Obtaining The Requisite Approvals AND Support Essays Example

Implementation Process

The approval of a capstone project is often a requirement. In order to get the requisite approval and support for the proposal, I will first pitch the idea in a concept paper. This is in order to prove t the stakeholders and the audience that that the idea upon which the capstone project is based is researchable, worthwhile and has the potential to either improve service delivery within health care or improve the patient outcomes. The concept paper will feature the prospective topic for the capstone project, the rationale for the choice of the topic and the significance of the topic to patient care and the nursing process. Before the concept paper is presented to the institutional review board, I will review it with the capstone mentor. The intention is to improve it so that its scope is relevant to the level of study, and that the topic upon which the capstone project is based is not too broadly defined.

Description of the Current Issue

Falls occurring to inpatients in hospital are common. Falls and injuries that are related to inpatient falls are very common and pose problems, especially for the elderly patients. Patients aged sixty-five years and above had the highest risk of falls while they were hospitalized. In general, the falls range between 2.3 and 7 falls for every 1000 patient days (Hitcho et al., 2004) 30% of the inpatient falls lead to injuries. Of these injuries, 4% to 6% lead to serious injuries, some of which include subdural hematomas, fractures, excessive bleeding, and at times death. Studies have revealed that the mean age of the patients who commonly fall while in hospitalization are 63.4 years. A study by Hitcho et al., (2004) found that 79% of the falls were unassisted. The same study also found that 85% of the falls occurred while the patient was in his room.

Proposed Solution

The proposed solution to address the issue is hourly rounding of nurses. This ensures that the patients are monitored by the hour. By doing the hourly rounds, the nurses will be able to not only monitor the needs of the patients, especially the needs that require the movement of the patients. When such needs are identified, the nurses can then tend to them, thereby limiting unnecessary movements by the elderly patients, movements that might result in the falls.

Rationale for Proposed Solution

Hourly rounding by the nurses is one of the most effective prevention strategies that can used to minimize the falls incidences in the hospital settings. Basically, rounding is an effective and proactive approach that involves effectual coordination of nursing care aimed at minimizing falls. While doing hourly rounding, the nurse usually checks on the needs of the patients such as position, potty, pain as well as the proximity of the patient’s personal items (Ford, 2010). This enables the nurses to identify the needs of the patients and institute the appropriate interventions to ensure that the needs are adequately met (Olrich, Kalman & Nigolian, 2012). Additionally, this reduces the patient needs to move without the support of a care provider thereby minimizing the chances of falling. Thus, it is important for the nurses to effectively understand the impact of hourly rounding in preventing falls and embrace the hourly rounds to minimize the falls that occur in the clinical settings and improve the safety as well as the outcomes of the patients (Mant, Dunning & Hutchinson, 2012).

Review of Literature in Support of Proposed Solution

The article by Brosey and March, (2014) describes the effectiveness of a hourly rounding program launched in a medical-surgical unit in a community hospital to reduce the level of patient falls as well as improving the outcomes and the satisfaction of the patients. The study was implemented for three months. They were 70% nurses were compliance doing hourly rounding. The fall rate reduced by 11 incidence from pre to post implementation period and saved about $46, 563 by reducing fall rate. This evidence-based study indicates that by hourly rounding helps to cost avoidance by reducing falls and related injuries (Brosey & March, 2014)

Implementation Logistics

If this proposed solution is accepted as the most appropriate solution to the issue described, its implementation will require the input of a number of personnel. For instance, the initiation of the change into the hourly rounding will be done by the nurse administrator of the organization. Her authority is required in approving the change and issuing memorandums. The responsibility of educating the staff in the modalities of the changes will be done by registered nurses with the permission of the nurse administrator. The nurse administrator will also appoint the registered nurse in charge of overseeing the process through which the proposed changes will be implemented.

Requisite Resources for Implementation

A significant part of the implementation process is the education of the staff. The resources that are required to enable the education of the changes envisioned in the proposed solution include PowerPoint presentations detailing the modalities of the changes and handouts with information on the evidence upon which the proposed changed are based and clinical trials and evidence-based research supporting the proposed changes. Assessment tools such as pre and post-tests, surveys and questionnaires are required to assess the knowledge of the staff regarding the proposed changes and their attitude. Funding is also required to facilitate the education of the staff, assessment of attitudes and knowledge and funding the other elements of the implementation process.

References

Brosey, L., & March, K. (2014). Effectiveness of structured hourly nurse rounding on patient satisfaction and clinical outcomes. Journal Nurse care, 30(2), 153-159.
Ford B. (2010). Hourly rounding: a strategy to improve patient satisfaction scores. Medical Surgical Nursing. 19(3): 188-91.
Hitcho, E., Krauss, M., Birge, S., Dunagan, W., Fischer, I., Johnson, S., Nast, P., Costantinou, E. and Fraser, V. (2004). Characteristics and Circumstances of Falls in a Hospital Setting: A Prospective Analysis, Journal of General Internal Medicine, 17 (7): 732-739.
Mant, T., Dunning, T. and Hutchinson, A. (2012). The clinical effectiveness of hourly rounding on fall-related incidents involving adult patients in an acute care setting: a systematic review. JBI Library of Systematic Reviews, 10 (56)
Olrich, T., Kalman, M., and Nigolian, C. (2012). Hourly Rounding: A Replication Study. Medical Surgical Nursing. 21(1): 23-36.