PICK ONE OF THIS TOPIC:

1.Blood and Blood Products   

2.Central Venous Access  

3.Pharmacological Pain Management 

4.Total Parenteral Nutrition 

INSTRUCTION

In this paper the student will provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint, the priority concept (topic), and professional practice.

1) Write a 4-6 page paper (not including the title page or reference page) using

APA

format

2) Include the following sections

a. Introduction- 20 points/8%

· Offer a detailed description of the statement of purpose for the paper.

· Identify a priority concept (topic) from the Individual Student ATI Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint:

§ Assurance of a safe and effective care environment

§ Health promotion and maintenance of health

§ Preservation of the patient population’s psychosocial integrity

§ Preservation of the patient population’s physiological integrity

· Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).

b. Importance – 20 points/8%

· Describe the importance of the priority concept (topic) to professional practice

· Describe the health of the patient population.

· Include the potential negative effect to professional practice if the priority concept (topic) is unresolved.

· Include the potential negative effect to the patient population if the priority concept (topic) is unresolved.

c. Healthcare Disparities, Inequalities, and Interventions- 70 points/28%

• Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.

• Identify healthcare resources to support evidence-based professional practice related to the priority concept (topic).

• Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.

• Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.

• Identify three (3) evidence-based practice interventions.

• Prioritize the identified evidence-based practice interventions and provide rationale.

• Discuss two (2) patient education considerations related to the priority concept (topic).

d. Legal & Ethical Considerations and Intervention Challenges- 40 points/16%

• Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.

• Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.

• Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.

• Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.

• Identify one (1) anticipated challenges to the success of resolving the priority concept (topic) in professional practice.

e. Participants and Interdisciplinary Approach – 20 points/8%

• Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.

• Discuss the role of each member in the intervention implementation for the priority concept (topic).

• Identify a minimum of two (2) members of a discipline outside of nursing.

• Discuss the benefit of including the identified interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.

  

f. Quality Improvement– 20 points/8%

• Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.

• Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.

• Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.

• Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.

g. Conclusion – 20 points/8%

• Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.

• Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).

• Include a complete statement describing why addressing the priority concept (topic) matters and to whom.

h. APA Style and Organization– 20 points/8%

• References are submitted with paper.

• Uses current APA format and is free of errors.

• Grammar and mechanics are free of errors.

• At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.

For writing assistance (APA, formatting, or grammar) visit the APA Citation and Writing page in the online Chamberlain library.

NR452 Capstone

Course

RUA- Capstone Evidence-Based Practice Paper Guidelines

Purpose

To analyze own performance on the integrated comprehensive assessments and reflect on areas of opportunity and strategies to promote NCLEX-RN success and transition into practice. The student will apply the priority concept (topic) to evidence-based professional practice upon which nurses have the ability to resolve or have a positive impact. There is a focus on the healthcare disparities of the individual, as well as ethical and legal implications to professional practice. The student will discuss how an interdisciplinary approach promotes quality improvement for the patient and evidence-based professional practice, driving positive outcomes.

Course outcomes: This assignment enables the student to meet the following course outcomes:

CO # 1: Synthesize knowledge from sciences, humanities, and nursing in managing the needs of humans as consumers of healthcare in a patient-centered environment.(PO#1)

CO # 2: Integrate communication and relationship skills in teamwork and collaboration functioning effectively with health team members and consumers of care.(PO#3)

CO # 3: Utilize information technology to manage knowledge, mitigate error, andsupport decision making with health team members and consumers of care. (PO# 8)

CO # 4 Integrate critical thinking, clinical reasoning skills, best current evidence, clinical expertise, and patient/family preferences/values in the implementation of the nursing process. (PO# 4)

CO # 5: Explore the impact of professional standards, legislative issues, ethical principles, and values on professional nursing, using data to monitor outcomes and improve quality and safety. (PO# 5, 6)

Due date: Your faculty member will inform you when this assignment is due. The Late Assignment Policy applies to this assignment.

Total points possible: 250 points

Preparing the assignment

Follow these guidelines when completing this assignment. Speak with your faculty member if you have questions.

1) Track performance on the comprehensive assessments by logging NCLEX-RN Client Need Category performance on the Individual Student ATI Assessment Trends: Longitudinal Performance tool.

2) Based on individual performance on the comprehensive assessments, prioritize the top concept (topic) of greatest opportunity.

3) Include the following criteria for each identified concept (topic): The

NCSBN NCLEX-RN Test Plan

will support this process (detailed criteria listed below and in the Grading Rubric must match exactly).

a. Priority Concept (Topic)- 20 points/8%

· Identify the priority concept (topic) of opportunity.

· Provide a description of how this aligns with the NCLEX-RN Test Plan as indicated by performance in the Individual Student ATI Assessment Trends Table.

· Identify a minimum of two learning strategies that you plan to implement to address your learning need.

· Identify a minimum of two resources that you will integrate into your NCLEX-RN Readiness plan to assist you with improving the identified learning need.

(
NR452_RUA- Capstone Evidence-Based Guidelines
) (
Revised: 03/2021
) (
1
)

(
Learning Resources:
Identify
a
minimum of
two
resources that you will integrate into your NCLEX-RN Readiness plan to assist you with improving the identified learning need.
1)
Adaptive quizzes in ATI and THE COMPREHENSIVE NCLEX-RN REVIEW 19
TH
EDITION
2)

Saunders 2020-2021 Strategies for Test Success: Passing Nursing School and the NCLEX Exam, Edition 6
)

85.7%

80.0%

92.3%

77.8%

Individual Student ATI Assessment Trends: Longitudinal Performance Table
ATI Assessment Title	NCLEX-RN Client Need Categories: Students will log their individual assessment performance in each category below and highlight the scores below 60% or lowest three scores for each assessment
Course	Manage- ment of Care	Safety & Infection Control	Health Promotion & Maintenance	Psychosocial Integrity	Basic Care & Comfort	Pharma- cological & Parental Therapies	Reduction of Risk Potential	Physiological Adaptation
ATI Capstone Comprehensive Assessment B	NR-446	93.3%	88.9%	71.4%		85.7%	45.5%		77.8%		80.0%
ATI Comprehensive Practice- Form A	NR-452	83.3%	64.3%		92.3%	82.6%	66.7%

Based on individual performance on the comprehensive assessments, prioritize the top concept (topic) of greatest opportunity:

1) Pharmacological and Parental Potential

Apply the priority concept (topic) of greatest opportunity below:

(
Learning Strategies:
Identify a
minimum of two
learning strategies that you plan to implement to address your learning need.
1)
I will do NCLEX practice questions to test my knowledge about the content that I have learnt
2) I will make use of medication templates to study my medications, know their contraindications, interaction, complications, administration methods and client education.
) (
Learning Needs:
Pharmacological and Parental Potential:
According to (NCSBN
),
the
nurse provides care related to the administration of medications and parenteral therapies.
Pharmacological and Parental Potential entails:
-Participation in medication reconciliation process
–

Administration of blood products and evaluation of client response
-Central venous access devices
–

Dosage calculations for medication administration
-Pharmacological pain management
-Total parenteral Nutrition
– Evaluation of Intravenous Therapies
–

Identification of contraindication, adverse effect, side effect and interactions to the administration of a medication to the client.
)Identified Priority Concept (Topic):

(
NR452 Capstone Course
Capstone Evidence-Based Practice Paper Guidelines
)

(
NR452_RUA- Capstone Evidence-Based Guidelines
) (
Revised: 03/2021
) (
2
)

In this paper the student will provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint, the priority concept (topic), and professional practice.

1) Write a 4-6 page paper (not including the title page or reference page) using APA format

2) Include the following sections

a. Introduction- 20 points/8%

· Offer a detailed description of the statement of purpose for the paper.

· Identify a priority concept (topic) from the Individual Student ATI Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of the NCLEX-RN examination blueprint:

· Assurance of a safe and effective care environment

· Health promotion and maintenance of health

· Preservation of the patient population’s psychosocial integrity

· Preservation of the patient population’s physiological integrity

· Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).

b. Importance – 20 points/8%

· Describe the importance of the priority concept (topic) to professional practice

· Describe the health of the patient population.

· Include the potential negative effect to professional practice if the priority concept (topic) is unresolved.

· Include the potential negative effect to the patient population if the priority concept (topic) is unresolved.

c. Healthcare Disparities, Inequalities, and Interventions- 70 points/28%

· Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.

· Identify healthcare resources to support evidence-based professional practice related to the priority concept (topic).

· Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.

· Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.

· Identify three (3) evidence-based practice interventions.

· Prioritize the identified evidence-based practice interventions and provide rationale.

· Discuss two (2) patient education considerations related to the priority concept (topic).

d. Legal & Ethical Considerations and Intervention Challenges- 40 points/16%

· Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.

· Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.

· Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.

· Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.

· Identify one (1) anticipated challenges to the success of resolving the priority concept (topic) in professional practice.

e. Participants and Interdisciplinary Approach – 20 points/8%

· Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.

· Discuss the role of each member in the intervention implementation for the priority concept (topic).

· Identify a minimum of two (2) members of a discipline outside of nursing.

· Discuss the benefit of including the identified interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.

f. Quality Improvement– 20 points/8%

· Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.

· Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.

· Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.

· Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.

g. Conclusion – 20 points/8%

· Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.

· Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).

· Include a complete statement describing why addressing the priority concept (topic) matters and to whom.

h. APA Style and Organization– 20 points/8%

· References are submitted with paper.

· Uses current APA format and is free of errors.

· Grammar and mechanics are free of errors.

· At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.

For writing assistance (APA, formatting, or grammar) visit the

APA

Citation and Writing page in the online Chamberlain library.

Please note that your instructor may provide you with additional assessments in any form to determine that you fully understand the concepts learned in the review module.

Grading Rubric

Criteria are met when the student’s application of knowledge within the paper demonstrates achievement of the outcomes for this assignment.

Assignment Section and Required Criteria

(Points possible/% of total points available)

Highest Level of Performance

High Level of Performance

Satisfactory Level of Performance

Unsatisfactory Level of Performance

Section not present in paper

Priority Concept (Topic)
(20 points/8%)

20 points

18 points

16 points

8 points

0 points

Required criteria
1. Identify the concept (topic) of opportunity.
2. Provide a description of how this aligns with the NCLEX-RN Test Plan as indicated by performance in the Individual Student ATI Assessment Trends Table.
3. Identify a minimum of two learning strategies that you plan to implement to address your learning need.
4. Identify a minimum of two resources that you will integrate into your NCLEX-RN Readiness plan to assist you with improving the identified learning need.

Includes all 4 requirements for section.

Includes all 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no less than 1 requirement for section.

No requirements for this section presented.

Introduction
(20 points/8%)

20 points

16 points

8 points

0 points

Required criteria
1. Offer a detailed description of the statement of purpose for thepaper.
2. Identify a priority concept (topic) from the
Individual Student ATI Assessment Trends: Longitudinal Performance Table drawn from one (1) of the four (4) main categories of theNCLEX-RN examination blueprint:
a. Assurance of a safe and effective care environment
b. Health promotion and maintenance of health
c. Preservation of the patient population’s psychosocial integrity
d. Preservation of the patient population’s physiological integrity

Includes all 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

(
NR452 Capstone Course Capstone Evidence-Based Paper

Guidelines
)

(
NR452_RUA- Capstone Evidence-Based Guidelines
) (
Revised: 03/2021
) (
5
)

Assignment Section and Required Criteria

(Points possible/% of total points available)

Highest Level of Performance

High Level of Performance

Satisfactory Level of Performance

Unsatisfactory Level of Performance

Section not present in paper

3. Provide a detailed description of the relationship between the category from the NCLEX-RN examination blueprint and the priority concept (topic).

Importance
(20 points/8%)

20 points

18 points

16 points

8 points

0 points

Required criteria
1. Describe the importance of the priority concept (topic) to professional practice
2. Describe the health of the patient population.
3. Include the potential negative effect to professional practice if the priority concept (topic) is unresolved.
4. Include the potential negative effect to the patient population if the priority concept (topic) is unresolved.

Includes all 4 requirements for section.

Includes no fewer than 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

Healthcare Disparities, Inequalities, and Interventions
(70 points/28%)

70 points

63 points

54 points

21 points

0 points

Required criteria
1. Identify patient populations that may be negatively influenced by the priority concept (topic) if unresolved.
2. Identify healthcare resources to support evidence-based practice related to the priority concept (topic).
3. Summarize potential priority concept (topic) healthcare disparities and inequalities related to diverse populations.
4. Propose an evidence-based solution for the priority concept (topic) related to healthcare disparities.
5. Identify three (3) evidence-based practice interventions.
6. Prioritize the identified evidence-based practice interventions and provide rationale.

Includes all 7 requirements for section.

Includes no fewer than 5-6 requirements for section.

Includes no fewer than 3-4 requirements for section.

Includes no fewer than 1-2 requirements for section.

No requirements for this section presented.

Assignment Section and Required Criteria

(Points possible/% of total points available)

Highest Level of Performance

High Level of Performance

Satisfactory Level of Performance

Unsatisfactory Level of Performance

Section not present in paper

7. Discuss two (2) patient education considerations related to
the priority concept (topic).

Legal & Ethical Considerations and Intervention Challenges
(40 points/16%)

40 points

36 points

31 points

12 points

0 points

Required criteria
1. Identify at least one (1) ethical and one (1) legal implication for addressing the priority concept (topic) in professional practice.
2. Discuss at least one (1) strategy in prevention of an ethical dilemma related to the priority concept (topic) in professional practice.
3. Discuss at least one (1) strategy in prevention of legal consequences related to the priority concept (topic) in professional practice.
4. Identify one (1) anticipated challenge to the success of preventing the priority concept (topic) in professional practice.
5. Identify one (1) anticipated challenges to the success of resolving the priority concept (topic) in professional practice.

Includes all 5 requirements for section.

Includes no fewer than 4 requirements for section.

Includes no fewer than 3 requirements for section.

Includes no fewer than 1-2 requirements for section.

No requirements for this section presented.

Participants and Interdisciplinary Approach
(20 points/8%)

20 points

18 points

16 points

8 points

0 points

Required criteria
1. Identify all the parties who will be involved in the implementation of the priority concept (topic) interventions.
2. Discuss the role of each member in the intervention implementation for the priority concept (topic).
3. Identify a minimum of two (2) members of a discipline outside of nursing.
4. Discuss the benefit of including the identified

Includes all 4 requirements for section.

Includes no fewer than 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

Assignment Section and Required Criteria

(Points possible/% of total points available)

Highest Level of Performance

High Level of Performance

Satisfactory Level of Performance

Unsatisfactory Level of Performance

Section not present in paper

interdisciplinary member from disciplines outside nursing to promote evidence-based professional practice.

Quality Improvement
(20 points/8%)

20 points

18 points

16 points

8 points

0 points

Required criteria
1. Provide at least one (1) benefit in patient outcomes from addressing the priority concept (topic) within the clinical environment.
2. Provide at least one (1) benefit to the nursing profession that will result from addressing this priority concept (topic) in clinical professional practice.
3. Discuss at least one (1) resource utilized to promote improved patient outcomes in the clinical environment.
4. Discuss at least one (1) resource utilized to increase professional nurse knowledge promoting improved clinical professional practice.

Includes all 4 requirements for section.

Includes no fewer than 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

Conclusion
(20 points/8%)

20 points

16 points

8 points

0 points

Required criteria
1. Provide a thorough recap of the purpose to promote increased evidence-based professional practice knowledge related to the priority concept (topic) deficiency.
2. Summarize resources identified to support improved evidence-based professional practice related to the priority concept (topic).
3. Include a complete statement describing why addressing the priority concept (topic) matters and to whom.

Includes all 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

Assignment Section and Required Criteria

(Points possible/% of total points available)

Highest Level of Performance

High Level of Performance

Satisfactory Level of Performance

Unsatisfactory Level of Performance

Section not present in paper

APA Format, Grammar, and Punctuation
(20 points/8%)

20 points

18 points

16 points

8 points

0 points

Required criteria
1. References are submitted with paper.
2. Uses current APA format and is free of errors.
3. Grammar and mechanics are free of errors.
4. At least three (3) scholarly, peer reviewed, primary sources from the last 5 years, excluding the textbook, are provided. Each section should have a cited source to support information provided.

Includes all 4 requirements for section.

Includes no fewer than 3 requirements for section.

Includes no fewer than 2 requirements for section.

Includes no fewer than 1 requirement for section.

No requirements for this section presented.

Total Points Possible = 250 points

Evidence Based RUA

Chamberlain College of Nursing

NR452: Capstone

Evidence Based RUA

Although The Joint Commission (JACHO) has seemed to disappear behind the curtain in light of recent events with COVID-19, preventing falls in the hospital continues to be one of the top safety goals for the accreditation and certification committee. Hospitals care a great deal about earning accreditation and certification from The Joint Commission as they set the standard for what patient quality of care and safety of care should be. It should also be mentioned that accreditation [from The Joint Commission] builds confidence in the community that they will receive competent care (The Joint Commission, n.d.).

Patient falls, when resulting in serious injury or death, are considered “sentinel events”. In other words, something that is preventable and should never happen. Although a patient fall is considered a never event, falls do still happen in the hospital setting. The purpose of this paper is to explore the importance of fall prevention along with a proposed solution and goal. With any proposed solution and goal there are barriers and benefits that will be encountered. Barriers being staff knowledge and lack of motivation, and benefits for both the health care team and patients alike. This is where healthcare thrives as working as a team to accomplish a common goal in the benefit of our patients. In relation to what NCLEX-RN category this falls under, the clinical problem this is drawn from is client needs with the subcategory being safety and infection control (National Council of State Boards of Nursing, 2019)

Importance

On average 1.3 to 8.9 falls happen per 1000 patients. Although this may not seem like a significant number of patients, it is one of the leading negative events recorded against hospitals accounting for approximately 70% of inpatient incidents and could lead to even more if left unresolved. This is an issue for patients and hospitals because patient falls lead to increased cost that quickly adds up (averaging $4200 per fall), and reduction of resources (increased length of hospital stay uses up a bed that otherwise would have been available and need for additional skilled nursing staff) (Ashok & Khyathi, 2019). The lost funds could have gone to a range of things the hospital needs. Such as: purchasing staff valuable PPE, purchasing equipment, giving staff raises, and the list goes on and on.

Yes, limited funds and resources are becoming a greater concern to hospitals as the COVID-19 pandemic in The United States worsens. Ethically, however, it is more important not to forget who is the center of this issue. The patient and their families. The more serious injuries include fractures, and subdural hematomas that have led to excessive bleeding and death. Injuries or deaths that could have been prevented (Ashok & Khyathi, 2019).

Patient Population

The population this paper is focusing on is the older adult patients who are admitted in an acute care healthcare facility. They considered the patient an older adult if they are 65 years old or older. The study had both male and female participants. The common medical risk factors seen in this patient population are cognitive impairment, confusion, dementia, neurological disease, cardiovascular disease, urinary and bowel incontinence, musculoskeletal issues, visual and hearing impairments (Zhao & Kim, 2015). The non-medical risk factors that the patient had are lengthy stay at the facility, had a previous fall, and not being able to care for themselves. Taking a psychotropic or antidepressant medication was also one of the risk factors.
The study reviewed different data from healthcare facilities in different counties including the United States, Europe, and Australia. However, the risk factors among patients in Europe may not be directly comparable to those patients in the US and Australia due to the different policies and regulations in their own respective countries. Despite the diverse population sample, they found that “Hispanics patients were likely to have less falls in the hospital compared to African American, Caucasians, and Asian patients” (Zhao & Kim, 2015). Despite all the information they had, there was no consistent data that shows cultural background as a risk factor.
Two of the ethical considerations for this population is autonomy and beneficence. The healthcare team caring for the patient must advocate for patients right by allowing them to make their own decisions and be involved in planning their care. It is advisable that patients’ independence is promoted to respect their dignity. The patients should also be provided a fall risk assessment upon admission and a safe environment during their stay to prevent harm.

Proposed Solution

Raising awareness of fall risk factors by educating all staff to do something as simple as responding to call lights (from janitor to primary care provider), and educating family/visitors to ask for help with their loved one when ambulating, lays the foundation of the solution. This fosters an environment of safety and includes participation from all parts of the healthcare team. It upholds the ethical principle of beneficence, to do no harm. Taking an interdisciplinary approach to fall prevention, which includes strong administrative support, makes everyone responsible and cultivates an environment and attitude of preventing falls (Ayton et al., 2017).

Specialized assessment tools, as many of the patients who enter the hospital have unique needs (different sets of comorbidities), is another solution to address this issue. An example is to provide assistance in using the toilet especially to those who are incontinent as most of the falls are related to elimination (Zhao & Kim, 2015). The patients can also benefit from environmental modifications such as providing clean, clutter-free room and hallways. The use of interventions for nurses like using assessment tools (MORSE fall scale, and Braden scale assessment tool) and hourly rounding (Nuckols et al., 2017) can be used to prevent falls as well as using exercise for the patients (Fuzhong, Hanner, & Fitzgerald, 2016).

Goals

The long-term goal would be to reduce falls in the hospital by fifteen percent within the first six months of implementing intervention bundles such as education and awareness of fall prevention, specialized assessment tools, and hourly rounding. In order to assess this goal, the first step would be to perform a systematic review. This is when the data is analyzed, and a number of falls is definitively established through an appraisal of the company’s documentation. This will be the benchmark we use to compare the data gathered during the first six months of implementing the new guidelines. Using a randomized controlled study, we would assign half of the hospitals units to implement these changes, and half to serve as the control group for this study by computer randomization (Guerrera et al., 2017). When informing the units of these changes make sure to use a democratic approach and allow for staff to vocalize concerns. Staying on site to observe the staff performing these new protocols on the unit during their normal work shift to ensure the integrity of the study. Then after six months of the new protocol another appraisal of the unit’s data will be compiled, compared to the control group and benchmarks set at the beginning of the study. The goal of the study will be to show that implementing intervention bundles such as education and awareness of fall prevention, specialized assessment tools, and hourly rounding lead to at least a fifteen percent decrease in documented falls.

The short-term goal is to make sure that staff is willing and capable of adhering to the units fall reduction protocol three weeks into the study. To measure this, we will use a survey which is a cross-sectional research method (Jacobs et al., 2012). The staff will have education on new fall protocols if they are in the independent variable group of the study. In order to do this a survey with appropriate questions must be developed. The questions on the survey would inquire about how long these new protocols take to complete, if they feel they are easily integrated into their work routine and any suggestions. These surveys will be anonymous to encourage the staff to be transparent about their answers (Jacobs et al., 2012). This will help evaluate how adaptable these new protocols have been for the staff and enhance the evidence-based research trial (Jacobs et al., 2012).

Barriers

There are several barriers that can prevent implementation of fall prevention programs such as: staff knowledge, education, and motivation; organizational and leadership skills; healthcare workers workloads; proper equipment access; audits and feedback (Ayton et al., 2017). Face-to-face education programs for nurses can improve their knowledge for skills practice to prevent falls and enhance their motivation to prevent future occurrence of falls. Implementation of the educational programs can save many complications following falls, such as trauma injuries, local or systemic infections and even deaths. Another convenient option for education nursing staff is e-learning systems, which is easily accessible through computers or mobile devices. Education can enhance a nurse’s motivation to prevent falls. Lack of motivation is another barrier among healthcare personnel. One of the main motivation factors for nurses is following utilitarian ethical principles when taking care for patients, which refers to doing the best care for each patient, so emphasizing the benefits for preventing falls among patients can increase nursing motivation to prevent future complications from falls. Organization and developing a system of audit and feedback for fall prevention can also affect nursing motivation. Creating a benefits system is a strategy that can enhance nursing motivation and lower the rate of falls

Fall prevention requires development of nursing care plans with proper and achievable goals with successful implementation of the nursing interventions that can prevent future occurrence of the falls. For example, patients who have altered mental status and those who take strong pain medication often require supervision and the occurrence of falls among these patients are often anticipatory. In addition, nurses have to develop a plan of care for each patient with recognizing patient’s major health problems and creating goals and interventions that can prevent future falls. On the other side, unanticipated falls or often accidental events happen with patients who are in low risk. The problem in developing care plans is often connected with a low nursing workload and not enough time for nurses to develop and implement fall prevention plans. Multiple patients’ care and shortage of healthcare personnel can be challenges for nurses. Those are time consuming and lead to lowering attention for fall prevention. Implementation of fall risk assessment tools such as MORSE Fall Scale can help for early recognition of patients, who are at risk for falls.

Another barrier for implementation of fall prevention is not enough equipment or environmental factors. Lack of proper equipment such as bed alarms, call lights, proper lightening and etc., can increase the risk of patient falls. The problem can be connected with not enough finance, poor management, and lack of resources. Managers can develop programs for gathering equipment and improving the facilities environment which can help for lowering the rate of falls occurrence. Implementation of interventions like posting a sign for fall alert, call light within reach, personal belongings and walking aids within reach, bed in the lower position, bed alarms are used in the healthcare system as useful universal precautions for fall prevention.

Benefits

Every patient and medical professional can benefit from fall prevention but not just from using the standard precautions of yellow slipper socks, using the call light, assessing patients with the MORSE fall scale, and identification of a fall risk on doorways (Nuckols et al., 2017). Other interventions need to be researched and implemented to reduce falls for all patients and to give medical professionals a peace of mind when caring for them.

One such intervention that benefited patients of community senior centers was implementing an exercise program to improve balance (Fuzhong, Hanner, & Fitzgerald, 2016). Formerly called Tai Chi, the Tia Ji Quan program was implemented in 32 senior centers with 392 participants for a one-year period. The patients were taught several movements to help with balance and to remain functional for activities of daily living. Results of this intervention produced a 54% reduction in falls, improved physical performance of the participants, and 17 senior centers continued to offer the program after the research was completed (Fuzhong et al., 2016).

To help health care workers, hourly rounding has been implemented in many hospitals. One specific study conducted hourly rounds for nurses with the implementation of training them to think critically about fall risk using the 4P method (pain, personal needs, position, and placement) (Nuckols et al., 2017). Another such study implemented several strategies within their hourly rounding resulting in a 50% reduction of falls (Morgan et al., 2016).
One intervention that has assisted both the patients and health care workers combined is a study which put together a team of health care workers and social care professionals to respond to calls of older people who have fallen at home. Results showed that the “rates for patients to hospital were lower during the hours that the falls ambulances were in service, than when only general ambulances were running” (Pyer, 2014, p. 71). Patients filled out questionnaires which they responded they were “respected as an individual, treated with dignity and consulted about their care” (Pyer, 2014, p. 71).
Fall prevention is something to take very seriously for each person involved. It should have benefits for the patients and for the health care workers who provide care not only to save money, but to save lives and to give everyone a peace of mind.

Participants and Interdisciplinary Approach

Preventing falls is a safety issue that needs to be accountable to all those that are a part of patient care. The best approach to preventing falls is an interdisciplinary one. While nurses are the forefront for preventing falls, it takes a team approach to provide patient safety. Part of this team includes physical therapists and physicians.

During a hospital stay an adult, despite level of independence, experiences a reduced level of mobility (Johnson, Kuperstein, Howell, & Dupont-Versteegden, 2018). Physical therapists are an integral part of the plan of care for an adult inpatient stay in preventing mobility decline which reduces fall risk (Johnson et al., 2018). It has been proven that getting patients out of bed and moving as soon as the first day has better patient outcomes and decreased length of stay which in turn reduces cost (Johnson et al., 2018).
Establishing the level of patient mobility at admission and providing appropriate interventions for maintaining or improving a patient’s mobility status throughout their stay will reduce falls risk (Johnson et al., 2018). According to Morris and O’Riordan (2017), these interventions include “balance, gait training, range of motion exercises, and strengthening”. It should be stressed to the patient that these tools should continue to be utilized outside of the hospital to maintain or improve level of agility.
The other integral part of this equation is the physician. One of the biggest contributors to this problem is medication. All physicians involved in a patient’s care need to be diligent in closely monitoring their medications and the potential side effects that contribute to increased fall risk (Morris & O’Riordan, 2017). Medications that potentiate the problem include narcotics, psychotropic, and blood pressure medications. By reducing the strength, providing alternative medications, or removing the medications that contribute to orthostatic hypotension, drowsiness, lethargy and altered mental status can lead to a large reduction of fall risk (Morris & O’Riordan, 2017).

Conclusion

In conclusion, falls are a preventable sentinel event if everyone does their part by placing importance on preventing them. Knowing the patient population being cared for and the risk factors they have is a key in identifying the appropriate action to protect them from such an event. A team approach reduces hospital costs, length of stay and utilizes less resources. Ultimately it prevents injury, harm, and promotes safety and quality care.

References
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Ayton, D. R., Barker, A. L., Morello, R. T., Brand, C. A., Talevski, J., Landgren, F. S., … Botti,
M. (2017). Barriers and enablers to the implementation of the 6-PACK falls prevention
program: A pre-implementation study in hospitals participating in a cluster randomised
controlled trial. Plos One, 12(2). doi: 10.1371/journal.pone.0171932
Fuzhong, L., Hanner, P., & Fitzgerald, K. (2016, November). Implementing an evidence-based
fall prevention intervention in community senior centers. American Journal of Public
Health, 106(11), 2026-2031.
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doi: 10.3928/00989134-20150616-05

EVIDENCE BASED 2

Evidence Based RUA

Student Name

Chamberlain College of Nursing

NR452: Capstone

Session Month and Year

1

EVIDENCE BASED 4

Evidence Based RUA

Type your introduction. Although the first paragraph after the paper title is the introduction, no heading labeled Introduction is used. Refer to your assignment guidelines for the headings to be used for the body of the paper. Include NCLEX category with appropriate in text citation

Importance

Use as many paragraphs as needed to cover the content appropriately. Include negative effect of leaving issue unresolved.

Healthcare Disparities, Inequalities, and Interventions

Use as many paragraphs as needed to cover the content appropriately.

Legal & Ethical Considerations and Intervention Challenges

Use as many paragraphs as needed to cover the content appropriately. Include ethical and legal implications.

Participants and Interdisciplinary Approach

Use as many paragraphs as needed to cover the content appropriately. Include members of a discipline outside of nursing (please note that case managers and educators are nurses).

Quality Improvement

Use as many paragraphs as needed to cover the content appropriately. Provide benefits in addressing the priority concept (topic) and resources utilized.

Conclusion

Papers should end with a conclusion or summary. The assignment directions will specify which is required. It should be concise and contain little or no detail. No matter how much space is left on the page, the references always start on a separate page (insert a page break).

References

Author Last Name, First Initial. (Year of Publication). Title of article. Title of Journal, volume number (issue number), pages. Retrieved from http://dx.doi.org/xx.xxx/yyyy.

National Council of State Boards of Nursing (2019). NCLEX-RN Examination [PDF file], (2019). Retrieved from https://www.ncsbn.org/2019_RN_TestPlan-English.htm.