Type of organization
Santa Paula Hospital is a fully fledged healthcare center within the region of Santa Clara Valley. The hospital services such as infection control, ICU, pediatric unit, oncology unit, surgical services, neonatal ICU, and full time acute care among others.
Number of clients it serves
The hospital has a 49-bed capacity for inpatients and can serve more than 300 clients in a day. The healthcare services are delivered in different units, depending on the service needed by each client.
Professional fit for advanced nursing role
While serving as an intern nurse at the Santa Paula Hospital, I noted that the greatest risk in the post-operation surgery is a decrease in mobility of the patient who is in the process of recovery. As a result of the reduced mobility, patients are exposed to the risk of frequent falls since they are confined in unfamiliar environments. Besides, the post-surgery recovery facility has varying medication regimen and treatment. In addition, some patients may feel that they are strong enough to ambulate. Thus, falls are more likely to occur and increase the health care costs. Therefore, as an advanced nurse, I would propose introduction of rules and changes within the facility to minimize frequent falls.
Implement the new nursing role at Santa Paula Hospital
Despite the fact that the Santa Paula Hospital has implemented numerous interventions to prevent injuries from falls, little effort has been carried out in terms of implementation. The current intervention mechanism has loopholes that implementers may take advantage of. Therefore, there is need to introduce the aspects of patient contract, bed alarms, and hourly rounding within the intervention mechanism (Dykes, Carroll, Hurley, Benoit, & Middleton, 2011). The contract will be signed by the patient stating that he/she agrees not to transfer, ambulate, or go to restroom without calling for assistance. This contract will be signed once the nurse feels that the patient is moderately independent. Whenever the contract is breached by the patient, a bed alarm, which is attached to patient’s mattress/wheelchair, will automatically alert the staff if the patient attempts to get up without calling for assistance (Iglehart, 2013). Therefore, the proposed change will create a safe nurse practicing environment to promote good and quality care for desirable patient outcome.
As indicated in the Lewin’s Change Theory, the steps in implementing the proposal to avoid and minimize frequent falls will involve research, documentation and training, implementation, and evaluation. Under research, the change agency will carry out explicit analysis of best practices in other hospitals in order to create a flexible and sustainable change platform (McCarthy, Adedokun, & Fairchild, 2014). The second stage will involve creating legal contracts and other documentation to make the proposed change part of the treatment guideline in the post-surgery recovery environment. The third stage will be characterized by creating flexible training program for the nurses, who will be the main change implementers. Implementation stage will involve the actual process of testing and practicing the proposed change (Marquis & Huston, 2012). The last stage will involve evaluation of the effectiveness of the proposed change, in terms of reviewing the number of falls after implementation against the same number before implementation (Weick & Quinn, 2009).
Board of nursing in California and the Nurse Practice Act supporting the role
The California Board of Vocational Nursing and Psychiatric Technicians would support my role as an advanced nurse in the post surgery environment. Through the Rehabilitation Act of 1973, the advanced nurse is empowered to manage the post-surgery environment by ensuring that recovering patients are protected from any injury (Bustin, 2004).
References
Bustin, G. (2004). Take charge: How leaders profit from change. Irving, Texas: Tapestry Press.
Dykes, P. C., Carroll, D. L., Hurley, A. C., Benoit, A., & Middleton, B. (2011). Why do patients in acute care hospitals fall? Can falls be prevented? Web.
Iglehart, J. (2013). Expanding the Role of advanced nurse practitioners-risks and rewards. New England Journal of Medicine, 1935-1941.
Marquis, B. L., & Huston, C. J. (2012). Leadership roles and management functions in nursing (7th ed.). Philadelphia, PA: Wolters Kluwer.
McCarthy, R., Adedokun, C. W., & Fairchild, R. M. (2014). Preventing falls in the elderly long term care facilities. Web.
Weick, K. & Quinn, R. (2009). Organizational change and development. Annual Review Psychology, 50(2), 361-386.