Following increased falls in the medical-surgical unit, the hospital administration deemed it fit to initiate a committee to help solve the problem. Notably, staff has started blaming one another as well as patients due to the increased falls. The increase in falls has been notable in the last four months. Reports indicate that the falls have gone up by 150% within the same period. In that sense, an action is needed immediately. As the committee leader, I and my team are responsible for maintaining a safe unit, and addressing any safety issue notable by my team members. The following is a plan on how I am going to address the issues that have led to increased falls within the surgical unit.
Compliance
Notably, all nurses within the unit will be required to report all falls. By so doing, I will remind the nurses that they will help to identify the predictors of injurious falls in the unit. During the meetings, I will emphasize that, by documenting all the falls, the approach will help to identify the significant risk factors likely to lead to a serious-fall injury (Allbee et al. 2012). This approach will be vital in identifying the environmental circumstances leading to each fall, which will be done by assessing the patients environment, and interviewing the affected patient. The information will be vital in developing significant relation between the patient and the type of injury suffered.
Delegate your assignment to our experts and they will do the rest.
The Attitude of Blaming Others and Teamwork
The unhappy members in the team will have to be reminded that their cardinal role as nurses is ensuring patient safety (Perry, 2019). Nurses are expected to carry out numerous activities among them preventing injuries and participating in advocacy for care of patients. Expectedly, nurses should demonstrate positive attitude towards their patients and care. Bad attitude has a negative effect on the quality of care and outcome (Perry, 2019). In that regard, as members of the committee, they need to have the right attitude, in a bid to get down to the bottom of the issue at hand. Nurses should always have time for their patient, and encourage them to assist patients, even when they are not cooperative.
The ultimate goal of the committee is to ensure safety within the surgical unit. As the nurse leader, I will address this issue by reminding my team that, patient safety is the fundamental goal of healthcare. As team we should strive to prevent errors and instead of blaming each other, we should strive to offer assistance by trying to figure out the cause of the error and the best approach to avoid it in the future (Allen, 2015). By so doing, we will all learn together. I will encourage the nurses to offer help and support to each other and to the patients too because the common goal is health and wellness for all. All nurses will be reminded that patients are not to be blamed (Perry, 2019). Sections of patients might be suffering from functional decline, and may end up with de-conditioning, which often leads to inactivity. The condition is a big risk for the hospitalized patients who normally spend prolonged time in bed, even when they are in a position to work.
Fall Prevention Practices: Fall Assessment Tool and Scheduled Rounding
Factually, all nurses within the facility are using the fall assessment tool to identify the fall risk. However, conducting an assessment without making a follow up does not help to achieve the desired goal of realizing patient safety (Phelan et al. 2015). In that regard, a follow-up is a mandatory as it will help in identifying the risk factors leading to falling and devise a way of mitigating them. According to Cochrane Systematic Review of 2012, fall assessment followed up by individualized treatment of the risk factors identified help to reduce the rate of falls by 24% (Phelan et al. 2015). In fact, a follow up serves as a quality indicator of fall prevent and management.
Report indicates that, some of the identified contributing factors include the fall assessment tool and the scheduled rounding. Notably, all nurses will be required to carry out hourly rounds on all the patients to determine the need for toilet, status of pain, assistance to relocate the personal items within reach and provide pain relief intervention (Allen, 2015). All nurses will be provided with surveillance mechanism to ensure all patients are safe and comfortable by meeting their needs proactively. While at it, the volume of admissions and discharges often prevent nurses to conduct rounds in an efficient manner. Notably, research indicates that, heavy workload among nurses has a direct negative impact on patient safety. The workload leads to burnout and dissatisfaction (Sir et al 2015). This probably explains why the nurses keep on blaming each other. To end this problem, nurse-patient ratio will have to be revised. The number of nurses will be increased in order to ensure each nurse handles appropriate number of patients (Allbee et al. 2012). By assigning nurses a reasonable number of patients to look after, the blame games will end, and the falls will adequately reduce. At the same time, increased patient satisfaction will be recorded. Research indicates that staffing levels among nurses has significant impact on nursing-sensitive patient outcomes (Allbee et al. 2012). With an appropriate workload, nurses will be expected to increase attention on patients and a direct positive impact on patient safety will be evident.
References
Allbee, B. H. et al. (2012). Avoiding Common Nursing Errors. Lippincott Williams & Wilkins
Allen, S. (2015). The Nurse-Patient Assignment: Purposes and Decision Factors. The Nurse- Patient Assignment: Purposes and Decision Factors. The Journal of nursing administration , 45(12):628-635. DOI: 10.1097/NNA.0000000000000276
Perry, A. P. (2019). Nursing Interventions & Clinical Skills E-Book. 7 th ed. Elsevier Health Sciences
Phelan, E. A., Mahoney, J. E., Voit, J. C., & Stevens, J. A. (2015). Assessment and management of fall risk in primary care settings. The Medical clinics of North America , 99(2), 281– 293. https://doi.org/10.1016/j.mcna.2014.11.004
Sir, M. Y. et al (2015). Nurse–patient assignment models considering patient acuity metrics and nurses’ perceived workload. Journal of Biomedical Informatics. Volume 55, Pages 237- 248
