Implementation Of Patient Care Information System In Healthcare Essay

*BENCHMARK** Assessment, Implementation, and Review – Write a 2500-2700 word essay addressing each of the following points/questions. Support your ideas with at least three (5) scholarly citations in your essay. Use strict APA guidelines to format the paper. The cover page and reference page do not count towards the minimum word amount and an abstract and table of contents are not necessary and if included are not part of the overall word count.Implementation Of Patient Care Information System In Healthcare Essay

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Choose a project that you would like to implement in a healthcare delivery environment. Research the topic. Develop a plan to implement the knowledge found in the research. Discuss how you would evaluate the project. Include a discussion of what you will do if the project does not successfully launch.Implementation Of Patient Care Information System In Healthcare Essay

In nursing practice, it is highly recommended that the implementation of projects is supported by evidence-based research in terms of decision-making and guidance. Evidence-based projects encourage and influence healthcare providers to make clinical decisions based on the best available scientific evidence, clinical expertise, and a patient’s beliefs. This paper discusses the implementation of a project that purposes to reduce falls among elderly hospitalized patients in inpatient settings using an EBP approach. EB Practice is meant to standardize practices in healthcare to the most current and best scientific evidence to reduce differences in care and unexpected outcomes (Warren, et al., 2016). The translation of evidence-based research findings into effective nursing projects influences health outcomes, improves the clinical performance of staff and healthcare systems.
Background Information
The organization that the proposed project will be implemented is a regional 1600 bed capacity hospital that provides healthcare services to a large population that is majorly comprised of elderly patients who with more than one comorbidity. Its healthcare workforce is primarily comprised of nurses although other healthcare providers including nurses, physician specialists, physicians, and nurse practitioners are present. The organization has witnessed a gradual increase in fall incidences among elderly hospitalized patients partly due to lack of fall-reduction strategies and partly due to inadequate knowledge amongst staff on how falls affect patient health outcomes, staff and organizational performance and how they can be reduced.
According to the oxford advanced English dictionary, a fall is an unexpected, accidental or expected incident that leads to involuntary rest on the ground. The risk of falls is higher among people with advanced age since they are very fragile. According to reports provided by the World Health Organization, the fall rates of aged individuals in community settings are lower in comparison to that of elderly people in nursing homes and hospital settings. As supported by Ang et al., (2011), falls have been associated with prolonged admissions in hospitals, increased morbidity and mortality rates, and a limited physical functional capacity. Currently, the prevalence of falls among elderly hospitalized patients across the US is significantly high. Implementation Of Patient Care Information System In Healthcare Essay Coupled with the challenges of an increase in the aging population, a high prevalence of chronic diseases, health disparities and limited finances, nurses are highly encouraged to cooperate in the development of evidence-based projects that can be used to prevent falls in the inpatient settings.
Proposed Project Implementation Of Patient Care Information System In Healthcare Essay
The project to be implemented is the hourly rounding. Hourly rounding encompasses nurses to check on patients more frequently (every hour) and to maintain proper documentation of the relation. As highlighted by Olrich, Kalman & Nigolian (2012), it specifically includes checking on the status of a patient with regards to his/her positioning, placement, pain, to prevent falls and address personal needs. The patient is to be assessed for pain and its level and drugs provided when necessary. When addressing the personal needs, the patient can be assisted with nutrition, using the toilet and hydration (Olrich, Kalman & Nigolian, 2012). Positioning involves assisting the patient to be comfortable and turning immobile to retain the skin’s integrity. To prevent falls, patients can be asked by nurses to use call lights, appropriate footwear, and other strategies. Currently, existing evidence backs hourly rounding as a highly effective approach that prevents falls in inpatient settings. According to Olrich, Kalman, & Nigolian (2012), it enhances efficiency and effectiveness among nurses and increases the safety of patients. Implementation Of Patient Care Information System In Healthcare Essay
Factors That Will Promote Project Implementation
Organization Culture
The organization in which the project will be implemented values patient safety and high-quality care to meet the expectations of patients and increase satisfaction among staff. This priority is reinforced by the availability of sufficient nurses whose roles and responsibilities are well defined with flexible work schedules. An adequate nursing workforce guarantees nurses the ability to address the needs of patients and prevent incidences such as the omission of care and adverse health events (Warren et al., 2016). This institution is also a learning organization as evidenced by team learning, a shared vision, and systems thinking. This inspires an increased performance level, competence, and knowledge among staff (Warren et al., 2016). As a result, healthcare staff will easily embrace the hourly-rounding project increasing the chances of highly successful outcomes.
Expected Outcomes
The project aims at influencing a significant reduction in the incidences of falls among elderly hospitalized patients. The present increase in fall incidences has been linked to the institution’s poor reputation, financial performance, prolonged admissions for patients, increased fall-related injuries, morbidities, and mortalities. When the project is implemented, it is expected that the hospital will record lower incidences of inpatient falls, fall-related injuries, mortalities, and morbidities. Its financial performance and reputation will also improve as evidenced by individual referrals.
Method to Achieve Outcomes
For the project to achieve the intended outcomes, it will be necessary to conduct an initial assessment that will help to establish the training needs and gaps in knowledge before conducting the actual implementation. This assessment will best be conducted through a survey and the feedback used to plan for a training schedule within a specified period. This training will be mandatory for all staff. The implementation will also be overseen by an implementation team. This team will also assess whether or not the project’s goals and objectives are achieved and the areas that will need improvement. Implementation Of Patient Care Information System In Healthcare Essay
Impact of Outcomes
The hourly rounding project will encourage the ability of nurses to conduct assessments and address the needs of each patient in the inpatient setting. This will encourage patient-centric care and good health outcomes as evidenced by increased nursing staff and patient satisfaction.
Project Implementation Barriers and How They Will Be Addressed
A potential barrier in the implementation of this hourly-rounding project is increased skepticism and reluctance from nursing staff in regards to extra schedules that will need to be accomplished. Besides, some nurses may think that extra time and documentation will be required within limited shift hours when other jobs should be done. However as recommended by Warren et al. (2016), this can best be addressed through training to improve nursing staff knowledge on hourly rounding and how this will positively impact the hospital, patients and staff.
Evidence to Support the Proposed Project
Hourly rounding to improve the quality of care given to patients began in the mid-20th century in nursing homes and acute care settings in the United States. However, in settings that experienced a shortage of nursing staff, hourly rounding was used less frequently. In a study with a quasi-experimental design to establish effectiveness of hourly rounding on the rates of falls among patients, call-lights use, satisfaction and safety in a 506-bed capacity med-Surg unit, Olrich, Kalman, & Nigolian (2012) started with collecting data on the rates at which patients used call lights, the rates of patient satisfaction and fall incidences. Implementation Of Patient Care Information System In Healthcare Essay
Following intervention implementation (hourly rounding), the researchers continuously collected outcome data for 6 consecutive months from the experimental and control units respectively. Before implementing the intervention, fall rates in the experimental unit was found to be 3.37 and after implementation, this decreased to 2.6. Although this outcome was not found to be statistically significant, it had a lot of clinical significance. Based on the findings, it was agreed that hourly rounding increases patient satisfaction and reduces fall incidences (Olrich, Kalman, & Nigolian, 2012).
These findings are similar to a RCT that was conducted to establish how effective several interventions were in reducing patient fall rates in settings that provide acute care. There was an intervention and control group comprising of 910 and 912 participants respectively. The estimate of fall risks reduced in the former than the latter group. The most effective intervention to reduce fall incidences was hourly rounding (Ang et al., 2011). Implementation Of Patient Care Information System In Healthcare Essay
Daniels (2016) acknowledges falls as an issue of public health significance among elderly people and particularly among those hospitalized in nursing homes and inpatient settings that provide acute care. It not only accounts for an estimated 40% of adverse events in inpatient units but also primarily contributes to a lack of confidence to perform activities of daily life, fear of mobility, placement in long-term care institutions, anxiety, extra medical costs and prolonged admissions (Daniels, 2016). The researcher, however, highlights hourly rounding as a best-practice intervention that promotes nurses’ ability to provide routine care to inpatients and ensures the safety of patients by decreasing the likelihood of a fall. Hourly rounding enables nurses to be proactive by addressing an issue before it occurs (Daniels, 2016).
The study conducted by Daniels (2016) purposed to advance the safety of patients, staff and patient rates of contentment after implementing a rounding protocol. Nurses in a US-based medical-surgical unit were observed on how they used care protocols, audit tools and conducted rounds. A follow-up on the same was done to determine the compliance levels before comparing the pre and post-intervention data. The findings suggested that rounding increased the levels of compliance from 0 to 64% with an increase in how nurses were responsive (11%), communication between staff (5%) and reduction in patient falls (50%)(Daniels, 2016).Implementation Of Patient Care Information System In Healthcare Essay
Based on these findings, Daniels (2016) concluded that rounding is an effective intervention that not only improves the responsiveness and communication amongst staff but also improves patient safety and reduces fall incidences. However, the most essential factor to ensure successful outcomes is adequate nursing staff, adequate infrastructure and an organized implementation strategy that involves all staff (Daniels, 2016).

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Implementation Plan
The proposed project will be implemented using the Iowa Change model. As highlighted by Buckwalter et al.,(2017), the choice of this model was influenced by the fact that it not only promotes multidisciplinary collaboration but also makes use of the response provided by an implementation team to influence organizational change. The model is made up of three points where decisions are made. First is establishing the importance of implementing a project, then forming a multidisciplinary team and later deciding whether the evidence obtained to support the proposed project is adequate.Implementation Of Patient Care Information System In Healthcare Essay
In determining whether or not the project is of primacy, it is worth understanding that the implementation of most projects in healthcare environments are prompted by challenges witnessed in the delivery of care and the need to improve care (Buckwalter et al., 2017). In this organization, implementing this project is an essential step towards reducing and preventing fall incidences among elderly hospitalized patients. Since it was noted that falls contribute to an increase in morbidity and mortality, longer admission periods, poor organizational financial performance and reputation and increased medical costs.
In the formation of a multidisciplinary team, stakeholders and staff from all healthcare disciplines will be incorporated. However, the project will have nurses at the frontline of its initiation to increase the chances of success. This will also promote the active involvement of nurses as change agents in the institution. More particularly, the multidisciplinary team will be made up of geriatric nurse practitioners, specialists, physicians, the clinical nurse supervisor, and nurse manager. As suggested by Buckwalter et al. (2017), the preliminary task of this team will be to search for evidence that backs hourly rounding in decreasing fall incidences. This search will involve the use of inclusion and exclusion criteria and keywords. This should be followed by the synthesis and critique of the obtained evidence using different skills. This process will also involve the identification of potential gaps from literature as the outcomes will influence references for research in the future. Implementation Of Patient Care Information System In Healthcare Essay
If agreed that the evidence obtained to support this project is adequate, the implementation team should pilot the project. On the other hand, if the evidence is deemed insufficient, alternative evidence to support implementation should be sought for. Alternatively, the implementation team will conduct unavailable research. The adoption of hourly rounding as a strategy to reduce falls with supporting evidence should prompt immediate piloting. This phase involves six steps starting with the determination of outcomes. In this context, this project aims at using hourly rounding to decrease fall incidences among elderly hospitalized patients. Expected outcomes include: reduced fall incidences, reduced stays in the hospital, reduced morbidity and mortality rates. As noted by Buckwalter et al. (2017), this will, however, be determined by comparing baseline data and outcome data before and after implementation of the proposed project.
The final step is the development of policies and guidelines which will guide the project. These guidelines should provide a clear explanation of hourly rounding, the involved stakeholders and effectiveness.Implementation Of Patient Care Information System In Healthcare Essay The policies should also outline the actions to be taken when staffs fail to implement the procedures outlined in the agreed project. By directly involving patients and staff with clear expectations, the project can be tested is a single unit in the organization within a given time duration. A comparison between the baseline data and outcome data during this period should be used to evaluate the project’s effectiveness. The outcome will influence modifications to meet the project’s expected goals.
Evaluation Plan
Methods to Collect Outcome Data
Outcome data will be collected using surveys and interviews at different points in the project’s timeline. Interviews have been evidenced to have high response rates and promote the researcher’s ability to ask more comprehensive questions while incorporating the perceptions, opinions, and feelings of respondents. Similarly, surveys promote data collection from a large population base which promotes the reliability and applicability of findings through an accurate population sample. The entire process of collecting outcome data will ensure that the respondents remain anonymous. This will not only promote truthfulness in the responses provided but also enhance the ethical principle of maintaining confidentiality.
Outcome Measures
This project purposes to demonstrate that hourly rounding is an effective strategy for reducing fall incidences among elderly hospitalized patients. Therefore, the project’s positive outcome is no fall incidence/reduced fall incidences in the target population. This outcome can be determined by analyzing fall-related mortality and morbidity data, fall-related injuries and fall incidences before and after project implementation. The outcome data will be collected at specified periods after implementation such as at 3 months, 6 months and 12 months. Implementation Of Patient Care Information System In Healthcare Essay
Reliability, Validity, and Applicability of Measured Outcomes
The validity of the outcomes to be measured will be upheld by ensuring data collection procedures that are transparent and systematic. For instance, all questions in the interviews and surveys will be standardized and specific to a fall incidence, fall-related morbidity, mortality and injuries among elderly hospitalized patients. Consistent measures will be used to collect, analyze and interpret data as guided by an inclusion and exclusion criteria. This will also help in maintaining the reliability of the project’s outcomes. Since the project does not have any safety concerns for the target population, the outcomes will easily be applied.
Steps To Take If The Project Fails To Successfully Launch
If the project does successfully launch, it will be necessary to scrutinize the methods that were used. As supported by Warren et al., (2016), the scrutiny will help to identify specific areas where errors could be made influencing the project to be re-done with necessary amendments. On the other hand, suggestions to improve results and successful outcomes in future projects will be provided.

References
Ang, E., Mordiffi, S. Z., & Wong, H. B. (2011, February 5, 2011). Evaluating the use of targeted multiple intervention strategies in reducing patient falls in an acute care hospital: a randomized controlled trial. Journal of Advanced Nursing, 67(9), 1984-1992. Implementation Of Patient Care Information System In Healthcare Essay
Buckwalter, K. C., Cullen, L., Hanrahan, K., Kleiber, C., McCarthy, A. M., & Authored on behalf of the Iowa Model Collaborative. (2017). Iowa model of evidence‐based practice: Revisions and validation. Worldviews on Evidence‐Based Nursing, 14(3), 175-182.
Daniels, J. F. (2016). Purposeful and timely nursing rounds: a best practice implementation project. JBI database of systematic reviews and implementation reports, 14(1), 248-267.
Krepper, R., Vallejo, B., Smith, C., Lindy, C., Fullmer, C., Messimer, S., & Myers, K. (2014). Evaluation of a standardized hourly rounding process (SHaRP). Journal for Healthcare Quality, 36(2), 62-69.
Olrich, T., Kalman, M., & Nigolian, C. (2012, January/February 2012). Hourly rounding: A replication study. Medsurg Nursing, 21(1), 23-36.
Warren, J. I., McLaughlin, M., Bardsley, J., Eich, J., Esche, C. A., Kropkowski, L., & Risch, S. (2016). The strengths and challenges of implementing EBP in healthcare systems. Worldviews on Evidence‐Based Nursing, 13(1), 15-24. Implementation Of Patient Care Information System In Healthcare Essay

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