NR 631 Week 7 Assignment; Final CGE PowerPoint Presentation

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Daniel Wiffen

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Nursing

Course

NR 631 Nurse Executive Concluding Graduate Experience I

Institute

Chamberlain

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20

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Title of Project Chamberlain Scottsdale Hospital ED Quality Improvement Project Student Name Chamberlain College of Nursing NR631 – Nurse Executive Concluding Graduate Experience I Dr. Dawn Julian February 16th ▶ The project change initiative takes place at Chamberlain Hospital in Scottsdale, AZ. ▶ The hospital’s ED had experienced operational issues. ▶ These negatively affected care provision and patient outcomes Identification of the Problem/Concern ▶ There was low patient admission rates. ▶ This lapse in care delivery led to increased patient falls ▶ It also increased the costs of care and reduced the revenues ▶ The hospital’s throughput was significantly affected leading to a near level closure. Identification of the Problem/Concern ▶ To remedy the situation, a QI change initiative was eminent. ▶ Since closing it would greatly affect the health of the community. ▶ For they depended on Chamberlain for most of their healthcare needs. Identification of the Problem/Concern ▶ Available evidence supports increasing nurses as a solution to patient falls. ▶ Patient falls is an increasing healthcare burden increasing costs to about $31billion each year. ▶ Hospital falls for inpatients are in the range of 13% and 23% prolonging their time in hospital. ▶ According to the CDC, an older patient dies from a fall every 20minutes in the U.S Summary of Relevant Literature ▶ 23% and 42% of these falls are injurious ▶ The geriatric population is at increased risk with 5% to 10% of these falls leading to major injuries. ▶ A slight fall reduces their functionality, increases health problems and hospital costs Summary of Relevant Literature Continued ▶ 15 scholarly articles were identified that supported the project’s problem. ▶ They revolved around the causes of patient falls in the ED and effective interventions in reducing these falls. ▶ For instance, half of these article supported increasing staff nurses to enable nurse rounding. ▶ The move would help serve the patients better and identify those at increased risk of falling. Summary of Literature Continued ▶ With enough nurses, patients would be attended to in the right manner and time. ▶ This move would improve the quality of care offered. ▶ The articles supported our study problem of patient falls caused by poor ED operations. ▶ They also supported increasing number of nurses as an effective intervention to reducing patient falls during care. Summary of Literature Continued ▶ Project sponsors were ADTALEM ▶ The project targeted the ED patients and the nearby community. ▶ It would improve the services at the ED ▶ Success of the project involved formulating an implementation strategy. ▶ This is explained in the Gantt chart below Project Details The Implementation Strategy The Implementation Strategy Continued Project Measures ▶ ED processes/throughput Measure efficiency by optimizing discharges, streamlining patient movements, smoothening the surgical procedures. ▶ Patient health Outcomes Assessing their satisfaction levels Improved Profits and Revenues To be assessed and analyzed after every six months for five years ▶ Patient falls are an increasingly troubling occurrence in most Emergency Departments. ▶ The Chamberlain hospital in Scottsdale is one of such hospitals with a troubled ED. ▶ It faced increased delays in care leading to increased cases of patient falls. ▶ This situation also affected the general operation of the hospital. ▶ For instance LWBS rate was 4.6% against a national benchmark of 2%. Summary of Project: Resolution of the Problem/Concern ▶ The hospital had lost 2013 patients last year due to poor services ▶ It had encountered an annual loss of $1,345,791.00 in revenues. ▶ The hospital did not benefit from diagnostic tests ▶ Its current inpatient admission rate was 29% which was low ▶ Lost $5,021,130.00 due to lack of admissions ▶ The accumulative loss was $6,366,941.00. Summary of Project: Resolution of the Problem/Concern continued ▶ A quality initiative project was initiated. ▶ A multidisciplinary team helped execute the project. ▶ Member roles and team work helped achieve success. ▶ The strategy included;    Slight renovations of the ED. Increasing the number of staff nurses during busiest hours of the day. Project assessment and evaluation ▶ Results so far were slight improvement in service delivery hence less –patient falls. Summary of Project: Resolution of the Problem/Concern continued ▶ The Lippitt’s change theory informed our change process. ▶ We applied transformational leadership style. ▶ No barriers were encountered: the PM and team were well prepared to counter any such barriers. ▶ No ethical issues were violated Summary of Project: Resolution of the Problem/Concern continued ▶ The project supports proper nurse staffing to improve ED processes and patient healthcare. ▶ With enough nurses, rounding can be effective. ▶ Through nurse rounding, patient falls can be minimized. ▶ This project can help hospitals achieve;       Improved ED processes Increased customer base Increased patient outcomes Increased patient satisfaction levels Increased profits and revenues. Minimized additional costs to care. Next Steps ▶ Dissemination of results to colleagues (Frontline staff) will be through;    Internal meetings Social media platforms such as emails, WhatsApp among others Poster presentations ▶ Dissemination to other researchers and healthcare professionals will be through quality improvement conferences such as;   The American Journal of Nursing The journal of Aging Research ▶ A proposal inform of an abstract will be submitted. Dissemination plan ▶ outcomes. Journal of Nursing Care Quality, 30(2), 153-159. doi: 10.1097/NCQ.000000000000086 ▶ de Jong, L. D., Kitchen, S., Foo, Z., & Hill, A. M. (2018). Exploring falls prevention capabilities, barriers and training needs among patient sitters in a hospital setting: A pilot survey. Geriatric Nursing, 39(3), 263-270. doi: 10.1016/j.gerinurse.2017.09.006 ▶ Fabry, D. (2015). Hourly rounding: Perspectives and perceptions of the frontline nursing staff. Journal of Nursing Management, 23(2), 200-210. doi: 10.1111/jonm.12114 ▶ Hicks, D. (2015). Can rounding reduce patient falls in acute care? An integrative literature review. Medsurg Nursing, 24(1), 51-55. ▶ 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 References Brosey, L. A., & March, K. S. (2015). Effectiveness of structured hourly rounding on patient satisfaction and clinical ▶ The Gerontologist, 58(2), 331-340. doi: 10.1093/geront/gnw156 ▶ McCarty, C. A., Woehrle, T. A., Waring, S. C., Taran, A. M., & Kitch, L. A. (2018). Implementation of the MEDFRAT to promote quality care and decrease falls in community hospital emergency rooms. Journal of Emergency Nursing, 44(3), 280-284. doi: 10.1016/j.jen.2017.10.007 ▶ McErlean, D. R., & Hughes, J. A. (2016). Who falls in an adult emergency department and why - A retrospective review. Quality Project Report, 20(1), 12-16. doi: 10.1016/j.aenj.2016.11.001 ▶ Morris, R. (2017). Prevention of falls in hospital. Clinical Medicine, 17(4): 360–362. doi: 10.7861/clinmedicine.17-4-360. ▶ Ozturk, T. C., Ak, R., Akoglu, E. U., Onur, O., Eroglu, S., & Saritemur, M. (2017). Factors associated with multiple falls among elderly patients admitted to emergency department. International Journal of Gerontology, 11(2), 85-89. doi: 10.1016/j.ijge.2016.05.009 ▶Pellerin, R., & Perrier, N. (2018). A review of methods, techniques and tools for project planning and control. International Journal of Production Research, https://doi.org/10.1080/00207543.2018.1524168. References King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. ▶ intervention: Falls risk factor assessment and management, patient engagement, and nurse co-management. Journal of the American Geriatrics Society, 65(12), 2733-2739. doi: 10.1111/jgs.15121 ▶ Sanyi, C. (2018). Hourly rounding and fall prevention: A change process. Capella University. doi: handle.net/10755/624134 ▶ Shankar, K. N., Lui, S. W., & Ganz, D. A. (2017). Trends and characteristics of emergency department visits for fall-related injuries in older adults, 2003–2010. Western Journal of Emergency Medicine, 18(5), 785–793. doi: 10.5811/westjem.2017.5.33615 ▶ Simamora, R. H., Nurmaini, & Siregar, C. T. (2019). Knowledge of nurses about prevention of patient fall risk in inpatient room of private hospital in Medan. Indian Journal of Public Health Research & Development, 10(10), 759-763. doi: 10.37506/ijphrd.v10i10.5427 ▶ Toye, C., Slatyer, S., Kitchen , S., Ingram, K., Bronson, M., Edwards, D. . . Hill, K. D. (2019). Bed moves, ward environment, staff perspectives and falls for older people with high falls risk in an acute hospital: A mixed methods study. Clinical Interventions in Aging, 14, 2223–2237. doi: 10.2147/CIA.S211424 ▶ University of West Florida. (2020). Literature Review: Conducting & Writing. Retrieved from: https://libguides.uwf.edu/c.php?g=215199&p=1420563 References Reuben, D. B., Gazarian, P. K., Alexander, N., Araujo, K. L., Baker, D., Bean, J. F. . . McMahon, S. (2017). The STRIDE

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