Capstone. How to reduce fall rates in post-operative patients on the surgical unit

The organization is an acute inpatient surgical unit setting (a multicultural stakeholder hospital)
Before making a case for an evidence‐based project, it is essential to understand the culture of the organization in order to begin assessing its readiness for EBP implementation. Select an appropriate organizational culture survey tool and use this instrument to assess the organization’s readiness.
1. Develop an analysis of 250 words from the results, addressing your organization’s readiness level, possible project barriers and facilitators, as well as how to integrate clinical inquiry.
2. Make sure to include the rationale for the survey categories scores that were significantly high and low, incorporating details and/or examples. Also explain how to integrate clinical inquiry into the organization, providing strategies that strengthen the organizations weaker areas.
3.Formulate PICOT question for the intended proposal Capstone. How to reduce fall rates in post-operative patients on the surgical unit
(How to reduce fall rates for the post-operative patients in the surgical unit)
3.
4. Submit a summary of your results.

Reducing Fall rates in Post-operative Patients In The Surgical Unit

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Introduction

Melynyk & Fineout-Overholt (2015) highly recommend the adoption and implementation of evidence-based practice as the most effective problem-solving approach in clinical practice. This is attributed to the fact that it incorporates the best available scientific evidence from studies and the preferences/values of patients with a clinician’s expertise in clinical decision making regarding patient care (Solomons & Spross, 2011). This paper discusses the adoption and implementation of EBP to reduce the fall rates among post-operative patients in the surgical unit of an acute inpatient surgical unit with multicultural stakeholders. An assessment of the organization’s readiness level to implement EBP, which can transform its culture through new practices, knowledge, values and attitude, will be discussed. Using the System-Wide Integration of Evidence Based Practice Survey, an analysis of the most potential facilitators and barriers for implementing EBP will be provided.

Organizational Readiness

Based on the survey results, this organization is ready to implement EBP. Majority of its staff are aware of the processes involved in nursing EBP and are committed to team up with other stakeholders to improve practice in the surgical unit. Besides, they are fully aware on the need for change in practice in line with the organization’s philosophy as revealed in its mission, vision, goals and objectives.

Barriers For The Implementation of EBP

The barriers to the implementation of EBP in this organization include organizational characteristics, individual characteristics of nurses and the nature of research material. It is likely that nurses may lack the skills needed to locate research details and prefer to seek the same information from colleagues as compared to searching a textbook or journal article. Other nurses might be unable to critically appraise or synthesize literature or lack computer and search skills. At organizational level, possible barriers include: lack of time to retrieve information that is clinically relevant since the surgical unit serves a large geographical area. Additionally, despite the fact that nurses are fully aware of the essence of research-based knowledge, the majority consider research as an overwhelming process. As recommended by Melynyk & Fineout-Overholt (2015), in order to integrate it into clinical practice, they need direction and more guidance. Capstone. How to reduce fall rates in post-operative patients on the surgical unit

Facilitators For The Implementation of EBP

The organization’s leadership is committed towards providing quality services to its patients. Therefore, it has maintained a good relation with staff and other stakeholders. Its leadership has a similar vision, mission, goals and objectives for practice with stakeholders. In order to change the culture of an organization through new practices, it is essential that the change should be consistent with the organization philosophy with adequate resource to support the intended change (Yano, 2014).

The organization’s healthcare environment promotes the independence, power and authority of nurses in clinical practice. This will undoubtedly increase the integration of EBP. Besides, the organization recently adopted the use of collaborative healthcare teams to provide culturally competent care to clients. Therefore, the ability of nurses to change a clinical practice can easily be made with the input, consent and approval of other stakeholders including: physicians, hospital administrators and other healthcare team members. Working in multidisciplinary teams will inarguably increase the success of implementation. According to Yano (2014), the use of multidisciplinary teams might bring tension among staff. However, this will be addressed by having clearly defined roles and responsibilities of each member.

The EBP has a dedicated leader with the following characteristics: positive, enthusiastic, self-driven, good interpersonal and communication skills and adequate knowledge regarding the project. The leader is also the nurse-in-charge of the surgical unit. This level of hierarchy gives her credibility in front of medical staff and other stakeholders. Lastly, staffs working in the surgical unit have recently realized a remarkable increase in fall incidences among post-operative patients. This has promoted awareness on the need for practice change and ownership of the implementation by clinicians, leaders and nurses. Capstone. How to reduce fall rates in post-operative patients on the surgical unit

PICOT Question

Among post-operative patients in the surgical unit (P), how does bedside shift report (I) compared to reports outside the patient’s room(C) help to reduce fall rates (O)?

References

Ackerman, D. B., Trousdale, R. T., Bieber, P., Henely, J., Pagnano, M. W., & Berry, D. J. (2010). Postoperative patient falls on an orthopedic inpatient unit. The Journal of arthroplasty, 25(1), 10-14.

Melynyk, B. & Fineout-Overholt, E. (2015). Evidence-based practice in nursing and healthcare. A guide to best practice (3rd ed.). China: Wolters Kluwer Health.

Ofori-Atta, J., Binienda, M., & Chalupka, S. (2015). Bedside shift report: Implications for patient safety and quality of care. Nursing2018, 45(8), 1-4.

Solomons, N. M., & Spross, J. A. (2011). Evidence‐based practice barriers and facilitators from a continuous quality improvement perspective: an integrative review. Journal of nursing management, 19(1), 109-120.

Yano, E. M. (2014). The role of organizational research in implementing evidence-based practice: QUERI Series. Implementation Science, 3(1), 1. Capstone. How to reduce fall rates in post-operative patients on the surgical unit