Quality Improvement Storyboard.
Quality Improvement Storyboard.
Quality improvement plan for fall management in the emergency room is one of the most important initiatives in hospitals and healthcare organizations. There are almost 1.6 billion nursing residents in USA healthcare, and half of them fall in the hospital and especially in the emergency rooms annually. The nurses are the cooperative and essential staff without which the things and operations cannot be the same, so it is necessary to guide them for their care, patient care and avoid falls. The quality management program will help provide the guidelines to nurses to prevent falls in emergency rooms.
The first parameter that needs to be developed in a quality management program is the culture of safety. The term is used when there is a safe culture and when the nurses are free to discuss their queries, and there are several other factors included in this term. Communication is the key to success, and it guarantees that the organization is moving in the right direction. Communication should be implemented in the hospitals. For example, if the nurses are given a chance to communicate with the management after regular intervals, they may report the falls, and the actions can be done accordingly (Singh, 2018).
The next factor is the change in staff beliefs and attitudes. In other words, it is said that the nurses are given specific training because, without training, they cannot be good enough. They should be told that everything should be managed in proper time and if they try to be in a hurry, falls occur. To avoid the situations, it is necessary for them to be on time and to be punctual. If everything goes according to the schedule, things will be appropriate, and the falls will be reduced (Dedhia, 2009).
The next important thing is communication with the patients. The nurses do the duty while talking to the patients, and sometimes they are frustrated enough that they do not care about the falls and it occurs. The patients usually do not respond to them as they want, and sometimes they do not understand the nurses. So, the quality improvement plans ensure that the nurses do a thing or a task properly before starting the next. If they listen to the patient, they should do it calmly before getting busy with other activities (Nebreda, 2018).
Strong and effective leadership is also included in the quality improvement plan because the senior managers have an eye on everyone. The nurses do not come late, and they remain busy in their tasks because they know if they are late, the different consequences can occur as they will need to answer to the leadership. Effective leadership is necessary because it is seen that the nurses often do the different activities in negligence, and sometimes they are busy talking with other friends and colleagues. Hence, the situation occurs, and falls are often seen in hospitals (Enns, 2014).
In the end, there should be different sign boards, and if there are slippery floors, it should be mentioned. The nurses are not the ones who fall, but some patients fall as well. Their family members are also in a hurry, and they are tense so they can feel. All these things should be considered, and the signboards should be available to the nurses, and they should be guided to read them and follow them. The patients should also be guided according to the signboards. The demonstration of hospitals and their rooms should be done in LEDs of big size.
There are different resources needed to change hospital management and culture and implement the quality improvement plan. First, the floor tiles should be changed. If the hospital management is reported to frequent falls and there are no reduction incidents reported, the management should arrange the new tiles. It is seen that the hospital floors have different instruments and machines that are pulled and pushed throughout the day, and there are thousands of people on them, so they lose the friction and become slippery. The new floor tiles can help in the reduction of incidents (Berian, 2018).
The next important thing is fall risks bands that should be stocked in the hospitals, which are high cost. The hospital should arrange them for the nurses because they have to walk throughout the day. They can use the fall risk band whenever they have to go to an area that is risky for falls. For example, the nurses and other staff have to take the patients upstairs or to the emergency rooms to use these bands at these times. They should be stocked and can be used in time of need.
The bed alarms should be used so the nurses can go only to the bed that needs assistance. Sometimes, the patients and families call in a hurry even when nothing is serious, becoming worried. As a result, the nurses also become worried, and they rush towards the emergency rooms. If the alarms are installed, the families will ring the alarm, and nurses will reach the bed calmly. They are of minimum cost and they can be easily used for the patients. At least, they should be present in the emergency room of the hospital (Engelhardt, 2018).
Another resource to be used in the quality improvement plan is the demonstration of posters and signboards. LED is also one of the resources to be used. They all are costly options so that the hospital can choose one according to the budget allotted for the purpose. The signboards can be more effective because they guide the nurses and patients to where they have to go. There is already a trend of charts in the hospitals, so some charts for fall management should also be made and pasted in the different areas of hospitals (Hempel, 2019).
Concluding the discussion, it is seen that the quality improvement plan and the different resources are necessary for the change. If positive change is not brought, the incidents of falls will be increased, and the safety of nurses will be at stake. There are different stakeholders of the hospital, and they all should be involved in it. They all should communicate about the issue and should try to find out the solution. Otherwise, the things may go harmful, and the people will keep on falling. It should be controlled, and resources should be used to avoid falls.
References
Alvarez-Nebreda, M. L., Bentov, N., Urman, R. D., Setia, S., Huang, J. C. S., Pfeifer, K., … & Javedan, H. (2018). Recommendations for preoperative management of frailty from the Society for Perioperative Assessment and Quality Improvement (SPAQI). Perioperative Care and Operating Room Management, 10, 1-9.
Brian, J. R., Zhou, L., Russell, M. M., Hornor, M. A., Cohen, M. E., Finlayson, E., … & Robinson, T. N. (2018). Postoperative delirium as a target for surgical quality improvement. Annals of Surgery, 268(1), 93-99.
Dedhia, P., Kravet, S., Bulger, J., Hinson, T., Sridharan, A., Kolodner, K., … & Howell, E. (2009). A quality improvement intervention to facilitate the transition of older adults from three hospitals back to their homes. Journal of the American Geriatrics Society, 57(9), 1540-1546.
Engelhardt, K. E., Reuter, Q., Liu, J., Bean, J. F., Barnum, J., Shapiro, M. B., … & Posluszny Jr, J. A. (2018). Frailty screening and a frailty pathway decrease length of stay, loss of independence, and 30-day readmission rates in frail geriatric trauma and emergency general surgery patients. Journal of Trauma and Acute Care Surgery, 85(1), 167-173. Quality Improvement Storyboard.
Enns, E., Rhemtulla, R., Ewa, V., Fruetel, K., & Holroyd‐Leduc, J. M. (2014). A controlled quality improvement trial to reduce the use of physical restraints in older hospitalized adults. Journal of the American Geriatrics Society, 62(3), 541-545.
Hempel, S., O’Hanlon, C., Lim, Y. W., Danz, M., Larkin, J., & Rubenstein, L. (2019). Spread tools: a systematic review of components, uptake, and effectiveness of quality improvement toolkits. Implementation Science, 14(1), 1-46.
Singh, I., & Aithal, S. (2018). Selecting best-suited “patient-related outcomes” in older people admitted to an acute geriatric or emergency frailty unit and applying quality improvement research to improve patient care: patient-related outcome measures, 9, 309. Quality Improvement Storyboard.