facilities about having no restraint rule especially for patients who need them. Provide them with data from previous year and current year for before and after the no restraint rule was implemented in a given facility. Planning the study of the intervention: Here the hospitals nursing staff will look at the interventions that had been used through the survey to see the comments that the patients as well as the families had to say about the care and interventions they had received. They will also look at what was their best part of the care and also what they lacked in and try to improve on that. After these six months period, the nurses will sit down with the quality assurance nurse to look at the data collected for the past six months and see if the falls have reduced and also to see if having implemented the new fall preventions as well as a one on one reduced or lessened injury to the fall. Methods of Evaluation: Over the next year, after fully implementing fall prevention, falls will reduce by 90%. It will be evaluated by using quantitative methods through use of surveys or questionnaires and qualitative methods through interviewing patients as well as families on the patient’s current status, their care as well as their previous falls. I will also look at the data collected for the six months period as well as the 12 months data. Analysis By analyzing the interviews , surveys/ questionnaires and the 6 month data, we will be able to analyze the data, which will allow us to reach a conclusion. Outcomes: When we complete this survey we will be able to pass show our results to the state board of nursing in Massachusetts as well as nursing facilities throughout the state. These results will hopefully allow the state to see the consequences and risks that these facilities are placing their patients in. By doing this hopefully they will be able to revise fall interventions and patients rights as well as pass a new law in Massachusetts regarding this issue. The new bill will hopefully require one on one throughout these facilities for patients whose families don’t want any restraints are a fall risk. References Institute for Healthcare Improvement: Improving health and health care worldwide. (2016). Retrieved June, 2016, from http://www.ihi.org/Pages/default.aspx (Links to an external site.) 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