NRS 465 Benchmark – Capstone Project Change Proposal Dissemination and Reflection Benchmark – Capstone Change Project Implementation Plan

Summary of the Problem or Issue

The identified issue involves patient falls among the geriatric population with over 1 million fall-related hospitalizations happening every year and leading to adverse effects. Falls are a patient safety concern as they lead to injuries like head fractures, increased cost of care, and longer stays in hospitals with patients susceptible to comorbidities (Roberts et al., 2020). As such, nurses need to implement evidence-based interventions to reduce and prevent the increasing prevalence of falls among elderly adults in their practice settings.

Proposed Solution

The proposed solution entails implementing hourly purposeful rounding in the facility to reduce and prevent the occurrence of falls. The assessment of the practicum site and the evaluation of existing literature support the implementation of purposeful rounding because of its benefits to patients and healthcare providers. The selected intervention will involve a consideration of sociocultural and linguistic aspects through effective communication to enhance the safety of the target population. Elderly individuals are susceptible to falls because of the fragility of their bodies and the use of medications due to age-associated conditions like dementia and schizophrenia. In their study, Gliner et al. (2022) note that hourly rounding by nurses in acute settings leads to better patient experience and outcomes since nurses can notice patients struggling to move; which increases their susceptibility to falls.

Khawaja et al. (2023) observe that hourly rounding ensures that healthcare providers like nurses have sufficient data on patient progress and closely monitor every patient to reduce the possibility of falling. Again, Anu (2021) shows that rounding improves patient safety by reducing falls within the facility. Studies by Leamy et al. (2023) Roberts et al. (2020) and Allari et al. (2020) demonstrate the effectiveness of the proposed intervention as it helps reduce falls and improve overall patient safety. Further, the studies are categorical that effective rounding ensures providers work in collaborative teams to attain quality outcomes. Di Massimo et al. (2022), Ryan et al. (2022), Sims et al. (2020), and Rasmussen et al. (2022) all agree that intentional hourly rounding by nurses plays a significant role in reducing falls and improving patient care outcomes. Therefore, the proposed solution will lead to a better patient experience and a lower rate of falls by 40% within three months.

Implementation Steps and Impact on Nursing Practice

Implementing the proposed solution in the practicum site will entail certain steps to achieve the intended objectives.

a). Assessment, identification, and development of the program

The initial step will be to assess and identify the magnitude of the problem through using data from the organization. For instance, the current data shows that ten falls occur each week at the practicum site. Secondly, the practicum site lacks an EBP intervention to curb these falls apart from normal rounding by nurses and other providers. The facility will develop the program using existing evidence and create a team to plan, implement, and evaluate.

b). Planning and Training

The selected team comprising nurse managers and leaders in the senior department will plan by gathering all requirements, communicating the need for change, engaging all stakeholders, and seeking resources and approval from the organizational management. The plan will also entail training nurses on the proposed intervention, its benefits, and strategies to implement it.

c). Implementation

Upon training and availing of sufficient resources, the practicum site will implement the intervention in one ward to evaluate its effects. The pilot implementation will take a week as providers gather data on the number of falls and tailor strategies for each patient. The facility has an average of 20 elderly patients at any time in the geriatric unit with at least five reporting falls each week. Based on the outcomes of the pilot implementation, the facility will roll out the project as part of its routine patient safety procedures and care provision.

d). Monitoring and Evaluation

Continuous monitoring of the implementation of the intervention and evaluation of its effects on the population will entail daily reports and documentation of the number of falls (Melnyk & Fineout-Overholt, 2022). The evaluation will involve quantitative measures like gathering data on the number of falls before and after the implementation to ascertain the effects of the intervention.

f). Impact of Nursing Practice

The implementation of purpo