DashboardAnalysis and Nursing Plan
DashboardAnalysis and Nursing Plan
NursingSensitive Indicators are used to measure the quality of nursing careprocesses, structures, and outcomes. These indicators can helphospitals evaluate the extent of the impact of nursing care onpatients’ satisfaction, safety and quality of healthcare services.It is important to understand the information collected on thesedashboards and to apply the data towards implementing interventionsthat can improve patient outcomes. The following paper will analyzethe data from the sample dashboard and identify a performance gap.The paper will proceed to provide a description of the identifiedindicator and will present various nursing plans on how to improveperformance in this area.
Thispaper will focus on patient falls as the area of performance toevaluate. The dashboard sample presents data collected over fourquarters alongside National Database of Nursing Indicators (NDNQI)targets for each quarter. The goal for patient falls was only metonce out of the four quarters. In the first quarter, the recordedfalls were 6.96 there was a drastic improvement in the secondquarter with no record of any patient falls. However, this changed inthe third quarter with 5.97 falls and 9.19 in the fourth quarter. Theorganization may have implemented protocols to mitigate the patientfalls, but they still occurred. As such, there is need to evaluatethe organization’s fall protocol and to introduce new strategies tomeet the NDNQI targets.
Theimplementation of a risk assessment tool is the first recommendation.Risk assessment is a significant element in most falls preventionprograms since it allows the medical care team to pay more attentionto the patients who are at high risk of falling. Risk assessmentinvolves using different scales to determine patients who requiremore attention (Hempel et al., 2013). According to Gu et al. (2016),some of the scales used in this assessment are the St. Thomas RiskAssessment Tool in Falling (STRATIFY) and the Morse Fall Scale. TheMorse Fall Scale gauges a patient’s risk of fall by evaluatingtheir diagnoses, history of falls and the severity of their medicalcondition. It also checks whether a patient requires aid to move,their gait status and mental health (Gu et al., 2016). All these arefactors that can contribute to a patient’s fall. The STRATIFY scalecannot be easily generalized as the Morse Fall Scale, but it ismostly used to predict falls in geriatric patients. The scores onthese scales determine the interventions used on the patients. Theseinterventions include communication to other caregivers, door signsor coded armbands, staff assignment, provision of patient aids, andenvironmental upgrades such as lighting and hand rails (Spoelstra,Given, & Given, 2012).
Secondly,the implementation of a fall prevention program is necessary once therisk of falling is assessed using the risk assessment tools. Thisprogram involves the identification of environmental issues thatshould be addressed to reduce the occurrence of patient falls and toimplement a standard operating procedure to be used by all medicalcare professionals (Gu et al., 2016). The fall prevention program canstart by providing assistive devices for patients. Hospitals can askpatients to call for help when they need to move around, and they canmake it easier for them by placing nurse call buttons within theirreach. Also, a patient can be issued with devices like canes orwalkers and non-skid footwear to reduce the risk of falls. Hospitalscan ensure that the patient’s environment is well lit and does nothave any obstacles (Spoelstra et al., 2012). Also, they should addsupport equipment such as handholds and side rails to prevent falls.
Thereare interventions that medical professionals can make to a patients’direct care. For instance, they should consider the effects ofcertain drugs when planning to move patients. Also, there should bean effective and efficient communication strategy to notifyprofessionals in the patient’s care team about the individual’srisk of falls. Gu et al. (2016) explain that most falls take placeduring visiting hours. As such, it is important to educate thepatient’s family about the patient’s plan of care, associatedrisks and ways to prevent falls. Family members should be informed ofthe need to monitor the patients to prevent falls.
Thefinal proposed nursing plan is a post-fall follow-up to ensure theimplementation of effective operating procedures to prevent patientfalls. If a fall occurs, the care team should conduct a post-fallanalysis to understand their roles and mistakes (Spoelstra et al.,2012). The analysis should be influenced by their determination totackle the underlying problem that resulted in the fall. A post-fallanalysis should be a discussion about what led to the fall, proposedsolutions and a modification of the plan of care to prevent otherfalls. Raising awareness about every individual’s responsibility inpreventing falls can decrease the likelihood of overlooking factorsthat may have led to the patient`s fall. This analysis makes itpossible for medical professionals to take preventive action againstpatient falls.
Theoccurrence of falls in a hospital can lead to complications of thepatient’s medical condition. Most falls are preventable, and thereare many ways to do this. Risk assessment is necessary to determinethe patients who are at a high risk of falling. By identifying thesepatients, the medical professionals can pay more attention to them,or they can implement the necessary care procedures tailored forthese patients. The second procedure to follow this assessment is theintroduction of interventions to prevent the patient falls. Theinterventions include providing walking aids, improving the lighting,adding support bars and adding door signs to identify the patientsthat medical professionals should pay more attention to due to theirhigh risk of falling. Finally, not all falls can be prevented, andwhen a fall occurs, it is important to conduct a post-fall analysis.During this analysis factors that contributed to the fall areidentified, and it makes it possible to modify the operatingprocedures to reduce future falls.
Gu,Y. Y., Balcaen, K., Ni, Y., Ampe, J., & Goffin, J. (2016). Reviewon prevention of falls in hospital settings. ChineseNursing Research, 3(1),7-10.
Hempel,S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B., …& Ganz, D. A. (2013). Hospital fall prevention: a systematicreview of implementation, components, adherence, andeffectiveness. Journalof the American Geriatrics Society, 61(4),483-494.
Spoelstra,S. L., Given, B. A., & Given, C. W. (2012). Fall prevention inhospitals: an integrative review. Clinicalnursing research, 21(1),92-112.