scholarly journals A Fall Prevention Quality Improvement Project in a Long Term Care Facility: Critical Analysis

2017 ◽  
Vol 2 (2) ◽  
Keyword(s):  
Quality Improvement ◽  
Fall Prevention ◽  
Quality Improvement Project ◽  
Term Care ◽  
Improvement Project ◽  
Prevention Education ◽  
Quality Improvement Process ◽  
Root Cause ◽  
Star Program

Falls are a main health burden among seniors, particularly in long term care facilities. A fall prevention quality improvement project was initiated in a geriatric care organization in Ontario, Canada. The purpose of this article is to critically analyze this quality improvement project for reducing fall incident rates by using a Six Sigma model. This quality improvement project consists of conducting a root cause analysis in post fall huddles, “Falling Star” program, and providing fall prevention education for residents and families. The strengths of this quality improvement process include the root cause analysis in post fall huddles and fall prevention education. Some limitations in this quality improvement process include insufficient collaboration with inter-professional team members and the exclusion of residents who are at fall risk, but had not fallen. Three recommendations are provided to increase the possibility of success for this project, including a monthly inter-professional fall safety meeting, the expansion of the “Falling Star” program for all residents at risk of falls, and staff education and training

scholarly journals Exploration of a quality improvement process to standardised preoperative tests for a surgical procedure to reduce waste

2021 ◽  
Vol 10 (3) ◽  
pp. e001570
Author(s):  
Rabia Shahid ◽  
Malone Chaya ◽  
Ian Lutz ◽  
Brian Taylor ◽  
Lily Xiao ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Root Cause Analysis ◽  
Quality Improvement Project ◽  
Improvement Strategy ◽  
Improvement Project ◽  
Cause Analysis ◽  
Quality Improvement Process ◽  
Root Cause ◽  
Time To Build ◽  
Unnecessary Testing

BackgroundPreoperative tests are done to determine a patient’s fitness for anaesthesia and surgery.Local problemAlthough routine tests before surgery in the absence of specific clinical indications are not recommended, we observed high volumes of routine preoperative tests were performed in our institution. We describe a process to implement a standardised preoperative investigational approach to reduce unnecessary testing before surgeries.MethodsA series of six Plan-Do-Study-Act (PDSA) cycles was conducted for root cause analysis and process mapping, development of standardised tool (GRID), collection of baseline data, education and feedback, pilot testing and implementation and uptake of GRID.Root cause analysis revealed a lack of awareness of guidelines and a lack of a standardised tool to guide preoperative testing. We undertook a pilot quality improvement project to reduce unnecessary testing before knee and hip arthroplasty by developing and implementing a standardised tool (GRID) and engaging all stakeholders.InterventionsA clinical development team (CDT) was formed, including all the stakeholders. Our CDT focused on a continuous rapid cycle improvement strategy.ResultsAfter implementation of the tool in a subgroup of patients undergoing elective hip or knee arthroplasty, unnecessary coagulation tests (activated partial thromboplastin time and the international normalised ratio), electrolyte/renal panel tests and electrocardiograms were reduced by 81% (91%–17%), 81% (41%–7%) and 68% (35%–11%), respectively. No surgery was delayed or cancelled due to tests not performed before surgery.ConclusionsA standardised preoperative investigational approach based on patients’ medical conditions rather than routine testing can reduce unnecessary tests before surgery. Further, implementing guidelines is more complex than developing guidelines. Hence, continuous PDSA cycles are essential to evaluate the processes in a quality improvement project. It can take time to build teams and have shared goals; however, once this is achieved, the success of a quality improvement project is certain.

scholarly journals Increasing Nurses' Knowledge and Confidence Using the Teach-back Method to Teach Fall Prevention Strategies to Residents in Long Term Care

2018 ◽  
Author(s):  
Christine Nichols
Keyword(s):  
Health Care ◽  
Quality Improvement ◽  
Fall Prevention ◽  
Long Term Care ◽  
Role Playing ◽  
Prevention Strategies ◽  
Term Care ◽  
Improvement Project ◽  
Nurses Knowledge

Fall prevention in health care settings, either acute care or long-term care, has been identified as an area of focus for quality improvement. The Joint Commission and the Centers for Medicare and Medicaid have developed goals and recommendations for all areas of health care to follow to decrease falls and improve patient and resident quality of life. Direct care nurses are relied upon to provide the education and to assist in preventing falls, but often do not measure the retention of the information provided. The purpose of this quality improvement project was to provide education on the teach-back method to nurses working in a small, family owned long-term care facility. Benner’s skills acquisition theory and Kellogg’s Logic Model were used as the theoretical framework for developing the project and education. The aim was to increase knowledge and confidence using the teach-back method. An educational program was developed to provide education to the nurses. The education was followed by the opportunity to practice using the teach-back method in a role-playing scenario. Pre and post education tests were provided to determine if the education increased the nurses’ knowledge of the method. Thirty-three percent (N=10) of the nurses employed at the facility participated. Prior to the education, 40% (n=4) of the participants felt the teach-back method was not a practical method for teaching fall prevention strategies to the residents, as compared to 80% (n=8) in the post test. With a greater focus by regulatory agencies on fall prevention programs in long-term care settings, the advanced practice registered nurse can take on the role of leader in guiding nurses through the process of improving education and resident outcomes.

Sign in / Sign up

Export Citation Format

Share Document