Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls

Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls Hello please find attached papers. Go through the suggested comments and make changes please. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls revised_dpi_project_proposal_2019__2_.docx graded_commented_revised_dpi_project_proposal_2019__1___1_.docx rubric_print_format.xlsx Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsSubmitted byNjideka Laura Akubuilo DPI Project CommitteeShiela A. Leander, R.N, PH.D., C.C.CSusan. Revero, R.N, MSNDirect Practice Improvement Project ProposalDoctor of Nursing PracticeGrand Canyon UniversityPhoenix, ArizonaMarch 03, 2019 Table of Contents List of Tables iv List of Figures v Chapter 1: Introduction to the Project 1 Introduction 1 Background of the Project 3 Problem Statement 5 Purpose of the Project 6 Clinical Question 6 Advancing Scientific Knowledge 8 Significance of the Project 10 Rationale for Methodology 11 Nature of the Project Design 12 Definition of Terms 13 o Telesitter 13 o Patient-falls 13 o Caregiver 13 o Impromptu patient calls 13 o Impromptu caregiver calls 13 o Elderly patients 13 o Panic 14 o Anxiety 14 o Fear 14 o Fall rate 14 o Fallarm 14 Assumptions, Limitations, Delimitations 14 Summary and Organization of the Remainder of the Project 15 Chapter 2: Literature Review 18 Introduction to the Chapter and Background to the Problem 18 Theoretical Foundations and/or Conceptual Framework 22Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls Review of the Literature 23 Falls and their effects on patients and hospitals. 23 Factors related to falls. 27 Fall prevention interventions including Telesitter type systems, Fallarm wearable devices, and fall risk assessments. 31 Literature findings on the variables. 35 Summary 39 References 41 List of TablesTable 1. Correct Formatting (Note: single-space table titles; double-space between entries)List of FiguresFigure 1. Graphic of Teacher Years of Experience (Note: single-space figure titles; double-space between entries) Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsPatient falls in hospitals remain one of the biggest issues facing the healthcare sector. It leads to the patient incurring injuries, deaths, extended hospital stays, and equally high medication costs (Chan, 2015). Although there are many interventions put in place to help prevent patient falls, it remains one of the most challenging issues in the healthcare sector, especially in the acute care setting. As such, finding the most reliable and effective patient-falls prevention method is the key in enhancing the quality of patient care and patient satisfaction. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThis project focuses on identifying the challenges associated with the Telesitter monitoring technology in preventing patient falls. The working mechanism of the Telesitter systems is closely related with that of bed alarms and sensors, and the resultant effect of using the two systems is expected to be the same concerning their effectiveness (Shorr et al., 2013). This exposes the Telesitter systems to the same challenges posed by the bed alarms. One such instance is when the video observer in the Telesitter systems abruptly starts conversation with a specific patient, which can cause panic and disturbance among patients. This scenario can cause the Telesitter system to be associated with many downsides that can enhance the rate of patient falls rather than help in preventing patient falls (El-Khoury, Cassou, Charles, & Dargent-Molina, 2013).In order to enhance the effectiveness of this phenomenal and important tool in the healthcare sector, this research will find solution to the challenges associated with the Telesitter systems. Apart from that, the use of the Fall alarm equipment alongside the Telesitter systems is encouraged for the high fall-risk patients (Davis, Kutash & Whyte, 2017). This device is beneficial because it will help in detecting high fall risk situations and alert the patient as well as the caregivers. Fall alarm is a small wearable wrist device that can detect patient movements and positions, and warn the patient whenever the fall-risk rises (Delahoz & Labrador, 2014). The device has mini speakers where the patient can communicate with a caregiver, visual feedback component and tactile feedback component (Davis, Kutash & Whyte, 2017). The device uses inertial sensor to detect the position and movements of the patient. The device warns the patient of high fall-risk by flaring a light alert. The lighting system gives red, amber, and green to indicate high fall risk, medium fall risk, and low fall risk respectively. The device also has a tactile system that uses pager motor to tap the user consistently whenever their fall risk levels rise (Davis, Kutash & Whyte, 2017). The system also notifies the caregiver whenever a patient’s movements or position translates to high fall risk. This enables the caregivers to attend to patients that need immediate attention, thus helping to reduce falls. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsAlthough studies have in the past focused on the benefits of the Telesitter technology in preventing patient falls, no study has yet ventured in finding out the disadvantages of using this technology in the acute care setting (McCurley & Pittman, 2014). In light of this, this project will be unique and beneficial in the healthcare sector because it will help to fix the challenges associated with the Telesitter monitoring systems, helping this phenomenal tool to further reduce the rate of falls when used as a falls reduction intervention. According to Davis, Kutash & Whyte (2017), the use of Telesitter monitoring systems as opposed to in-room sitters helped to reduce fall rate by 6%. Considering the technological advantage of Telesitters, this reduction rate is small and there is need to fix the possible challenges associated with the tool to ensure that it has higher capability of reducing falls significantly. Fixing these challenges, as well as combining with the use of Fall alarm devices among the high fall risk patients is deemed to offer a better solution to the challenge of patient falls in the healthcare sector (Delahoz & Labrador, 2014). Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsBackground of the ProjectPatient falls, especially in the acute care setting, have been a long time problem in the healthcare sector. Although many solutions have been adopted to prevent patient falls, the incidence of patient falls across the United States has remained alarmingly high. Currently, at least 700,000 to 1 million patients exhibit falls in the healthcare setting each year (AvaSys, 2014). Among those who experience falls, at least 30% and above exhibit serious injuries that result in extended hospital stay or even death due to head injuries (Pearson & Coburn, 2011). On average, each single patient fall costs the healthcare system and the patients an extra $14,000 (AvaSys, 2014). In 2008, the Centers for Medicare & Medicaid Services classified patient falls as a hospital-acquired condition and withdrew compensation for the complications that ensued (AvaSys, 2014). Considering that the costs associated with patient falls are not payable by Medicaid and other third party payers, it is important that better patient fall prevention strategies be implemented to help in reducing the additional falls-related cost burden on healthcare institutions.A new milestone in the healthcare sector occurred in 2008 when the AvaSure Corporation developed the AvaSys Telesitter Solution as a technological solution to the problem of patient falls (AvaSure Holdings, 2015). Although this system is effective, it does not offer the best solution to the issue of patient falls. The main downside of this technological tool is its impromptu mode of operation where the video controller or a patient abruptly initiates communication through the device. This is mainly associated with disturbances to the other patients in the ward, who require calm environments to enhance their rest. The impromptu blaring of sound from the video operator through the system or from a patient to the video operator can cause disturbance to resting patients, which can then induce panic, anxiety, and fear among patients, leading to more falls. To the nurses, the impromptu mode of operation of the Telesitter systems can cause panic, anxiety, and nervousness among nurses, which can lead to more accidents and errors. The reliance on calls from the video operator can also lead to non-observance of the other patients. This is because the nurses will rely more on the video operator, which can derail their attention from the other patients who do not show physical signs of suffering and pain. Reliance on the video operators is also not an effective approach because the mode of operation of the Telesitter systems would fail when the video operator falls asleep or is not attentive in monitoring the patients. This challenge gives chance to the idea of combining Telesitter systems with Fallarm devices (Delahoz & Labrador, 2014). This project will also set out to find solutions to all other challenges associated with using the Telesitter systems. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsAssignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThe main problem of focus for this project is the increasing incidence of patient falls even after the implementation of the Telesitter monitoring systems as a falls prevention strategy. This project is set to find solutions to the challenges associated with using Telesitter systems as a falls prevention strategy. Telesitter systems are a technological tool, and one that offers better prospects to the clinical sector when focusing on patient monitoring and surveillance. The system was specifically designed as a falls prevention system, but has fallen below expectations in the recent years since patient falls are still on the rise (CDC, n.d.). Finding and fixing the challenges associated with the Telesitter systems is vital in enhancing the fight against patient falls.The population affected by the problem includes patients aged 40 years and older, receiving care in the acute care setting in a Southern California hospital. This project will contribute to the literature by outlining the challenges associated with the Telesitter systems, and equally offering possible lasting solutions to these challenges. It is not known whether the use of the Telesitter system could be causing panic, anxiety, and fear among patients and caregivers, which could lead to more falls, accidents, and errors in the healthcare setting. This is because the system works using observation, which has the assumption that patients that appear to be still and relaxed during observation are doing fine, but this assumption might be wrong in most cases. There is need to find out if the use of the Telesitter system decreases caregivers’ vigilance and alertness in providing care to patients. There is also an importance to investigate if the Telesitter systems are a contributory factor to some of the falls. The Telesitter system is particularly of focus because it is technological, but its mode of operation is similar to that of bed alarms and sensors, which in the past have been associated with many challenges to both the patients, as well as the caregiver. As such, the project will help in identifying the most effective solutions to the challenges associated with Telesitter systems, and thus improve its effectiveness in preventing patient falls. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsPurpose of the ProjectThe purpose of this quantitative exploratory-descriptive research is to identify the challenges associated with using the Telesitter monitoring systems in the clinical setting, and finding lasting solutions to these challenges to ensure that the Telesitter system is a reliable tool in the reduction of patient falls. The project will assess and evaluate the causes of patient falls in two wards – surgical/oncology and the progressive care units, at Southern California Hospital. Using the two units will help to identify the fall risk factors associated with the patients in these wards, which will give a more comprehensive list of the factors leading to falls despite the use of the Telesitter systems. All patients in these two units will be included in the study.This project is set to determine the effectiveness of the Telesitter systems in preventing patient falls, The findings from this project will guide in understanding the challenges associated with the Telesitter systems and how best these challenges can be addressed to ensure that it is a more effective tool in reducing patient falls. The Telesitter system is a phenomenal intervention in the fight against patient falls, ironing out its associated challenges will present a more reliable and effective tool in reducing patient falls.Clinical QuestionThe major clinical questions that will guide this project include: Question 1: What are the challenges associated with using the Telesitter monitoring system as a falls reduction intervention? Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls Question 2: What solutions can be implemented to avoid these challenges and make the Telesitter systems more reliable and effective as a falls reduction intervention? Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThe first clinical question will help in understanding the challenges associated with the Telesitter monitoring systems whereas the second question will help in understanding how these challenges can be avoided. Evaluating the rate of patient falls in the two units will help in identifying the most pertinent risk factors in reducing falls. Assessing both units will also shed light on how best the patients in the two units can be safeguarded to reduce falls. This is considering the patients in the two units have different patient characteristics, but are both highly affected by falls.The clinical PICOT elements that will guide this project include: Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient Falls The DNP student will mainly be interested in finding out how the rate of patient falls compare in the two units of intervention. Comparing the fall rate in the two units will help in understanding which factors among patients and the clinical environment are more affiliated with high risk of falling. The DNP student will also be interested in finding out the challenges associated with the Telesitter systems, which might have led to the falls in each unit. Getting the factors that led to the falls in each unit will give the DNP student a wider view on the challenges associated with using the Telesitter systems as a falls reduction strategy. Dependent Variable: Number of patient falls Independent Variable: Telesitter monitoring systems H o The Telesitter systems do not have challenges in reducing patient falls. H 1 The Telesitter monitoring systems have numerous challenges in reducing patient falls. These hypotheses will be proven by evaluating the rate of patient falls in the previous months with the fall rate during the project implementation. The survey findings from the nurses will also help to identify the challenges that led to the occurrence of falls during the project implementation period. This information will be used to formulate possible solutions to the challenges, thus help in improving the effectiveness of the Telesitter systems in reducing the rate of patient falls. Advancing Scientific KnowledgeConducting this project will have many benefits to the healthcare system. This project advances knowledge because it is set to identify the challenges associated with the Telesitter systems and their solutions, thus enhancing the effectiveness of this tool in reducing the rate of falls. Improving the effectiveness of the Telesitter systems is important because it a patient surveillance technology that enables for caring for many patients at the same time. There are many benefits associated with the use of the Telesitter systems, which makes it a vital tool in the healthcare delivery process. One benefit is that it relieves nurses the burden of worrying about the high risk patients, which helps to reduce burnout and work related stress. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThis project also advances knowledge by emphasizing that although the use of the Telesitter systems is more convenient, utilizing more caregivers in the treatment process can help to alleviate challenges that might be leading to increased falls. This standpoint is guided by two major theories – Newman’s theory of health as expanding consciousness and the Nightingale’s environment theory of nursing (Nursing Theory, n.d.). Newman’s theory of health as expanding consciousness states that health and sickness, the two opposite conditions of concern in the healthcare sector are interrelated. Patients exhibit body stressors, pain, suffering, and other adverse body reactions and require close interaction with healthy people to instill health into them through emotional, physical, cognitive interaction. Keeping the senses and body parts of the patient engaged and active can help a great deal in alleviating pain, suffering, and restore health. On the other hand, the Nightingale’s environment theory of nursing states that the patient’s environment is an important factor in the healing process. This is because the patient interacts actively and continuously with the environment and thus interacting with cleaner, more beautiful and appealing environments could enhance the rate of healing. Similarly, beautifying the patient environment with human factors is crucial in enhancing the development of good health (Masters, 2015). Beautifying the patient environment with human factors helps in understanding patient needs and preferences during their ailing, thus altering the important factors in the healing process to enhance healing. In doing this, patient falls will also be reduced considering that patients will be receiving satisfactory care. Close supervision of patients will also help to reduce the risks factors that lead to falls (Meade, Bursell, & Ketelsen, 2006). Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThe project is thus vital in the healthcare sector and it will help in showing how the use of human factors in the caregiving process is essential (Meade, Bursell, & Ketelsen, 2006). This will help in regulating the use of technological tools and systems in the healthcare sector. In this technological age, many tools and systems will be designed to assist in the healthcare sector, but the use of human factors remains an essential part of the healing process (Johnson, 2014). The use of technological tools remains a major gap in the healthcare delivery since the use of systems like the Telesitter can limit how often a patient sees a caregiver once the video operator is satisfied that the patient is doing fine and does not need assistance from a caregiver (Malasinghe, Ramzan, & Dahal, 2017). The project will advance the use of the two theories in the healthcare sector by highlighting how invaluable the use of human factors is in the patient’s environment. Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsAssignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThe findings of this project are expected to be transformative; changing the strategies used in the healthcare sector to prevent patient falls. This project is also significant because it offers new findings concerning the challenges associated with using the Telesitter systems, as well as solutions to these challenges. Identifying and fixing the challenges associated with the Telesitter systems will ultimately help in improving the effectiveness of the system in reducing patient falls. This is significant in the healthcare sector since it will help to save the $14,000 extra per patient that goes into treating fall-related conditions and ailments (AvaSys, 2014).The findings from this project will also foster and encourage the use of Nightingale’s environmental nursing theory and Newman’s nursing theory in nursing care. This is because using the theoretical principles of these theories can enhance healing, improve patient satisfaction, improve the environment state in clinical settings, and overall reduce medication costs (Masters, 2015).The findings from this project, coupled with the theoretical foundations used in this project, the Nightingale’s environmental nursing theory and Newman’s nursing theory, will help in highlighting that the use of technological tools and systems in the healthcare setting should be managed such that they do not replace human caregivers in the healthcare setting (William, 2014). This is because the theoretical guidelines emphasize on the use of human caregivers to enhance the healing process. Using human caregivers also beautifies the patient environment and gives hope to the patients, ensuring that the patients receive the best care, higher satisfaction rates, and faster healing processes (Chu, 2017).The findings from this research will help in improving the effectiveness of Telesitter systems as a falls reduction intervention. It will thus benefit patients since patients will be exposed to reduced fall risks, thus guaranteeing them better safety during their hospital stays. Safer hospital stays will in turn guarantee them reduced hospital stays and reduced pain. The patients will also benefit by getting better service delivery, and thus higher satisfaction.Rationale for MethodologyThe quantitative research methodology is the best fit for this project because it will offer analytical and numerical findings on what factors nurses consider to be the most pertinent in the reduction of falls when using the Telesitter systems. This is considering that surveys will be the main form of date collection . Statistical analysis will show which factors are more relevant and thus of high priority in the reduction of falls. The survey will be a 15-question Likert type survey and will give the respondents five options for selection.Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThis project utilizes the exploratory-descriptive research design. This design entails the use of data findings to compile information and meaningful statistical analyses that will lead into formulation of solutions to existing problems. In this case, the design will help in collecting and compiling data findings from the survey in both units, which will guide in understanding the most relevant factors in the fight against falls. Getting the factors related to falls in their priority order will help in addressing them systematically, ensuring that the use of Telesitter systems has more reliability and effectiveness in reducing falls.The design will also enable for the use of different data and information sources to offer the most in-depth and up-close information and data examination, which gives the most reliable conclusions regarding the contextual conditions surrounding a problem (Yin, 2013). The DNP student will collect information and data from previous research studies, as well as collect primary data from nurses using surveys.The project sample population will be nurses working in the surgical/oncology unit and Progressive care unit at Southern California Hospital. The patient population under investigation is patients receiving care in the surgical/oncology unit and Progressive care unit. The Das well as collecting survey data to help in understanding the factors that led to the patient falls. Understanding the factors that caused the falls will then guide the DNP student into formulating solutions to these problems. It is expected that fixing these challenges and problems will help in improving the effectiveness of the Telesitter monitoring systems in reducing the prevalence of falls. The survey data collected from the two units will then be assessed and analyzed using Statistical Package for the Social Sciences (SPSS) software to give finer details as to which factors have more priority in reducing patient falls. The analysis will also show how the factors in the two units are related.Definition of TermsThe following terms were used throughout the project proposal.o TelesitterA system designed with a 360 degrees video coverage of a room, a two-way audio transmitting system, and a lockable wheel system used for observing patients and controlled from a central operator room (Martin, 2015). Assignment: Assessing the Effectiveness of Telesitter Systems in Reducing Patient FallsThe literal act of patients rolling over their beds and falling on the floor, or the act of patient tripping when walking around the ward, and falling on the ground (Martin, 2015)o Caregiver A nurse or physician that takes care of patients in a ward (Martin, 2015)o Impromptu patient callsWhen a video operator initiates calls to the patients to inform them that they might fall or giving instructions to help prevent falls (Martin, 2015).o Impromptu caregiver callsWhen the video operator initiates calls to the caregiver, informing them that they need to attend to patients urgently (Martin, 2015).o Elderly patientsFor this project, elderly patients are any patients above the age of 40 years receiving care in the acute care unit.o PanicThis is a sudden and unexpected fear induced by something. It is a strong sense of fear that dominates an individual to an extent of preventing logical thinking and reasoning (Martin, 2015).o AnxietyThis is a feeling of nervousness, worry, and uneasiness about or due to the occurrence of an event (Martin, 2015).o FearThis is a feeling of insecurity, threat, and danger that engulfs an individual after the occurrence of unexpected or unpleasant event (Martin, 2015).o Fall rateThis is the rate at which patients fall in a specific health facility. It is calculated periodically or in relation to a constant number – the best example of this is rate per 1000 patients. o Fall alarmA wearable device with a tactile sensor, visual presentation, and movement sensor that detects patient movements and warns patients and caregivers whenever there is high fall risk. Assumptions, Limitations, DelimitationsThis project entails the use of some assumptions to ensure that it runs as expected: The first assumption is that the context of the surgical/oncology unit and Progressive care unit at Southern California hospital is similar to those in other hospitals throughout the country. It is expected that the findings from this project will be applicable to all other hospital settings throughout the country. It is also assumed that the Telesitter systems will not interfere in anyway with the day to day activities and operations in the targeted units. The normal healthcare activities including admission, transfers, medication administration and others should continue normally. Apart from the assumptions, the following limitations and delimitations apply to the project: One limitation of this project is that it will only be conducted at one healthcare institution. As such, the findings might only be specific to the context of the institution. The project may be limited by the sample size, which can be too small for effective drawing of conclusions. If the number of respondents or sample size is not sufficient, the period of the project might need extension. One delimitation of this project is that it will be done for a period of two months, which is a short duration for adequate data collection that can give meaningful findings. Extending the duration of the project can help in reaching more reliable findings and conclusions from a reliable sample size. The DNP student can decide to extend the number of the targeted wards from the surgical/oncology unit and Progressive care unit to other units including the intensive care unit, emergency department, and the orthopedic unit. This can help to increase the sample size.Summary and Organization of the Remainder of the ProjectIn summary, it is evident that this project is of great importance to the healthcare sector and will help in shaping decisions regarding the best solution to the problem of patient falls. The theoretical frameworks used in this project clearly direct that the use of more human factors in the clinical setting could improve patient care. This project sets out to find the challenges associated with the Telesitter systems as well as possible solutions to these challenges. It is expected that solving the identified challenges will help in enhancing the effectiveness of Telesitter systems in reducing the prevalence of falls. In Chapter 2 of this project, the literature review will present past findings on the effectiveness of using the Telesitter systems in the healthcare setting, as well as the possible negative consequences of Telesitter systems in the clinical care setting. This section will also discuss in detail the Fallarm technological device. This will be followed by Chapter 3, which will entail information relating to the methodology of the project. The methodology is quantitative and will highlight how the data collection and documentation will be done. It will also highlight all the variables and data elements that will be collected. This chapter will be followed by the data analysis and results section, which will be Chapter 4.Chapter 4 will have data analysis and evaluation, which will show how the variables relate to one another, and how the results help in answering the given research questions. The summary, conclusions, and recommendations, which is chapter 5, is the last chapter and gives the concluding remarks from the project. It also gives the implications of the findings, as well as how the outcome of the project shapes clinical practice.The project will be conducted over a period of two months, during which the DNP student will be collecting data from the surgical/oncology unit and Progressive care unit at Southern California Hospital. The project implementation will first entail explaining to the nurses the need and benefits of conducting the project, training the nurses on what data should be collected, and how the data should be entered in the electronic health record (EHR) system. At the end of the two months, the DNP student will collect all the data from the electronic health records and store the data in a secure folder in the personal computer, ready for data analysis. The data analysis will be conducted for a period of one month, during which all data comparisons of the two interventions will be done. After that, project compiling and writing of the project report will take two weeks. Chapter 2: Literature ReviewIntroduction to the Chapter and Background to the ProblemThis section will present information and findings from previous research, and discuss how the findings have helped to shape this research. The main sections of this chapter include Introduction and background of the problem; theoretical foundations; review of the literature – falls and their effects on patients and hospitals, factors related to falls, fall prevention interventions including Telesitter monitoring systems, Fall alarm wearable monitoring systems, and fall risk assessment, literature findings on the variables; and finally the summary of the chapter.This literature review is completed utilizing the most recent journal articles published in the past 10 years, although most of the articles were published within the last five years. The articles were retrieved using rigorous research on the topic of focus, regarding emerging trends in preventing patient falls. The DNP student mainl

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