Advocating For Organization Policy Changes Discussion Paper

In advocating for institutional policy changes related to local, state, or federal health care laws or policies, health leaders must be able to develop and present clear and well-written policy and practice guideline proposals that will enable a team, a unit, or an organization as a whole to resolve relevant performance issues and bring about improvements in the quality and safety of health care. This assignment offers you an opportunity to take the lead in proposing such changes.
As a master’s-level health care practitioner, you have a valuable viewpoint and voice to bring to discussions about policy development, both inside and outside your care setting. Developing policy for internal purposes can be a valuable process toward quality and safety improvement, as well as ensuring compliance with various health care regulatory pressures. This assignment offers you an opportunity to take the lead in proposing such changes.

ORDER  HERE A PLAGIARISM-FREE PAPER HERE

Executive Summary

Healthcare organizations should meet performance benchmarks at different levels. Additionally, they must ensure that performance in a particular performance area aligns with the set target. Thus, the healthcare organization’s performance must be evaluated regularly to identify areas that must be improved to achieve the desired score or align with the set benchmark. This project aims to improve the quality of care in underperforming inpatient units based on performance scores indicated on the dashboard Advocating For Organization Policy Changes Discussion Paper.

Dashboard Metrics Evaluation

The QSEN focuses on equipping nurses with the six competencies, preparing them to improve the safety and quality of patient care. Nurse practitioners (NPs) apply their evidence-based practice (EBP) and quality improvement (QI) skills to address gaps in their practice for better health outcomes. Thus, NPs advocate for institutional policy changes depending on the practice area that requires improvement to align with health care policies at the local, state, or federal levels. NPs formulate a well-written practice guideline proposal and present it to the stakeholders, including top management, for approval. The proposed policy must indicate how the proposed policy will resolve the identified clinical issue at the unit or organizational level. This paper proposes changes needed to reduce the high rate of patient falls in the medical-surgical units Advocating For Organization Policy Changes Discussion Paper.

 Evaluating Underperforming Matrix

Medical and surgical units are experiencing a significantly high rate of patient falls. The current target for patient fall rate in these units is approximately 6.0 falls/1000 patient days. However, the prevalence of patient falls in the surgical and medical departments is about 19.48 falls per 1000 patient days based on data gathered from the healthcare facility’s dashboard. Hence, the actual inpatient fall score is over three times higher than the organization’s set target for patient falls. Consequently, an evidence-based guideline should be adopted in the affected inpatient units to lower the high patient fall rates, achieving the organization’s target for inpatient falls.

Consequences of the Underperforming Matrix

A relatively high rate of inpatients characterizes the underperforming matrix falls in the surgical and medical departments. This clinical issue compromises the provision of quality care in the entire healthcare organization. About 25% of inpatient falls result in severe injuries and fractures (Trinh et al., 2020). The high prevalence of injuries and fractures increases healthcare providers’ workload, compromising their ability to provide effective and timely medical care to patients seeking treatment for various medical conditions. Failure to implement policy measures for addressing patient falls would negatively affect the entire healthcare organization. First, the medical facility’s reputation would be damaged due to the increased rate of fall-related severe fractures and injuries, resulting in prolonged hospital stays and increased treatment costs (Su et al., 2021)Advocating For Organization Policy Changes Discussion Paper. The cost of treating fall-related injuries is relatively high, exposing the affected inpatient units to a massive financial burden. Su et al. (2021) reported significantly high fall-related injuries and total hospitalization costs in the geriatric unit. Therefore, failure to propose practice guidelines for improving fall rates in the surgical and medical units would increase the overall cost of treatment in the affected departments, jeopardizing the healthcare organization’s operations.

ORDER HERE 

The Recommended Practice Guidelines and Organizational Policy

The federal health care law benchmarks inpatient fall rates in the surgical and medical units. The national benchmark for patient fall rate in the surgical and medical units in the United States is about 3.44 falls/1000 patient days (Venema et al., 2019). On the other hand, the fall rate in the two units in the healthcare facility is 19.48. This fall score is approximately six times higher than the national benchmark for patient falls (3.44)Advocating For Organization Policy Changes Discussion Paper. Therefore, the inpatient fall score in the two units is significantly higher than the national benchmark. For this reason, an organizational policy must be implemented in the affected departments to lower the high rate of inpatient falls. The proposed practice guidelines involve introducing bed and chair alarm systems in the surgical and medical units. Studies indicate the efficacy of alarm systems in preventing falls in inpatient units (LeLaurin & Shorr, 2019). The bed or chair alarm system sends signals when an individual is about to fall, alerting the healthcare provider on shift. The clinician assists the individual patient in leaving the bed or chair, reducing the possibility of a fall. Therefore, implementing this EB policy in the healthcare organization will significantly lower the rate of falls in the affected department, achieving the national benchmark for inpatient falls.

Potential Impacts of Environmental Factors on the Proposed Practice Guidelines

The proposed practice change entails installing alarm systems (bed and chair) in the surgical and medical units. Implementing this EB change intervention in the affected departments might result in noise pollution. Dash et al. (2022) reported that medical alarm systems result in noise pollution. Medical equipment noise hinders communication and exposes patients to noise-triggered stress (Dash, 2022)Advocating For Organization Policy Changes Discussion Paper. Therefore, the project implementation team must consider all safety measures and precautions during alarm system installation to prevent potential noise pollution and related challenges. Dash et al. (2022) reported that educating healthcare workers, particularly nurses, on managing the equipment reduced the alarm systems’ noise level while keeping them alert. Thus, nurses working in surgical and medical units will be educated on minimizing alarm system-related noise to ensure the new practice guideline meets regulatory measures for noise pollution.

Additionally, the successful implementation of the new intervention will significantly depend on the availability of various resources. First, the efficacy of the alarm system in preventing falls will significantly depend on staffing rates in the surgical and medical departments. Healthcare providers, in particular nurses, must be readily available to meet the patient’s immediate needs upon receiving an alarm system’s alert to prevent an individual patient at a high fall risk from falling. Moreover, alarm systems would be affected by the availability of support services required post-implementation stage to enhance the efficacy of the alarms in preventing patient falls in the surgical and medical units Advocating For Organization Policy Changes Discussion Paper.

Ethical Impact of the Alarm Systems on Patients at High Fall Risk

The proposed EB practice change involves adopting an alarm system in inpatient units with a relatively high rate of patient falls. LeLaurin and Shorr (2019) reported the effectiveness of alarm systems in preventing falls in inpatient units. Thus, chair and bed alarms will prevent patient falls in the surgical and medical units. Consequently, the rate of inpatient falls in these departments will reduce significantly from the current score of approximately 19.48 to 3.44 falls/1000 patient days, the national benchmark for inpatient falls (Venema et al., 2019). The proposed practice guideline focuses on preventing falls in the inpatient units with a relatively high fall score. This initiative will prevent patients from fall-related severe fractures and injuries. Consequently, the new practice guideline will align with the ethical principle of Nonmaleficence, which advocates for patient protection from potential harm (Varkey, 2021)Advocating For Organization Policy Changes Discussion Paper. Moreover, the proposed policy will consider the cultural beliefs of individual patients. For this reason, alarm systems will not be installed in beds or chairs of patients whose cultural beliefs are against using digital devices, such as alarm systems and the Internet of Things. The new strategies will directly impact stakeholders’ job requirements. Specifically, nurses working in the surgical and medical departments must undergo training to acquire the knowledge and skills needed to operate the alarm system.

Stakeholders Involved in the Implementation Process

Successful implementation of the proposed policy significantly depends on stakeholder’s support. Stakeholders and groups involved in practice guideline implementation include department heads, IT experts, and nurses working in the surgical and medical units. These teams will perform various roles in system design and implementation. The contribution of every group will impact the implementation process positively. Thus, involving these groups and stakeholders during project implementation is recommended since they will work together to prevent inpatient falls in the affected units Advocating For Organization Policy Changes Discussion Paper.

Strategies for Collaborating with the Stakeholder Group during EB Change Implementation

Change project team members collaborate with key stakeholders’ groups during practice guideline implementation. The team members should assign different roles to various stakeholder groups. First, heads of surgical and medical units will approve the implementation of alarm systems in their departments. Furthermore, IT experts will design and install an alarm system that effectively prevents falls in underperforming units. Moreover, nurses will prevent patients who are more likely to fall from falling by responding to alarm alerts. The stakeholder groups’ collaboration is essential since their roles contribute to successfully implementing the proposed practice guideline Advocating For Organization Policy Changes Discussion Paper.

Conclusion

The underperforming area in the medical facility is the significantly high inpatient fall rate in the surgical and medical units. This clinical issue is justified by the significantly high rate of actual inpatient falls, exceeding the organization’s score and the national benchmark for falls. This underperforming matrix can be improved by implementing policy guidelines involving installing bed and chair alarm systems. The new system will alert nurses on duty when a patient is at a high risk of falling. Nurses’ response will reduce the likelihood of falls, reducing overall fall rates in the affected departments. The new practice guideline aligns with nonmaleficence since it will prevent individuals with significantly high fall risk from fall-related injuries and fractures. Stakeholders’ collaboration will contribute to successfully implementing the proposed practice change since stakeholders’ groups will play various roles during alarm system implementation Advocating For Organization Policy Changes Discussion Paper

ORDER NOW

References

Dash S. (2022). Identifying Noise Sources & Alarm Hazards in ICUs – Occurrences. Tools to Minimize. Salud Cienc. Tecnol; 2(S2):236.

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: state of the science. Clinics in Geriatric Medicine, 35(2), 273-283.

Su, F. Y., Fu, M. L., Zhao, Q. H., Huang, H. H., Luo, D., & Xiao, M. Z. (2021). Analysis of hospitalization costs related to fall injuries in elderly patients. World journal of clinical cases, 9(6), 1271.

Trinh, L. T. T., Assareh, H., Wood, M., Addison-Wilson, C., & Sathiyaseelan, Y. (2020). Falls in hospital causing injury. The Journal for Healthcare Quality (JHQ), 42(1), 1-11.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice, 30(1), 17-28.

Venema, D. M., Skinner, A. M., Nailon, R., Conley, D., High, R., & Jones, K. J. (2019). Patient and system factors associated with unassisted and injurious falls in hospitals: an observational study. BMC Geriatrics, 19, 1-10. Advocating For Organization Policy Changes Discussion Paper