Proposed EBP Project Solution

proposed evidence‐based practice project solution. Address the following criteria:
1. Proposed Solution: (a) Describe the proposed solution (or intervention) for the problem and the way(s) in which it is consistent with current evidence. Heavily reference and provide substantial evidence for your solution or intervention. (b) Consider if the intervention may be unrealistic in your setting, too costly, or there is a lack of appropriate training available to deliver the intervention. If the intervention is unrealistic, you may need to go back and make changes to your PICOT before continuing.
2. Organization Culture: Explain the way(s) in which the proposed solution is consistent with the organization or community culture and resources.

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Expected Outcomes: Explain the expected outcomes of the project. The outcomes should flow from the PICOT. PICOT (P) For post-operative patients, (I) can standardized hourly rounding by a medical team be a better deterrent (C) compared to bed alarms or other tools that are readily available within a hospital (O) and designed to reduce patient fall risk (T) during hospitalization.
3. Method to Achieve Outcomes: Develop an outline of how the outcomes will be achieved. List any specific barriers that will need to be assessed and eliminated. Make sure to mention any assumptions or limitations which may need to be addressed.
4. Outcome Impact: Describe the impact the outcomes will have on one or all of the following indicators: quality care improvement, patient‐centered quality care, efficiency of processes, environmental changes, and/or professional expertise. Proposed EBP Project Solution

Proposed Evidence‐Based Practice Project Solution

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Proposed Solution

Postoperative patients are at high risk of falls in acute care settings. The outcomes associated with falls in this patient population include disability, prolonged hospital stays, additional medical costs, loss of independence and loss of hospital revenue. Some of the most prevalent causes of falls among post-operative patients are associated with mental, physical, emotional, social and physiological symptoms of an individual (Mitchell et al., 2014). The most preferred approach to ensure a reduction in fall incidences among post-operative patients in clinical settings is through standardized hourly rounding by healthcare teams.

Standardized hourly rounding has proven to be a highly effective and proactive approach of communicating with families and patients to address their needs during hospitalization. As noted by Moorer et al., (2017), it is used in the clinical setting to promote the ability of the healthcare team members to assess the most potential risks that are likely to result to falls among post-operative patients and institute prevention measures where necessary. Standardized hourly rounding has also shown to increase patient safety, nursing efficiency and to reduce documentation (Morgan, 2019). When conducting around, the medical team should assess the 4 P’s (pain, personal needs, position, and placement).

During the rounding process, a patient’s pain level should be assessed and if need be, pain mediation administered. Members of the medical team can also address a patient’s needs such as offering assistance to use the toilet, nutrition or hydration. For patients who are wrongly positioned, medical team members can help them to get into a comfortable position. For post-operative patients who are immobile, they should be turned to ensure that the integrity of the skin is maintained. With regards to placement, an hourly rounding process would help to ensure that the patient’s most vital needs such as equipment for toileting, phone or bed alarm can easily be reached. Lastly, with regards to preventing falls, in this case, a patient or family caregiver can be asked to sound the bell alarm when the patient needs to get out of bed.

The proposed intervention has been embraced in most care settings as a quality improvement strategy that increases patient safety and the satisfaction of staff and patients. The implementation of this intervention is realistic since there’s available staff who are adequately informed on the need to deliver this intervention. Besides, the intervention is cost-effective as it will not incur any additional costs. Instead, it will help the organization to save on additional healthcare-related costs and collect more revenue.

Organization Culture

The organization purposes to provide quality surgical care for individuals suffering from both chronic and acute illnesses and uphold an environment that promotes healing as revealed in its mission, vision, goals, and objectives. It is also determined to prevent additional harm and complications to post-operative hospitalized patients through interprofessional collaboration, evidence-based research, effective leadership, and communication. Post-operative patients have numerous needs that should be addressed including spiritual, emotional, nutritional, physical, psychological, physiological and social needs. This requires intervention from different providers including a nutritionist, physiotherapist, psychologist, physician and pharmacist among others. As supported by Jacobs (2014), the adoption of a multidisciplinary team approach for standardized rounding will promote nurses ability to change specific clinical practices with the consent, input and approval of other stakeholders and all a patient’s needs will be addressed.

To promote evidence-based research, the organization has been transformed into a learning organization and has a library that is fully equipped with adequate resources. Besides, the staffs have adequate knowledge and skills in conducting literature searches, critiquing and synthesizing literature to address specific clinical problems. Therefore, integrating the proposed evidence-based solution into clinical practice will be efficient and effective. Proposed EBP Project Solution

Method to Achieve Outcomes

The outcomes to be achieved following the implementation of standardized hourly rounding by a medical team are as follows:

• A significant reduction in fall incidences among post-operative patients in the surgical unit based on outcome data as compared to baseline data
• Shorter hospital stays, reduced mortality and morbidity rates based on monthly mortality and morbidity data
• Increased staff and patient satisfaction as evidenced by low readmission rates
• Increased hospital revenue based on financial outcome and baseline financial data

Potential barriers to the achievement of the aforementioned outcomes that may hinder the implementation of the proposed solution can be categorized under individual and organizational characteristics. To ensure success, these barriers ought to be assessed and eliminated. Individual barriers: some nurses lacking the skills to locate research sources and opting to seek for information from colleagues as opposed to conducting a scientific search in scientific databases (Odias, 2015). Other stakeholders may have the skills to critique, appraise and synthesize literature but lack technology/computer skills which can, however, be addressed through training. A potential organizational barrier is the lack of adequate time to participate in the entire process since staffs in the surgical department are often engaged.

Outcome Impact

Following the implementation of standardized hourly rounding with a medical team, it is expected that the outcomes will impact the following indicators: improving patient-centered quality care since every patient’s need will be addressed separately by members of a healthcare team. Interprofessional collaboration will promote members of the medical team to acquire new knowledge and skills which enhances professional expertise.  Since the proposed solution aims at reducing the incidence of falls among post-operative patients, it is expected that it will result to shorter hospital stays, reduced medical costs and improved health outcomes which denote an improvement in the quality of care. Proposed EBP Project Solution

References

Jacobs, D. (2014). Evidence-Based Falls Management Program in the Nursing Home.

Mitchell, M. D., Lavenberg, J. G., Trotta, R., & Umscheid, C. A. (2014). Hourly rounding to improve nursing responsiveness: a systematic review. The Journal of nursing administration, 44(9), 462.

Morgan, K. (2019). Improving Nurse Responsiveness through Advanced Call Bell Implementation & Hourly Rounding.

Moorer, M. B. A., Kunupakaphun, S., Delgado, E., Moody, M., Wolf, M. S. N., Moore, R. N., & Eamranond, M. D. (2017). Using appreciative inquiry as a framework to enhance the patient experience. Patient Experience Journal, 4(3), 128-135.

Odias, M. J. B. (2015). Barriers encountered by nurses and nursing assistants that prevent purposeful rounding.

Tatevossian, A. (2017). Fall Prevention: Responder 5 Bed Connectors. Proposed EBP Project Solution