Evidence based practice review assignment

CPT (R) Gwendolyn Godlock, MS-PSL, BSN, RN, AN, CPHQ, is Field Representative Nurse Surveyor, The Joint Commission, Oakbrook, Terrace, IL. CPT Mollie Christiansen, BSN, RN, AN, CMSRN, is Clinical Nurse Officer in Charge, Burn Progressive Care Unit, United States Army Institute of Surgical Research, Joint Base San Antonio Fort Sam Houston, TX. COL Laura Feider, PhD, RN, is Dean, School of Nursing Science and Chief, Department of Nursing Science, Army Medical Department Center and School, Health Readiness Center of Excellence, Joint Base San Antonio Fort Sam Houston, TX. Acknowledgments: The team would like to thank nursing leaders COL (R) Sheri Howell, for- mer Deputy Commander of Nursing and Chief of Staff; and COL Richard Evans, Assistant Deputy Chief Army Nurse Corps, for their support. A special acknowledgment for the former Chief, Medical Nursing Section, COL Vivian Harris, who remained a staunch supporter, advo- cate, and cheerleader, the Medical Section nursing staff, and the Center for Nursing Science and Clinical Inquiry. Note: The view(s) expressed herein are those of the authors and do not reflect the official policy or position of Brooke Army Medical Center, the U.S. Army Medical Department, the U.S. Army Office of the Surgeon General, the Department of the Army, Department of Defense, or the U.S. Government.

ORDER EBP ASSIGNMENT PAPER NOW

Implementation of an Evidence-Based Patient Safety Team to Prevent Falls in Inpatient Medical Units

The Centers for Medicare &Medicaid Services identifiedfalls as a preventable health care acquired condition (DuPree, Fritz-Campiz, & Musheno, 2014). A large portion of the medical-surgical inpatient population is aging, and therefore at high risk for falls (Boltz, Capezuti, Wagner, Rosen berg, & Secic, 2013). Falls have physical and emotional implications for patients, as well as increased financial costs for facilities. Nationally, medical units have the highest rates of falls (Bouldin et al., 2013). Most notably, falls can cause significant injuries resulting in increased length of stay, unexpected surgeries, and even death (Williams, Szekendi, & Thomas, 2014). Historically medical-surgical nurses care for a mix of complex patients with an array of comorbidi- ties and patient needs (Carter & Burnette, 2011).

Literature Review The literature search was limited

to keyword searches on falls, team- work, patient safety, nursing, hourly rounding, and communication. Data – bases included PubMed, EBSCO, Agency for Healthcare Research and Quality, CINAHL, and The Joint Commission for years 2008-2014. Use of fall prevention teams was an emerging evidence-based practice (EBP) intervention to decrease the incidence of inpatient falls (Graham, 2012). Consistently, the evidence demonstrated ineffective communication, situation awareness, teamwork, assessment, hourly rounding, and environmental challenges as key factors related to preventable inpatient falls.

Collectively, researchers have shown improving teamwork through successful integration of standard EBP tools proved most efficient in reducing preventable inpatient falls. Successful falls prevention strategies included staff education about the fall-injury risk assessment tool, post- fall assessments, alarm device usage, side effects of medications, hourly rounding, and offering toileting frequently (Tzeng & Yin, 2012). Re – search also suggested hourly rounding positively impacts patient fall rates, call bell usage, and patient satisfaction (Olrich, Kalman, & Nigolian, 2012).

The focus of the literature review was to identify strategies for improving collaborative care, with emphasis on teamwork at the microsystem level. Engaging clinical nurses is key in the creation of an effective falls prevention team. Teams include champions on each nursing unit. Unit champions are responsible for educating staff on all incident trends and the latest preventions strategies (Graham, 2012).

This project examined the use of Continuous Quality Improvement

Continuous Quality Improvement

Gwendolyn Godlock Mollie Christiansen

Laura Feider

Falls are a patient safety priority among hospital inpatients. The creation of a Patient Safety Team engaged frontline staff in patient safety and falls prevention. This intervention decreased the fall rate from 1.90 to 0.69 falls per 1,000 occupied bed days.

January-February 2016 • Vol. 25/No. 118

EBP TeamSTEPPS® to enhance com- munication and teamwork. Prior to this EBP project, clinical nursing staff were not aware of environmen- tal risk factors contributing to inpa- tient falls. Patient education regard- ing fall risks varied across the depart- ment and preventive strategies were not standardized. EBP TeamSTEPPS provided clinical nursing staff with a simple, yet structured approach to identify fall risk factors and apply patient-specific interventions. Most notably, this project emphasized shared accountability and adher- ence to a standardized process. This was a departmental approach be – cause inpatient falls were considered the nurse executive’s patient safety priority.

Evidence based practice review assignment