... Date: _3/25/12_____ Topic: Hourly Nursing Rounds to Improve HCAHPS Scores * Clearly state the proposed project (what do you plan to do): Implement hourly nursing rounds on the Progressive Care Unit at SPGH to improve patient satisfaction. Hourly nursing rounds have been shown in evidenced based practices to not only improve patient satisfaction but also help to reduce patient falls and reduce the occurrence of decubitus ulcers. Not only does hourly nursing rounds help the before mentioned items it also serves to reduce the call light usage by patients thereby increasing productivity for nurses (Culley, 2008). The proposed project includes education of the nursing staff on PCU to the initiation of hourly nursing rounds, including evidenced based research showing how regular rounds helps to improve patient satisfaction and safety. Described potential or real barriers and solutions (financial, political, social, etc) and methods that will or could be used to address these barriers: Some potential barriers could be reluctance by the nursing staff to participate in the hourly nursing rounds due to the feeling that they do not have enough time to complete these hourly rounds. By providing the unit with appropriate staff and helping to reduce or eliminate their fears by providing them with the research gathered can hopefully achieve this goal. Also by showing them that call light frequency will be lower when hourly rounds are completed they may be less reluctant...
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...Running Head: Hourly Rounds and Patient Falls 1 Keeping patients safe while they are in the hospital is a priority to all members of the healthcare team. Patient falls contribute to a greater length of stay for the patient and contribute to increased injuries and longer periods of time before they can regain independence. It can also result in them being out of work longer than anticipated. "The average hospital stays for patients who fall is 12.3 days longer, and injuries from falls lead to a 61 percent increase in patient care costs" (American Nurse Today, March, 2011) Nationally, hospitals are now being threatened with the possibility of not being reimbursed for injuries resulting from falls. Two nursing students at the Massachusetts College of Pharmacy and Health Sciences researched the need for hourly rounding to prevent patient falls and injury. While the reason for falls may vary, one way proposed to reduce patient falls was hourly nursing rounds on the patients. Armed with The Joint Commissions' National Safety Goals and the nurse's concern over the safety of their patients, a decision was made that hourly rounding should be implemented and that this would decrease the number of falls. Specific questions identified were: Is there a difference between every...
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...A Critique of the Literature Effects of Nursing Rounds: on patients’ Call Light Use, Satisfaction and Safety. Introduction: The findings of this article will critically review the methods of research, population, systems and data used to obtain results regarding this study. This evaluation of the outcome would determine whether or not there was a need to change the nursing management of patient care. The study would determine if patients were happy with their care and if the rate of falls were minimised. In the health care setting, the call light is an important communication tool for the nursing staff and patients especially in an emergency situation. Title: The title clearly summarises the content of this Journal article which suggests there was either a qualitative or quantitative designed research data used to conclude the findings. There was limited context which was not clearly defined (Meade et al.2006, p 58). Abstract: This is succinct, meaning the writer has been brief and precise with the back ground information about the research article. This...
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...percentages of patients admitted, reported falling of at least once during an inpatient hospital stay period” (Oliver, Healey, & Haines, 2010). The author works at a city hospital located in Gilbert, Arizona and encounters a great amount of orthopedic patients along with other general surgery patients. All patients that are on that floor are at a risk of falls during the first 48 hours after surgery due to anesthesia that is still in the system and pain medication that is scheduled to help ease the patient during the post-surgical time frame. One of the side effects of anesthesia exiting the body is nausea and vomiting which can make the patient feel dizzy and lightheaded, thus making them a great risk for falls. This has been the reason that the topic was chosen; to attempt to improve this issue in the hospital setting and to provide a system in which all hospital staff collaborate to help increase the quality of patient care. The location that is being observed is the post-surgical/orthopedic floor where the author is currently working. A description of risks and concerns are provided and patient outcomes depend on implementing the proposed interventions. The two solutions that are presented are hourly rounding and the importance of an improved nurse call light button and education on proper usage. Each intervention is supported by evidence-based practice peer-reviewed journal articles. The proposal will show the improvements of patient safety and increased patient compliance to...
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...the patient process of essential care for the elderly. It summarizes the IHI map and then discusses the specific goals of The Joint Commission (TJC) and how they relate to the IHI map. The paper then continues on to discuss how the standards of TJC are put into effect at McKenzie Willamette hospital to provide the essential care for the older patient. Essential Care of Frail Older Adults Overview On the improvement map from the Institute for Healthcare Improvement’s (IHI) website, the patient process “Essential Care for Frail Older Adults” is outlined. IHI states that the purpose of this process is to “Ensure coordinated, reliable, and safe care for frail older patients as they enter the hospital.” As the title of the map indicates this patient process is related to the care of our older adult patients. The IHI website indicates that it would be moderately challenging to implement this patient process for the following reason “Either it involves multiple units or disciplines OR requires a substantial shift in culture an/or operations, but not both of these.” This patient process will need to be implemented in any medical facility that may treat the frail older adult including medical, surgical and emergency departments of hospitals along with nursing homes and intensive care units and also in the transfer of care between the above-mentioned agencies. This patient process aims towards delivering safe, fair, and evidence –based care for our older adult patient population...
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...In this regard, given that the study has no associated risks to the patients, the patients will not be told on any study. The blind study will also ensure that patient bias does not surface, thus, the findings will more likely be what is expected in natural setting once the proposed project is adopted. The nurses and nursing assistants will be expected to make rounds every hour for the assigned primary patients. The round will involve addressing the major issues as identified by the nurse or as communicated by the patient. A few key behaviors and tasks that should be used when conducting rounds is to introduce self, address the 3 P’s which is positioning, pain and potty, address additional needs such as giving the patient water, conduct environmental assessments and use closing key words or actions such as “Is there anything else I can do before I leave your room? I have the time”. After every round, the nurse will be expected to inform the patient the time for the next round and ensure that the patient is left comfortable. The nurses and nursing assistants will be required to mark charts on the number of rounds made for every patient during their routine even when the patient is sleeping, the challenges face or associated with the hourly rounding, the number of call bells made by each patient under their care, and record comments from patient’s feedback. These data will be used in analyzing the feasibility, challenges...
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...There is always opportunity for improvement of patient services within a health care setting. Total quality management (TQM) and continuous quality management (CQI) are processes used to improve services offered to consumers by placing the consumer first (Hood, 2014). The success of this approach relies on the premise that if staff involved in service delivery are empowered and educated on the process of incremental change, the quality and efficiency of patient care will improve (Hood, 2014). The TQM/CQI process is comprised of eight steps which include: identify a work process to be improved, organized a TQM/CQI team, clarify the current work process, identify and understand all variation sources, implement the improvement, check and compare...
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...Patient safety and improved patient outcomes is a leading factor into the implementation of fall prevention strategies. Therefore, to more effectively measure and implement fall and injury prevention programs, a proposed module is suggested. This module shows that high reliability organization key elements and incorporating a culture of patient safety by looking closer at each level and including nurses, should be included when evaluating effective prevention strategies. This article helps to effectively measure changes to improve patient safety related to falls. A project was developed to improve patient safety and reduce falls in an inpatient setting. The project takes place at a highly recognized hospital with many fall prevention...
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...older) falls and about 30% of those falls require medical treatment. Falls are not only the leading cause of fatal and nonfatal injuries but also the most common cause of hospital admission for trauma. More than $19 billion annually is spent on treating the elderly for the adverse effects of falls: $12 billion for hospitalization, $4 billion for emergency department visits, and $3 billion for outpatient care. Most of these expenses are paid for by the Center for Medicare and Medicaid Services through Medicare. It is projected that direct treatment costs from elder falls will escalate to $43.8 billion annually by 2020. (www.cdc.gov ). Because unanticipated falls by nature cannot be prevented, the goal is to create an environment that would reduce injury, should a fall occur. Our current...
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...Immobility. Immobility in hospitalized patients is one of the main risk factors contributing to the development of pressure ulcers. Objective: Identify risk factors related to complications secondary to immobility such as pressure ulcers on the integumentary system. Immobility also leads to other adverse effects affecting cardiovascular system, respiratory system, and musculoskeletal system as well. The assessment is performed on admission data, then once a week. The risk assessment scale used was the Risk Assessment Pressure Sore (RAPS) scale, which includes the following variables; general physical condition, activity, mobility, moisture, food intake, fluid intake, sensory perception, friction and shear, and body temperature (Lindgren & Unosson, 2004). Results: 25 % of patients developed pressure ulcers. Non-blanchable erythema was the most common pressure ulcer noted among these patients. The majority of these patients were significantly older, and hospitalized for a longer period of time. In the analysis using variables included in the RAPS scale, immobility emerged as a major risk factor. Conclusion: Immobility is the main cause of pressure ulcer development among adult hospitalized patients. Part II: After reviewing patient’s charts and documentation in 4 west, it is concluded that: 37% charts with mobility documented. 63% charts with no mobility documented. Problem statement: After carefully reviewing patients charts, baseline data was gathered on 4West...
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...Accreditation Audit AFT Task 4 Regulatory Audit Organization Plans Compliance Facility Compliance The following represents the level of compliance in the pain assessment area of patient care that was audited for Nightingale Community Hospital: There were 3 departments audited for Pain Assessment compliance over a 12 month period, NIGHTINGALE COMMUNITY HOSPITAL averaged 86.94% compliance. Audit | Audit Period | Location | Compliance % | Pain Assessment | 12 Months | ED | 70.66% | Pain Assessment | 12 Months | 3E | 93.5% | Pain Assessment | 12 Months | PACU | 96.66% | There were 3 departments audited for Pain Reassessment compliance over a 12 month period, NIGHTINGALE COMMUNITY HOSPITAL averaged 80.415 % compliance. Audit | Audit Period | Location | Compliance % | Pain Reassessment | 12 Months | ED | 54.83% | Pain Reassessment | 12 Months | 3E | 92.916% | Pain Reassessment | 12 Months | PACU | 93.5% | The following are the results of the audit that was completed for use of prohibited abbreviations in an aggregate of ICU, Telemetry, 3E and 4E over a 12 month period: Audit | Audit Period | Abbreviation | Occurrences per 50 opportunities | Prohibited Abbreviations | 12 Months | “cc” | 33.75 | Prohibited Abbreviations | 12 Months | “qd” | 15.916 | Fire Dill History of drills held once per shift per quarter over a 12 month period: Quarter | Shift 1 | Shift 2 | Shift 3 | Compliance Analysis | 1st (Jan-Mar) | √ | √ |...
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...Evaluating Patient Fall in Hospitals 1 Evaluating Patient Falls in Hospitals Michael Carter Southern Illinois University August 12, 2012 Evaluating Patient Falls In Hospitals 2 Abstract Hospitalization represents a vulnerable time for elderly people. The presence of acute illness, an unfamiliar environment, and the frequent addition of new medications predispose an elderly patient to such iatrogenic hazards of hospitalization as falls, pressure ulcers, and delirium.1 A fall is a seminal event in the life of an elderly person. Even a fall without injury can initiate a vicious circle that begins with a fear of falling and is followed by a self-restriction of mobility, which commonly results in a decline in function.4 Functional decline in the elderly has been shown to predict mortality and nursing home placement.5 Inpatient falls are thought to occur via a complex interplay between medications, inherent patient susceptibilities, and hospital environmental hazards Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years. The mortality rate for falls increases dramatically with age in both sexes and in all racial and ethnic groups, with falls accounting for 70 percent of accidental deaths in persons 75 years of age and older. Falls can...
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...nurses, nursing peers, patients, families and other inter-disciplinary healthcare members in a professional manner. Effective healthcare communication is important in care delivery because it enhances higher outcomes, patient safety, patient compliance to treatment, creates trust, utilization of healthcare and, satisfaction. Definition of Health Care communication Health care communication is defined as the process in which an individual is able to collect and process adequate or basic health information needed to make the right health care decisions. Communication is the process of sharing information using a set of common rules (Northouse & Northouse 1998. p.2). Relevance of effective personal health care communication with other health care professionals, clients and patients. Health care communication in intrapersonal context refers to our inner thoughts, beliefs, feelings, and, our self-talk about issues that influence our health directed behaviors (Northouse & Northouse 1998. p.4). Personal communication is vital in health care communication, starting from the first encounter with the patient throughout the care and treatment phase or hospitalization. The conversation with patient and families tells you a lot about the way they feel. As a health care provider, treating patients and families with empathy, listening and respect enhances clinician-patient relationship. The health care provider must communicate with patient and significant others...
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...* Private Practice Lactation Consultant Business Plan * * * * * * * * * * * * * * Executive summary Breastfeeding is not only a lifestyle choice but also an important health care choice. Any amount of time that a mother can do it will help both her and the baby. Many benefits of breast milk are noted for mothers, babies, and others. Breast milk has disease-fighting cells called antibodies that help protect infants from germs, illness, and even SIDS. Infant formula cannot match the perfect chemical composition of human milk, specifically the cells, hormones, and antibodies that fight disease. The private practice of lactation consultants has increased over the last decade. According to the CDC (2006), the rates of breastfeeding have slightly increased. Healthy People objectives for breastfeeding in early postpartum period, at six months, and 12 months are 75%, 50%, and 25%, respectively. Healthy People 2010 objectives for exclusive breastfeeding through three and six months of age are 40% and 17%, respectively. National data on exclusive breastfeeding are available only from respondents interviewed after 2005 and thus are not available for children born prior to 2003. The Private Practice of Lactation Consultants (PPLC) will provide care and assistance to any mother who is breastfeeding regardless of financial ability to pay. The need for lactation consultants outside of the hospital...
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...Models and Frameworks: A care plan for Mrs Ashton. The following essay will outline and describe the assessment, care plans and evaluation for an adult patient using Orem’s model of nursing. The patient’s name has been changed in order to protect her right to confidentiality which is a requirement of the NMC code of conduct (NMC 2008). Mrs Ashton is 71 years old and she was admitted to hospital following an episode of severe shortness of breath. She suffers from Asthma and has a history of recurrent chest infections and bouts of bronchitis, which she takes antibiotics for in the winter. She takes Salbutamol 100mgs three times a day. However, over the last week she has been feeling very tired and reports an inability to sleep because of the tightness in her chest, coughing up sputum and wheezing. She has lost her appetite and is unable to carry out her usual activities because she experiences difficulty breathing. Mrs Ashton lives alone in a first floor flat. Her husband died five years ago, her only son lives a few miles away and he visits once a week with his children. Mrs Ashton’s difficulty breathing was noticeable during the initial assessment as she had to take long pauses while communicating, her respiration rate was rapid and wheezing was audible. The care plan for Mrs Ashton will be informed by Orem’s Self Care Model. This model takes an individual and holistic approach to health care; it is underpinned by three inter connected concepts namely: the theory...
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