Measuring Change
The best measure to use when measuring changes in the evidence-based model is to conduct regular assessments to determine whether the number of elderly falls is reducing. Medical staff should complete this assessment when making their rounds to check and help any fallen patients (Veazie et al., 2019). Furthermore, using the bell system would help medical personnel address any case of elderly falls within a short time. A reduction in the time taken for individuals to gain help once they have fallen will also posit a positive movement in the field as it would prove that the bell system is working effectively.
List of Outcomes
- Nursing rounds should be frequent and involve checking on the elderly to assess whether they are safely positioned on their beds.
- The nurses should also determine whether every nursing bed bell works if an elderly person falls while there is a long time between assessments.
- It is also essential to conduct a departmental meeting with every faction of the medical institution to promote the use of safety measures, such as lowering beds for the elderly to prevent them from falling.
Responsible Parties
- The Joint Commission should be sought to introduce various elderly fall risk regulations that every nurse should adhere to. They should include a checklist to help nurses assess patients without relying on their memories.
- The hospital should also provide a vocational training program for its staff to learn about fall prevention interventions. It should follow up weekly with reports about how these interventions have been integrated into the staffer’s work.
- Nurses should also develop a rotational timetable that involves visiting every elderly patient to ensure they have not fallen and are not at risk of such activities.
Actions to Promote Outcomes
Firstly, it is vital to communicate with department heads to seek help from the Joint Commission in developing effective regulations that address the problem. Moreover, the departments help provide managerial backing to the new rules (Veazie et al., 2019). Individuals are better coordinated through their departments. As such, each department should deal with its workforce to ensure each individual adheres to the principles set out to protect the elderly from falls.
It is also essential to communicate with the elderly in the hospital to provide them with information about the program. They should be alerted to use the alarm system if they feel uncomfortable and cannot effectively move from their beds (Veazie et al., 2019). The nurses should also inform patients they should communicate when they are being set up in their areas as they may be poorly positioned. While the nurse is responsible for these actions, the patients could ask if they are correctly situated, as the nurse may have made an error.
Medical institutions should provide these instructions to their workforce during their vocational training period.
Resources
It is crucial to consider the necessity for various resources to implement the new interventions. Budgetary allocations should include vocational training money for new and experienced medical personnel for every department in the hospital. The project also provides the use of various personnel with an understanding of elderly fall risk intervention methods. Suing experienced personnel to provide other individuals with on-the-job training would save money while preventing the hospital from straining its resources.
It is also important to discern the necessity for various equipment and supplies to implement the project (Zawada Jr., 2016). The hospital should ensure the alarm bed systems are working correctly in this instance. It should also make sure the beds can move in every direction with ease so that patients do not strain to operate them. They should also exhibit significant ease to use to ensure patients do not have issues when using them. Nursing assessments also require additional personnel to prevent the hospital from straining its human capital as it would experience issues such as fatigue and burnout.
Milestones
- The hospital should discern the number of elderly people who fall because of poor initial positioning by their nurses based on each department.
- It should also consider the average time taken by nurses to respond to alarm bed systems.
- The hospital should also include patient satisfaction averages in its milestones to determine if they are improving and the areas that need addressing.
How to check on the milestones
The hospital should conduct monthly reviews of the average falls exhibited in every department. A department with bad ratings should be given two weeks to improve, and if conditions persist, its staff should be required to attend a two-week training session to help them with this issue.
It is also prudent for the hospital to conduct yearly reviews to determine whether it has boosted its patient satisfaction ratings and whether the number of elderly bed falls has reduced.
Potential setbacks
The hospital should be ready for staff shortages before fully implementing the plan across the departments. It should expect these issues because of the number of staff that would be attending vocational training. It should also expect reduced operational revenue as it would use some money to upgrade its systems to promote safety for the elderly (LoBiondo-Wood et al., 2019). Nonetheless, the hospital should begin planning for these issues; an individual would take up more shifts when others are attending training and take time off when they are training to avoid burnout and fatigue.
It is crucial to develop a timetable and alert the staff about the issues it would face for the period it would conduct training. Each department is responsible for training its staff and would take up the budget, roles, and responsibilities for this exercise using its experienced nurses.
The use of the Advancing Research and Clinical practice through close Collaboration (ARCC) model would help the hospital develop accurate measures to define and implement the intervention in every department (LoBiondo-Wood et al., 2019). Close collaboration is essential as the staff would be introducing a relatively new concept in which communication would help each member boost their productivity.
Evaluation Plan
Each month would necessitate departmental formative assessments to gauge staff progress in discerning and promoting the intervention (Ammenwerth & Rigby, 2016). They would be assessed for issues such as average response time to patients after the alarm bed rang and if they had any incident involving erroneous initial patient placement.
The hospital would also conduct yearly summative assessments requiring each department to provide its average performance in the previously mentioned sections (Cannon & Boswell, 2016). They should also illustrate whether failing teams were given additional training to help improve their skills in delivering high-quality services.
Data Collection
Staff should write the time taken to respond to alarm beds daily and the number of individuals they attended. They should consider the number of individuals that evidence falls each day and write it on their clipboard. The individuals must submit a copy of their results to the department head daily and keep another one to measure their progress.
The monthly evaluations should include an overall assessment of the implementation’s success and where staff feels it should be altered for effective performance. The same should be done in the yearly review to determine the implementation’s efficacy.
References
Ammenwerth, E., & Rigby, M. (2016). Evidence-based health informatics promoting safety and efficiency through scientific methods and ethical policy. IOS Press.
Cannon, S., & Boswell, C. (2016). Evidence-based teaching in nursing: A foundation for educators (illustrated). Jones & Bartlett Learning.
LoBiondo-Wood, G., Haber, J., & Titler, M. G. (2019). Evidence-based practice for nursing and Healthcare Quality Improvement. Elsevier.
Veazie, S., Peterson , K., & Bourne, D. (2019). Evidence Brief: Implementation of High Reliability Organization Principles. NCBI.
Zawada Jr., E. T. (2016). Challenges in elder care. BoD – Books on Demand.