Utilizing Assessment Tools in Decreasing Fall Risk Among Community-Dwelling Adults: A Quality Improvement Project

2021 ◽  
pp. 108482232110347
Author(s):  
Justin Fontenot
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Home Care ◽  
Fall Risk ◽  
Community Dwelling ◽  
Quality Improvement Project ◽  
Assessment Tools ◽  
Post Intervention ◽  
Improvement Project ◽  
The Mean

Although there are standardized fall risk assessment tools in home care clinical practice, there are no standardized tools to reduce fall risk. This quality improvement project aims to test the adaptability of the Fall TIPS (Tailoring Interventions for Patient Safety) tool among the community-dwelling adult population by measuring the impact of the tool’s implementation on client fall risk. Participants included n = 54 clients enrolled in home care and n = 14 members of the clinical team. This project used a quantitative method with a quasi-experimental pre-and post-intervention design. The quality improvement project implemented the Fall TIPS tool, and fall risk was measured using the Morse Fall Risk Assessment (MFRA). The Fall TIPS tool was provided to participants by visiting staff, and interventions were selected based on the participant’s assessment. Participants’ fall risk was scored during in-person home visits, and the results were recorded in the electronic health record. A dependent 2-tailed t-test measured the variance of means between the pre-and-post groups. The pre-intervention MFRA score mean was 63.43 ± 22.52; p = .000 and the mean score in the post-intervention group was 58.15 ± 22.49; p = .000. The mean difference between the pre-and post-groups was 5.28. Implementing the Fall TIPS toolkit in the home care clinical setting reduced fall risk post-intervention and offered tools for future evaluation in home care settings.

Risk Assessment for Skin Breakdown in the Perioperative Population: A Quality Improvement Project

2013 ◽  
Vol 28 (3) ◽  
pp. e20
Author(s):  
Helen Mandal ◽  
Kathleen Neville ◽  
Ina Cherepaha-Kantorovich ◽  
Nancy Parslow
Keyword(s):  
Risk Assessment ◽  
Quality Improvement ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Skin Breakdown

scholarly journals Nurse’s Knowledge of Early Ambulation of the Post Operative Patient and Complication Prevention: A Quality Improvement Project

2021 ◽  
Author(s):  
Meghan Carides
Keyword(s):  
Quality Improvement ◽  
Patient Outcomes ◽  
Nursing Intervention ◽  
Educational Programs ◽  
Quality Improvement Project ◽  
Complication Rates ◽  
Improvement Project ◽  
Nursing Knowledge ◽  
Early Ambulation ◽  
The Mean

Ambulation is the single most important nursing intervention in the prevention of postoperative complications. It is also a key component in maintaining optimal patient outcomes. Current literature has revealed that when ambulation is initiated early there is a marked decrease in pain, length of hospital admission, and overall complication rates. However, even with this depth of evidence early postoperative ambulation on the two surgical units at a teaching hospital in Rhode Island, patient ambulation continues to be inconsistent. The purpose of this quality improvement project is to improve nursing knowledge regarding early ambulation after surgery for the prevention of post-operative complications. This project utilized a pretest, educational in-service intervention, and posttest design. Seventeen out of a possible 22 surgical nurses participated in this project (N= 17, 77%). The educational in-service sessions combined information from an extensive literature review in the form of a 10-minute Power Point presentation. Pre and post tests were made up of 5 knowledge-based and 5 opinion-based questions. The mean scores for the pretest were 74% while the mean scores for the posttest were 95.2%. There was a 35% increase in overall scores following the educational intervention. APRNs play a pivotal role in establishing and implementing educational programs. This project aimed to recognize a need for ongoing education about postoperative ambulation for the surgical unit nurses. Educational programs about postoperative ambulation and complication prevention should be routinely incorporated in future trainings to ensure improved nursing knowledge and patient outcomes.

scholarly journals Examining trainee awareness of dermatoses and dermatological assessments during acute admissions (A quality improvement project)

2018 ◽  
Vol 17 (3) ◽  
pp. 137-143
Author(s):  
Priya Patel ◽  
◽  
Natalie King ◽  
Keyword(s):  
Quality Improvement ◽  
Elderly Patients ◽  
Skin Care ◽  
Quality Improvement Project ◽  
Psychological Consequences ◽  
Post Intervention ◽  
Improvement Project ◽  
Care Bundles ◽  
Trust Hospital ◽  
Acute Admissions

Studies demonstrate 67% of elderly patients can have dermatoses, which could result in functional and psychological consequences. Elderly presentations are further complicated by comorbidities and polypharmacy. This combined with limited dermatology training at undergraduate and postgraduate levels creates diagnostic challenges. This project investigated dermatology assessments by trainees using the Trust’s acute medical admissions proforma. 100 proforma were reviewed for skin assessments alongside nursing skin care bundles. Subsequently, a skin survey was conducted amongst trainees evaluating knowledge and confidence when diagnosing and managing common dermatoses. Successively, a dermatology teaching series was delivered. Post-intervention the above were reassessed, demonstrating improvements in most areas. The dermatology teaching series will continue alongside a Trust hospital guideline to sustain improvements in dermatological care on admission.

Please reconcile, not wait a while

2019 ◽  
Vol 105 (2) ◽  
pp. 122-126
Author(s):  
Ashifa Trivedi ◽  
Sadhna Sharma ◽  
Richa Ajitsaria ◽  
Nicola J Davey
Keyword(s):  
Quality Improvement ◽  
District General Hospital ◽  
Quality Improvement Project ◽  
Improvement Project ◽  
Acute Setting ◽  
Paediatric Department ◽  
Medicines Reconciliation ◽  
The Mean ◽  
Patient Safety Incidents ◽  
Main Factor

A quality improvement project to increase the rate of paediatric medicines reconciliation was carried out in a district general hospital between April and July 2018. Baseline data collected from our paediatric ward shows that medicines reconciliation by doctors is only accurately completed 50% of the time. Evidence shows that medicines-related patient safety incidents are more likely when medicines reconciliation happens more than 24 hours after a person is admitted to an acute setting. The aim of this quality improvement project was therefore to ensure that 100% of paediatric patients have their regular medications prescribed by mid-day the day after admission. The paediatric pharmacy team reviewed all paediatric inpatient drug charts from Monday to Friday for 12 weeks. The number of regular medications and the number of medicines reconciled was recorded each day. The effectiveness of various interventions were reviewed using Plan–Do–Study–Act cycles. On average, 40 patients were reviewed each week. The mean reconciliation rate was 79%, and the worst rate was 0%. 100% reconciliation was achieved on 34 occasions and was achieved continuously for the last 3 weeks of data collection. A repeat audit carried out in September 2018 found the reconciliation rate was maintained at 100%. Multiple interventions occurred during this quality improvement project: teaching sessions for doctors, posters to raise awareness and questionnaires for parents/children to complete about their regular medications. The main factor for success in this project has been involving all members of the paediatric department including children and their parents.

Poster 117: Pain Assessment Survey (PAS) for Assessing Physical Pain in Post-Cerebrovascular Accident (CVA) Patients Post Intervention: Quality Improvement Project

PM&R ◽  
2017 ◽  
Vol 9 ◽  
pp. S172-S172
Author(s):  
Kirill Alekseyev ◽  
Nikhil Verma ◽  
Swathy Sreekumar ◽  
Amarin Suriyakhamhaengwongse ◽  
Malcolm Lakdawala ◽  
...  
Keyword(s):  
Quality Improvement ◽  
Pain Assessment ◽  
Cerebrovascular Accident ◽  
Quality Improvement Project ◽  
Physical Pain ◽  
Post Intervention ◽  
Improvement Project ◽  
Assessment Survey

scholarly journals Using quality improvement to standardise and enhance the use of the national early warning score (NEWS) in an old age psychiatry inpatient setting

BJPsych Open ◽  
2021 ◽  
Vol 7 (S1) ◽  
pp. S38-S39
Author(s):  
Fraser MacNicoll ◽  
Mong Sun Tung ◽  
Brion McGowan
Keyword(s):  
Quality Improvement ◽  
Old Age ◽  
Quality Improvement Project ◽  
Assessment Process ◽  
Early Warning Score ◽  
Post Intervention ◽  
Improvement Project ◽  
Physical Deterioration ◽  
Increased Risk ◽  
Old Age Psychiatry

AimsWithin an inpatient old-age psychiatry setting, there is an increased risk of acute physical deterioration secondary to age, comorbidities and reduced physiological reserve. Numerous recent clinical incidents highlighted late recognition of physical deterioration within this population. We assessed the use of the NEWS, a system for scoring physiological measurements, in an old-age psychiatry ward and subsequently attempted to improve performance of obtaining physical health observations in this cohort of patients.MethodRetrospective pre- and post- quality improvement study in a twenty bed Old Age Psychiatry Ward in East Lothian Community Hospital, Haddington, Scotland. Data were collected from 12th October – 16th November, 2020 (pre- period) and from 16th November 2020 to 15th February, 2021 (post- period). The primary process measure was ensuring all patients had at least one full set of physical observations at least once a week, or more frequent as deemed clinically appropriate. Secondary measures included ensuring NEWS scores were accurately calculated and improved documentation. This was tracked using a run chart. Improvement activities focused on increased awareness, effective training, key stakeholder buy-in and reviewing trust policy.ResultThe percentage of NEWS documented for all patients at least once a week improved from a mean of 28.7% (31/108) in the 6 weeks prior to intervention, to a mean of 71.4% (125/175) in the following 13 weeks. The minimum required physical observations required to accurately calculate a NEWS improved from 51.6% (16/31) pre-intervention to 95.2% (119/125) post-intervention and NEWS being calculated correctly increased from 80.6% (25/31) to 96% (120/125). Documentation of a reason why physical observations were not taken increased from 2.5% (2/77) to 62% (31/50) pre- and post- intervention respectively.ConclusionThis quality improvement project highlighted that recording of physical observations and use of NEWS was inadequate in this setting, increasing the risk of a delay in identification of acute physical deterioration and thus increase morbidity and mortality. Introducing simple measures and standardising the NEWS assessment process, along with senior nursing and medical oversight, greatly enhanced acquiring and recording of physical observations and NEWS scores. This quality improvement project has shown that practical solutions and staff education can increase efficacy and are hoping further input can consolidate the gains achieved and lead to continued improvements.

scholarly journals A Systematic Review of the Guidelines and Delphi Study for the Multifactorial Fall Risk Assessment of Community-Dwelling Elderly

2020 ◽  
Vol 17 (17) ◽  
pp. 6097
Author(s):  
Jieun Kim ◽  
Worlsook Lee ◽  
Seon Heui Lee
Keyword(s):  
Systematic Review ◽  
Risk Assessment ◽  
Delphi Study ◽  
Fall Risk ◽  
Assessment Tool ◽  
The Elderly ◽  
Community Dwelling ◽  
Assessment Tools ◽  
Risk Assessment Tool ◽  
Fall Risk Assessment

As falls are among the most common causes of injury for the elderly, the prevention and early intervention are necessary. Fall assessment tools that include a variety of factors are recommended for preventing falls, but there is a lack of such tools. This study developed a multifactorial fall risk assessment tool based on current guidelines and validated it from the perspective of professionals. We followed the Meta-Analysis of Observational Studies in Epidemiology’s guidelines in this systematic review. We used eight international and five Korean databases to search for appropriate guidelines. Based on the review results, we conducted the Delphi survey in three rounds; one open round and two scoring rounds. About nine experts in five professional areas participated in the Delphi study. We included nine guidelines. After conducting the Delphi study, the final version of the “Multifactorial Fall Risk Assessment tool for Community-Dwelling Older People” (MFA-C) has 36 items in six factors; general characteristics, behavior factors, disease history, medication history, physical function, and environmental factors. The validity of the MFA-C tool was largely supported by various academic fields. It is expected to be beneficial to the elderly in the community when it comes to tailored interventions to prevent falls.

Improvement in Herpes Zoster Vaccination in Patients with Rheumatoid Arthritis: A Quality Improvement Project

2016 ◽  
Vol 44 (1) ◽  
pp. 11-17 ◽  
Author(s):  
Heena Sheth ◽  
Larry Moreland ◽  
Hilary Peterson ◽  
Rohit Aggarwal
Keyword(s):  
Rheumatoid Arthritis ◽  
Quality Improvement ◽  
Herpes Zoster ◽  
Immunosuppressive Therapy ◽  
Eligible Patient ◽  
Quality Improvement Project ◽  
Post Intervention ◽  
Improvement Project ◽  
Intervention Phase ◽  
Vaccination Rates

Objective.To improve herpes zoster (HZ) vaccination rates in high-risk patients with rheumatoid arthritis (RA) being treated with immunosuppressive therapy.Methods.This quality improvement project was based on the pre- and post-intervention design. The project targeted all patients with RA over the age of 60 years while being treated with immunosuppressive therapy (not with biologics) seen in 13 rheumatology outpatient clinics. The study period was from July 2012 to June 2013 for the pre-intervention and February 2014 to January 2015 for the post-intervention phase. The electronic best practice alert (BPA) for HZ vaccination was developed; it appeared on electronic medical records during registration and medication reconciliation of the eligible patient by the medical assistant. The BPA was designed to electronically identify patient eligibility and to enable the physician to order the vaccine or to document refusal or deferral reason. Education regarding vaccine guidelines, BPA, vaccination process, and feedback were crucial components of the project interventions. The vaccination rates were compared using the chi-square test.Results.We evaluated 1823 and 1554 eligible patients with RA during the pre-intervention and post-intervention phases, respectively. The HZ vaccination rates, reported as patients vaccinated among all eligible patients, improved significantly from the pre-intervention period of 10.1% (184/1823) to 51.7% (804/1554) during the intervention phase (p < 0.0001). The documentation rates (vaccine received, vaccine ordered, patient refusal, and deferral reasons) increased from 28% (510/1823) to 72.9% (1133/1554; p < 0.0001). The HZ infection rates decreased significantly from 2% to 0.3% (p = 0.002).Conclusion.Electronic identification of vaccine eligibility and BPA significantly improved HZ vaccination rates. The process required minimal modification of clinic work flow and did not burden the physician’s time, and has the potential for self-sustainability and generalizability.

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