scholarly journals Decreasing Falls through Shared Governance

2021 ◽  
Vol 6 (1) ◽  
Keyword(s):  
Shared Governance ◽  
The Other ◽  
Evidence Based ◽  
Fall Rate ◽  
Patient Falls ◽  
Clinical Nurses ◽  
Unsteady Gait ◽  
Fall Rates ◽  
Practice Implementation ◽  
Reality Distortion

In October 2018, at the unit based forum meeting, clinical nurses evaluated patient fall rates and noticed an increase in patient falls in the Q3 2018. The Q3 2018 fall rate was 6.20. Then nurses analyzed each fall including reviewing CCTV to determine possible causes. One of the falls was due to a slip in the shower. The shower floor was tiled and became slippery when wet. Additional falls occurred in the hallway of the unit and possible causes included reality distortion, unsteady gait due to age, medications, and physical condition. In some cases they noticed the CCTV did not capture a fall because there was no camera in that section of the hallway. The clinical nurses discussed this information with the Clinical Manager, at the November 2018 staff meeting. They suggested re-surfacing the floor to prevent slipping, additional cameras mounted in the hallways, and a second monitor at the other nurses station in an effort to prevent patient falls. After implementing these interventions along with CCTV monitoring the fall rate for Q1 2020 was 2.07 and Q2 2020 was 2.66. Through shared governance, evidence based practice implementation and environment of care enhancements the fall rate decreased by 40%.

Increasing Quality and Patient Outcomes with Staff Engagement and Shared Governance

2021 ◽  
Vol 26 (2) ◽  
Author(s):  
Deborah Brennan ◽  
Lori Wendt
Keyword(s):  
Shared Governance ◽  
Planning Process ◽  
Gap Analysis ◽  
Team Building ◽  
Hospital Setting ◽  
Action Planning ◽  
Governance Structure ◽  
Interdisciplinary Teams ◽  
Clinical Nurses ◽  
Governance Process

The shared governance structure is a nursing practice model which is a hallmark of engaging the front line team into the role of leading practice excellence. The main principles of shared governance include ownership, accountability, empowerment, team building, leadership, innovation, autonomy, and practice equity. Combining these key shared governance principles with formal models can drive sustainable action planning for improvement. This article offers an exemplar describing how we improved shared governance in a community hospital setting. After evaluating findings from a gap analysis, we incorporated guiding frameworks such as the A3 action planning process; the Plan, Do, Check, Act cycle; and Lean methodologies to increase nursing engagement in the shared governance process. Clinical nurses and interdisciplinary teams developed action plans for quality and patient satisfaction improvements. We describe specific improvements to our process, offer examples of our improved outcomes, and discuss essential shared governance factors that were critical to our successes.

Predictors of Evidence-Based Practice Implementation, Job Satisfaction, and Group Cohesion Among Regional Fellowship Program Participants

2016 ◽  
Vol 13 (5) ◽  
pp. 340-348 ◽  
Author(s):  
Son Chae Kim ◽  
Jaynelle F. Stichler ◽  
Laurie Ecoff ◽  
Caroline E. Brown ◽  
Ana-Maria Gallo ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Evidence Based Practice ◽  
Group Cohesion ◽  
Evidence Based ◽  
Fellowship Program ◽  
Practice Implementation

scholarly journals The Value Equation: Three complementary propositions for reconciling fidelity and adaptation in evidence-based practice implementation

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Ulrica von Thiele Schwarz ◽  
Gregory A. Aarons ◽  
Henna Hasson
Keyword(s):  
Patient Outcomes ◽  
Theoretical Approach ◽  
Internal Validity ◽  
Implementation Strategies ◽  
Implementation Process ◽  
Evidence Based ◽  
A Value ◽  
The One ◽  
Practice Implementation ◽  
Fidelity And Adaptation

Abstract Background There has long been debate about the balance between fidelity to evidence-based interventions (EBIs) and the need for adaptation for specific contexts or particular patients. The debate is relevant to virtually all clinical areas. This paper synthesises arguments from both fidelity and adaptation perspectives to provide a comprehensive understanding of the challenges involved, and proposes a theoretical and practical approach for how fidelity and adaptation can optimally be managed. Discussion There are convincing arguments in support of both fidelity and adaptations, representing the perspectives of intervention developers and internal validity on the one hand and users and external validity on the other. Instead of characterizing fidelity and adaptation as mutually exclusive, we propose that they may better be conceptualized as complimentary, representing two synergistic perspectives that can increase the relevance of research, and provide a practical way to approach the goal of optimizing patient outcomes. The theoretical approach proposed, the “Value Equation,” provides a method for reconciling the fidelity and adaptation debate by putting it in relation to the value (V) that is produced. The equation involves three terms: intervention (IN), context (C), and implementation strategies (IS). Fidelity and adaptation determine how these terms are balanced and, in turn, the end product – the value it produces for patients, providers, organizations, and systems. The Value Equation summarizes three central propositions: 1) The end product of implementation efforts should emphasize overall value rather than only the intervention effects, 2) implementation strategies can be construed as a method to create fit between EBIs and context, and 3) transparency is vital; not only for the intervention but for all of the four terms of the equation. Summary There are merits to arguments for both fidelity and adaptation. We propose a theoretical approach, a Value Equation, to reconciling the fidelity and adaptation debate. Although there are complexities in the equation and the propositions, we suggest that the Value Equation be used in developing and testing hypotheses that can help implementation science move toward a more granular understanding of the roles of fidelity and adaptation in the implementation process, and ultimately sustainability of practices that provide value to stakeholders.

scholarly journals Comparison of the fall rate and structure of recent T-7 XBT manufactured by Sippican and TSK

2010 ◽  
Vol 7 (5) ◽  
pp. 1811-1847 ◽  
Author(s):  
S. Kizu ◽  
C. Sukigara ◽  
K. Hanawa
Keyword(s):  
Quadratic Form ◽  
Water Entry ◽  
Rate Coefficients ◽  
Fall Rate ◽  
Current Standard ◽  
Expendable Bathythermograph ◽  
Structural Differences ◽  
Fall Rates ◽  
The Difference ◽  
Temperature Depth

Abstract. The fall rate of recent T-7 expendable bathythermograph (XBT) is evaluated based on a series of concurrent measurement with a calibrated Conductivity Temperature Depth profiler (CTD) in the sea east of Japan. An emphasis is placed on comparing the fall rates of T-7 produced by the two present manufacturers, the Lockheed Martin Sippican Inc., and the Tsurumi Seiki Co. Ltd., which have been believed to be identical but had never been compared directly. It is found that the two manufacturers' T-7 fall at rates different by about 3.5%. The Sippican T-7 falls slower than the current standard equation by Hanawa et al. (1995) gives by about 2.1%, and the TSK T-7 falls faster than it tells by about 1.4%. The fall-rate coefficients estimated based on the present sea test by applying the equation of traditional quadratic form, d(t)=at−bt2 where d is depth in meters and t is the time elapsed, since the water entry of the probe, in seconds, are a=6.553 and b=0.00221 for the LMS T-7, and a=6.803 and b=0.00242 for the TSK T-7. By detail examination of the probes, it is revealed that the two companies' T-7 have different total weight and many structural differences. Because the difference in the fall rate is about twice larger than the difference in weight (about 2%), it is inferred that those structural differences give sizable impact to the difference in their fall rates. Our results clearly show that the recent T-7 of the two companies needs to be discriminated.

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