Assignment: Change Project Proposal

Assignment: Change Project Proposal ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Change Project Proposal In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Assignment: Change Project Proposal Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Problem statement Purpose of the change proposal PICOT Literature search strategy employed Evaluation of the literature Applicable change or nursing theory utilized Proposed implementation plan with outcome measures Identification of potential barriers to plan implementation, and a discussion of how these could be overcome Appendix section, if tables, graphs, surveys, educational materials, etc. are created Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Assignment: Change Project Proposal nrs_490_week_9_capstoneprojectchangeproposal_portfolio__template_2017.docx benchmark_ruberic.docx hospitalfalls_anongoingproblem_.docx picotstatementpaper.docx literaturereviewand Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Capstone Project-Change Proposal Portfolio Your Name Grand Canyon University Date: Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Capstone Project-Change Proposal Portfolio Brief introduction to the problem you want to investigate and develop a change project. Make sure I have a clear understanding. Background Briefly identifies what is known about this problem area by providing insight with a research study Problem Statement and Purpose for Change Statement that concludes the discussion of a problem and indicates the gap in the knowledge needed for practice. The problem statement usually provides a basis for the study purpose. This can be more than one sentence- it explains why this change is so important PICO(T) Explain the patient or population, intervention, comparison and outcome. Then create a PICO question. Literature Search Strategy Employed How did you find your information? What resources did you use? What search engines. Evaluation of Literature Summarize similarities you found in literature and the common theme discovered with recommendations to fix the gap you discussed. Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Change or Nursing Theory Explain a change or nursing theory and show connection between the theory and your proposed change idea. Proposed Implementation Plan with Outcome Measures Using all the studies and evidence supported articles you found, summarize your plan with measurable outcomes- how will you know your plan worked? Potential Barriers and Strategies to Overcome Based on the data and your facility, what barriers do you anticipate and how will you overcome these barriers? Conclusion The conclusion should summarize the problem, the proposed solution and activation plan, evaluation process, as well as the goals for the future so the change remains in place.Assignment: Change Project Proposal References Your book and any articles you use. Grove, S., Gray, J., & Burns, N. (2015). Understanding nursing research (6th ed.). St. Louis:Elsevier. Appendix Material Benchmark – Capstone Project Change Proposal 2 1 Less Than Unsatisfactory Satisfactory 0-71% 72-75% 0.00% 75.00% 60.0 %Content 5.0 %Background 5.0 %Problem Statement 5.0 %Change Proposal Purpose 5.0 %PICOT Background section is not present. 3 5 4 Satisfactory Excellent 90Good 80-89% 76-79% 100% 89.00% 79.00% 100.00% Background Background Background section is section is section is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. Background section is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Problem Problem Problem Problem Problem statement is statement is statement is statement is statement is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. Purpose of Purpose of Purpose of Purpose of Purpose of change change change change change proposal is not proposal is proposal is proposal is proposal is present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. PICOT is not PICOT is PICOT is PICOT is PICOT is present. present, but present. Some present and present, incomplete or minor details complete. Assignment: Change Project Proposal The complete, and otherwise or elements are submission incorporates missing but the provides the additional lacking in omission(s) do basic required detail. not impede information understanding. required. 5.0 %Literature Literature Literature Literature Literature Search Strategy search strategy search strategy search strategy search strategy is not present. is present, but is present. is present and incomplete or Some minor complete. The otherwise details or submission lacking in elements are provides the required detail. missing but the basic omission(s) do information not impede required. understanding. 5.0 %Literature Literature Evaluation evaluation is not present. Literature Literature Literature evaluation is evaluation is evaluation is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. 5.0 %Utilization Theory of Change or utilization is Nursing Theory not present. (2.2) Theory Theory Theory utilization utilization utilization content is content is content is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. 5.0 %Proposed Implementatio Implementatio Implementatio Implementatio Implementation n plan is not n plan is n plan is n plan is Plan with present. present, but present. Some present and Outcome incomplete or minor details complete. The Measures (3.2) otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic relevant details and critical thinking to engage the reader. Literature search strategy is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Assignment: Change Project Proposal Literature evaluation is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Theory utilization content is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Implementatio n plan is present, complete, and incorporates additional relevant details not impede information understanding. required. 5.0 %Identification of potential barriers to plan implementation, and a discussion of how these could be overcome (2.3) 5.0 %Appendices Inclusive of Practice Immersion Clinical Documentation (1.2) 10.0 %Evidence of Revision and critical thinking to engage the reader. Identification Identification Identification Identification Identification of potential of potential of potential of potential of potential barriers to plan barriers to plan barriers to plan barriers to plan barriers to plan implementatio implementatio implementatio implementatio implementatio n and /or n with a n with a n with a n with a discussion discussion discussion discussion discussion component is component is component is component is component is not present. present, but is present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. Appendices are Appendices are Appendices are Appendices are Appendices are not present. present, but present with present and present, incomplete or minor elements complete. The complete, and otherwise missing that do submission incorporates lacking in not impede provides the additional required detail. understanding. basic relevant details information and critical required. thinking to engage the reader. Final paper Incorporation Incorporation Evidence of Evidence of does not of research of research incorporation incorporation demonstrate critique critique of research of research incorporation feedback or feedback and critique critique of feedback or evidence of evidence of feedback and feedback and evidence of revision is revision are revision is revision is revision on incomplete. present. clearly comprehensive research provided. and thoroughly critiques. developed. 30.0 %Organization and Effectiveness 10.0 %Thesis Paper lacks Thesis is Thesis is Development any discernible insufficiently apparent and and Purpose overall purpose developed or appropriate to purpose. Assignment: Change Project Proposal Thesis is clear and forecasts the development Thesis is comprehensive and contains the essence of or organizing vague. Purpose claim. is not clear. of the paper. the paper. Thesis is Thesis descriptive and statement reflective of makes the the arguments purpose of the and paper clear. appropriate to the purpose. 10.0 %Argument Statement of Sufficient Argument is Argument Clear and Logic and purpose is not justification of orderly, but shows logical convincing Construction justified by the claims is may have a progression. argument conclusion. lacking. few Techniques of presents a The conclusion Argument inconsistencies argumentation persuasive does not lacks . The argument are evident. claim in a support the consistent presents There is a distinctive and claim made. unity. There minimal smooth compelling Argument is are obvious justification of progression of manner. All incoherent and flaws in the claims. claims from sources are uses logic. Some Argument introduction to authoritative. noncredible sources have logically, but conclusion. sources. questionable not thoroughly, Most sources credibility. supports the are purpose. authoritative. Sources used are credible. Introduction and conclusion bracket the thesis. 10.0 Surface errors Frequent and Some Prose is largely Writer is %Mechanics of are pervasive repetitive mechanical free of clearly in Writing enough that mechanical errors or typos mechanical command of (includes they impede errors distract are present, but errors, standard, spelling, communication the reader. they are not although a few written, punctuation, of meaning. Inconsistencies overly may be academic grammar, Inappropriate in language distracting to present. The English. language use) word choice or choice the reader. writer uses a sentence (register) or Correct and variety of construction is word choice varied sentence effective used. are present. structure and sentence Sentence audiencestructures and structure is appropriate figures of correct but not language are speech. varied. employed. 10.0 %Format 5.0 %Paper Template is not Appropriate Appropriate Appropriate All format Format (use of used template is template is template is elements are appropriate style appropriately, used, but some used. fully used. correct. for the major or elements are Formatting is There are and assignment) documentation missing or correct, virtually no format is rarely mistaken. A although some errors in followed lack of control minor errors formatting correctly. Assignment: Change Project Proposal with may be style. formatting is present. apparent. 5.0 Sources are not Documentation Sources are Sources are Sources are %Documentatio documented. of sources is documented, as documented, as completely and n of Sources inconsistent or appropriate to appropriate to correctly (citations, incorrect, as assignment and assignment and documented, as footnotes, appropriate to style, although style, and appropriate to references, assignment and some format is assignment and bibliography, style, with formatting mostly correct. style, and etc., as numerous errors may be format is free appropriate to formatting present. of error. assignment and errors. style) 100 %Total Weightage Running head: HOSPITAL FALLS: AN ONGOING PROBLEM Hospital Falls: An Ongoing Problem Grand Canyon University – NRS 490 November 26, 2017 1 HOSPITAL FALLS: AN ONGOING PROBLEM 2 Hospital Falls: An Ongoing Problem Inpatient hospital falls especially in elderly patients can impact not only the quality of care provided but can have a substantial financial burden to the organization (Hoffman, Neumann, Golgert, & Von Renteln-Kruse, 2015). Healthcare providers must be aggressive in adhering utilizing tools and resources prevent falls and ensure patient safety. The Medical Telemetry unit has an average of four days stay for patients are admitted for multiple co-morbidities but all require cardiac monitoring (Hoffman et al., 2015). Examples include congestive heart failure (CHF), dialysis, irregular heart rhythms, altered mental status, and strokes to name a few. Many present with acute problems secondary to chronic conditions such as CHF exacerbation, altered mental status due to drugs, toxins, or infections. The population serves about 90% Caucasians and about 43% are age 60 and above (Office of Statewide Health and Planning Development [OSHPD], 2015). Staffing ratio is 1:4 and a multidisciplinary team approach is used in caring for patients. Problem, Issue, Suggestion, Initiative, or Education Need For every 1000 bed occupied, 3-20 falls will occur (Haines, Lee, O’Connell, McDermott, & Hoffmann, 2012). Many factors contribute to patient falls particularly chronic conditions and medications. For example, a patient on Lasix may try to jump out of bed to the bathroom, a dialysis patient is confused due to elevated toxin levels, and stroke patients on heparin drips are at higher risk for bleeds and falls if there are deficits from the stroke. A substantial contributing factor to this is that elderly patients a weak bone structure as a result of age hence their general weakness, often resulting to falling while in the hospital (Thomas & Mackintosh, 2016). HOSPITAL FALLS: AN ONGOING PROBLEM 3 Many falls occur during shift change when nurses are pre-occupied with report. It is recommended that fall risk is assessed at the beginning of every shift and interventions are implemented immediately (call light at bedside, mobility aids within reach, beds locked and at lowest position, and alarms on as necessary). Nurses should perform handoff at the bedside to ensure that IV lines and meds are evaluated, patient is involved in their plan of care, and to ensure that patient is safe and both staff member should sign off. Assignment: Change Project Proposal Education should be continuous to staff and to patients the importance of adhering to the plans discussed. Impact on Work Environment, Quality of Care, and Patient Outcomes The repercussions of patient falls not only affects patient outcomes, but the hospital work environment and quality of care provided. Looking at the effects of falls on patient outcomes, hospital falls have been an impeding factor to quick recovery of patients in hospitals. In this regard, patients who are victims of falls often end up being injured contributing to their health problems as well as their social and psychological well-being (Oliveira, Hammerschmidt, Schoeller, Girandi, & de Paula, 2016). This prolongs their recovery time hence elongating their stay in the hospital. Shifting gears to quality of care, hospital falls are a subtracting factor to quality of care given to patients in hospitals. Hospital falls are a pointer of lack of safety for inpatients. This significantly affects the reputation of hospitals with high number of falls (Babine et al., 2016). The effects of hospital falls on work environment are centered on the compromise of patient safety during their stay in the hospital. A work environment is rendered unsafe for patients having in mind that there is a high potential for patients to fall (Tzeng, Hu, & Yin, 2016). HOSPITAL FALLS: AN ONGOING PROBLEM 4 Implications to Nursing Poorly implemented programs, failure to follow recommendations, and quality of delivery of fall risk programs can explain why falls continue to occur (Morello et al., 2017). Studies show that fall programs are effective if carried out as it should. A study of the 6PACK falls program includes assessing patients daily using fall risk scales, placing a “Falls Alert” sign outside the door, and at least one of the 6-PACK recommended strategy: a) assisting patients to bathroom, b) bed at lowest level, c) mobility aids within reach, d) planned toileting, and e) using bed/chair alarms (Morello et al., 2017). Conclusion Preventive measures that are based on evidence-based practice are implemented to ensure the safety of patients during their stay. It is up to the organization as a whole to collaborate to ensure that programs are adhered to. Nurses musts be consistent with shift assessments and required interventions, handoff should be at the bedside, and management should provide resources and support to ensure that interventions are not missed due to overwhelming workload. HOSPITAL FALLS: AN ONGOING PROBLEM 5 References Arau?jo, J., Fernandes, A., Moura, L., Santos, M., Ferreira, M., & Vitor, A. (2017, May). Validation of nursing outcome content fall prevention behavior in a hospital environment. Revista da Rede de Enfermagem do Nordeste, 18(3), 337-344. http://dx.doi.org/10.15253/2175-6783.2017000300008 Babine, R., Hyrkas, K., Bachand, D., Chapman, J., Fuller, V., Honess, C., & Wierman, H. (2016, May/June). Falls in a tertiary care hospital – Association with delirium: A replication study. The Academy of Psychosomatic Medicine, 57, 273-282. Assignment: Change Project Proposal Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Haines, T., Lee, D., O’Connell, B., McDermott, F., & Hoffmann, T. (2012). Why do hospitalized older patients take risks that may lead to falls? Health Expectations, 18, 233-249. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Hoffman, V., Neumann, L., Golgert, S., & Von Renteln-Kruse, W. (2015, November 10). Proactive fall-risk management is mandatory to sustain in hospital-fall prevention in older patients – Validation of the Lucas fall-risk screening in 2, 337 patients. Journal of Nutrition Health and Aging, 19, 1012-1018. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Morello, R., Barker, A., Ayton, D., Landgren, F., Kamar, J., Hill, K., … Stoelwinder, J. (2017). Implementation fidelity of a nurse-led falls prevention program in acute hospitals during the 6-PACK trial. BMC Health Services Research, 17(383). http://dx.doi.org/10.1186/s12913-017-2315-z Office of Statewide Health and Planning Development. (2015). Hospital discharge summary report. Retrieved from http://gis.oshpd.ca.gov/atlas/topics/use/inpatient#charts HOSPITAL FALLS: AN ONGOING PROBLEM Oliveira, D. M., Hammerschmidt, K. S., Schoeller, S. D., Girandi, J. B., & de Paula, N. F. (2016). Assessment instrument for falls among the hospitalized elderly (Hospital AIFE): Nurse analyzing vulnerability and mobility. Journal of Nursing, 4065-4074. http://dx.doi.org/10.5205/reuol.9881-87554-1-EDSM1011201631 Thomas, S., & Mackintosh, S. (2016, June). Improvement of physical therapist assessment of risk of falls in the hospital and discharge handover through an intervention to modify clinical behavior. Physical Therapy, 96(6), 764-773. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Tzeng, H., Hu, H., & Yin, C. (2016, July-August). Understanding inpatient injurious fall rates using Medicare’s hospital compare data. MedSurg Nursing, 25(4), 255-269. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org 6 Running head: PICOT STATEMENT PAPER PICOT Statement Paper Grand Canyon University – NRS 490 December 3, 2017 1 PICOT STATEMENT PAPER 2 PICOT Statement Paper Background Hospital falls have become a common occurrence for inpatients due to poor compliance and general neglect by medical and nursing staff to utilize tools and perform frequent risk assessments and safety checks as supported by evidence. The underlying causative factors are issues pertaining to mobility of patients and their physiological wellbeing. Despite the looming challenges posing as risk factors for patient falls, intervention measures and best practices have been put forth … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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Assignment: Change Project Proposal

Assignment: Change Project Proposal ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Assignment: Change Project Proposal In this assignment, students will pull together the change proposal project components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. At the conclusion of this project, the student will be able to apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Assignment: Change Project Proposal Students will develop a 1,250-1,500 word paper that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Problem statement Purpose of the change proposal PICOT Literature search strategy employed Evaluation of the literature Applicable change or nursing theory utilized Proposed implementation plan with outcome measures Identification of potential barriers to plan implementation, and a discussion of how these could be overcome Appendix section, if tables, graphs, surveys, educational materials, etc. are created Review the feedback from your instructor on the Topic 3 assignment, PICOT Statement Paper, and Topic 6 assignment, Literature Review. Use the feedback to make appropriate revisions to the portfolio components before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. Assignment: Change Project Proposal nrs_490_week_9_capstoneprojectchangeproposal_portfolio__template_2017.docx benchmark_ruberic.docx hospitalfalls_anongoingproblem_.docx picotstatementpaper.docx literaturereviewand Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Capstone Project-Change Proposal Portfolio Your Name Grand Canyon University Date: Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Capstone Project-Change Proposal Portfolio Brief introduction to the problem you want to investigate and develop a change project. Make sure I have a clear understanding. Background Briefly identifies what is known about this problem area by providing insight with a research study Problem Statement and Purpose for Change Statement that concludes the discussion of a problem and indicates the gap in the knowledge needed for practice. The problem statement usually provides a basis for the study purpose. This can be more than one sentence- it explains why this change is so important PICO(T) Explain the patient or population, intervention, comparison and outcome. Then create a PICO question. Literature Search Strategy Employed How did you find your information? What resources did you use? What search engines. Evaluation of Literature Summarize similarities you found in literature and the common theme discovered with recommendations to fix the gap you discussed. Running head: CAPSTONE PROJECT-CHANGE PROPOSAL Change or Nursing Theory Explain a change or nursing theory and show connection between the theory and your proposed change idea. Proposed Implementation Plan with Outcome Measures Using all the studies and evidence supported articles you found, summarize your plan with measurable outcomes- how will you know your plan worked? Potential Barriers and Strategies to Overcome Based on the data and your facility, what barriers do you anticipate and how will you overcome these barriers? Conclusion The conclusion should summarize the problem, the proposed solution and activation plan, evaluation process, as well as the goals for the future so the change remains in place.Assignment: Change Project Proposal References Your book and any articles you use. Grove, S., Gray, J., & Burns, N. (2015). Understanding nursing research (6th ed.). St. Louis:Elsevier. Appendix Material Benchmark – Capstone Project Change Proposal 2 1 Less Than Unsatisfactory Satisfactory 0-71% 72-75% 0.00% 75.00% 60.0 %Content 5.0 %Background 5.0 %Problem Statement 5.0 %Change Proposal Purpose 5.0 %PICOT Background section is not present. 3 5 4 Satisfactory Excellent 90Good 80-89% 76-79% 100% 89.00% 79.00% 100.00% Background Background Background section is section is section is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. Background section is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Problem Problem Problem Problem Problem statement is statement is statement is statement is statement is not present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. Purpose of Purpose of Purpose of Purpose of Purpose of change change change change change proposal is not proposal is proposal is proposal is proposal is present. present, but present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. PICOT is not PICOT is PICOT is PICOT is PICOT is present. present, but present. Some present and present, incomplete or minor details complete. Assignment: Change Project Proposal The complete, and otherwise or elements are submission incorporates missing but the provides the additional lacking in omission(s) do basic required detail. not impede information understanding. required. 5.0 %Literature Literature Literature Literature Literature Search Strategy search strategy search strategy search strategy search strategy is not present. is present, but is present. is present and incomplete or Some minor complete. The otherwise details or submission lacking in elements are provides the required detail. missing but the basic omission(s) do information not impede required. understanding. 5.0 %Literature Literature Evaluation evaluation is not present. Literature Literature Literature evaluation is evaluation is evaluation is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. 5.0 %Utilization Theory of Change or utilization is Nursing Theory not present. (2.2) Theory Theory Theory utilization utilization utilization content is content is content is present, but present. Some present and incomplete or minor details complete. The otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic not impede information understanding. required. 5.0 %Proposed Implementatio Implementatio Implementatio Implementatio Implementation n plan is not n plan is n plan is n plan is Plan with present. present, but present. Some present and Outcome incomplete or minor details complete. The Measures (3.2) otherwise or elements are submission lacking in missing but the provides the required detail. omission(s) do basic relevant details and critical thinking to engage the reader. Literature search strategy is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Assignment: Change Project Proposal Literature evaluation is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Theory utilization content is present, complete, and incorporates additional relevant details and critical thinking to engage the reader. Implementatio n plan is present, complete, and incorporates additional relevant details not impede information understanding. required. 5.0 %Identification of potential barriers to plan implementation, and a discussion of how these could be overcome (2.3) 5.0 %Appendices Inclusive of Practice Immersion Clinical Documentation (1.2) 10.0 %Evidence of Revision and critical thinking to engage the reader. Identification Identification Identification Identification Identification of potential of potential of potential of potential of potential barriers to plan barriers to plan barriers to plan barriers to plan barriers to plan implementatio implementatio implementatio implementatio implementatio n and /or n with a n with a n with a n with a discussion discussion discussion discussion discussion component is component is component is component is component is not present. present, but is present. Some present and present, incomplete or minor details complete. The complete, and otherwise or elements are submission incorporates lacking in missing but the provides the additional required detail. omission(s) do basic relevant details not impede information and critical understanding. required. thinking to engage the reader. Appendices are Appendices are Appendices are Appendices are Appendices are not present. present, but present with present and present, incomplete or minor elements complete. The complete, and otherwise missing that do submission incorporates lacking in not impede provides the additional required detail. understanding. basic relevant details information and critical required. thinking to engage the reader. Final paper Incorporation Incorporation Evidence of Evidence of does not of research of research incorporation incorporation demonstrate critique critique of research of research incorporation feedback or feedback and critique critique of feedback or evidence of evidence of feedback and feedback and evidence of revision is revision are revision is revision is revision on incomplete. present. clearly comprehensive research provided. and thoroughly critiques. developed. 30.0 %Organization and Effectiveness 10.0 %Thesis Paper lacks Thesis is Thesis is Development any discernible insufficiently apparent and and Purpose overall purpose developed or appropriate to purpose. Assignment: Change Project Proposal Thesis is clear and forecasts the development Thesis is comprehensive and contains the essence of or organizing vague. Purpose claim. is not clear. of the paper. the paper. Thesis is Thesis descriptive and statement reflective of makes the the arguments purpose of the and paper clear. appropriate to the purpose. 10.0 %Argument Statement of Sufficient Argument is Argument Clear and Logic and purpose is not justification of orderly, but shows logical convincing Construction justified by the claims is may have a progression. argument conclusion. lacking. few Techniques of presents a The conclusion Argument inconsistencies argumentation persuasive does not lacks . The argument are evident. claim in a support the consistent presents There is a distinctive and claim made. unity. There minimal smooth compelling Argument is are obvious justification of progression of manner. All incoherent and flaws in the claims. claims from sources are uses logic. Some Argument introduction to authoritative. noncredible sources have logically, but conclusion. sources. questionable not thoroughly, Most sources credibility. supports the are purpose. authoritative. Sources used are credible. Introduction and conclusion bracket the thesis. 10.0 Surface errors Frequent and Some Prose is largely Writer is %Mechanics of are pervasive repetitive mechanical free of clearly in Writing enough that mechanical errors or typos mechanical command of (includes they impede errors distract are present, but errors, standard, spelling, communication the reader. they are not although a few written, punctuation, of meaning. Inconsistencies overly may be academic grammar, Inappropriate in language distracting to present. The English. language use) word choice or choice the reader. writer uses a sentence (register) or Correct and variety of construction is word choice varied sentence effective used. are present. structure and sentence Sentence audiencestructures and structure is appropriate figures of correct but not language are speech. varied. employed. 10.0 %Format 5.0 %Paper Template is not Appropriate Appropriate Appropriate All format Format (use of used template is template is template is elements are appropriate style appropriately, used, but some used. fully used. correct. for the major or elements are Formatting is There are and assignment) documentation missing or correct, virtually no format is rarely mistaken. A although some errors in followed lack of control minor errors formatting correctly. Assignment: Change Project Proposal with may be style. formatting is present. apparent. 5.0 Sources are not Documentation Sources are Sources are Sources are %Documentatio documented. of sources is documented, as documented, as completely and n of Sources inconsistent or appropriate to appropriate to correctly (citations, incorrect, as assignment and assignment and documented, as footnotes, appropriate to style, although style, and appropriate to references, assignment and some format is assignment and bibliography, style, with formatting mostly correct. style, and etc., as numerous errors may be format is free appropriate to formatting present. of error. assignment and errors. style) 100 %Total Weightage Running head: HOSPITAL FALLS: AN ONGOING PROBLEM Hospital Falls: An Ongoing Problem Grand Canyon University – NRS 490 November 26, 2017 1 HOSPITAL FALLS: AN ONGOING PROBLEM 2 Hospital Falls: An Ongoing Problem Inpatient hospital falls especially in elderly patients can impact not only the quality of care provided but can have a substantial financial burden to the organization (Hoffman, Neumann, Golgert, & Von Renteln-Kruse, 2015). Healthcare providers must be aggressive in adhering utilizing tools and resources prevent falls and ensure patient safety. The Medical Telemetry unit has an average of four days stay for patients are admitted for multiple co-morbidities but all require cardiac monitoring (Hoffman et al., 2015). Examples include congestive heart failure (CHF), dialysis, irregular heart rhythms, altered mental status, and strokes to name a few. Many present with acute problems secondary to chronic conditions such as CHF exacerbation, altered mental status due to drugs, toxins, or infections. The population serves about 90% Caucasians and about 43% are age 60 and above (Office of Statewide Health and Planning Development [OSHPD], 2015). Staffing ratio is 1:4 and a multidisciplinary team approach is used in caring for patients. Problem, Issue, Suggestion, Initiative, or Education Need For every 1000 bed occupied, 3-20 falls will occur (Haines, Lee, O’Connell, McDermott, & Hoffmann, 2012). Many factors contribute to patient falls particularly chronic conditions and medications. For example, a patient on Lasix may try to jump out of bed to the bathroom, a dialysis patient is confused due to elevated toxin levels, and stroke patients on heparin drips are at higher risk for bleeds and falls if there are deficits from the stroke. A substantial contributing factor to this is that elderly patients a weak bone structure as a result of age hence their general weakness, often resulting to falling while in the hospital (Thomas & Mackintosh, 2016). HOSPITAL FALLS: AN ONGOING PROBLEM 3 Many falls occur during shift change when nurses are pre-occupied with report. It is recommended that fall risk is assessed at the beginning of every shift and interventions are implemented immediately (call light at bedside, mobility aids within reach, beds locked and at lowest position, and alarms on as necessary). Nurses should perform handoff at the bedside to ensure that IV lines and meds are evaluated, patient is involved in their plan of care, and to ensure that patient is safe and both staff member should sign off. Assignment: Change Project Proposal Education should be continuous to staff and to patients the importance of adhering to the plans discussed. Impact on Work Environment, Quality of Care, and Patient Outcomes The repercussions of patient falls not only affects patient outcomes, but the hospital work environment and quality of care provided. Looking at the effects of falls on patient outcomes, hospital falls have been an impeding factor to quick recovery of patients in hospitals. In this regard, patients who are victims of falls often end up being injured contributing to their health problems as well as their social and psychological well-being (Oliveira, Hammerschmidt, Schoeller, Girandi, & de Paula, 2016). This prolongs their recovery time hence elongating their stay in the hospital. Shifting gears to quality of care, hospital falls are a subtracting factor to quality of care given to patients in hospitals. Hospital falls are a pointer of lack of safety for inpatients. This significantly affects the reputation of hospitals with high number of falls (Babine et al., 2016). The effects of hospital falls on work environment are centered on the compromise of patient safety during their stay in the hospital. A work environment is rendered unsafe for patients having in mind that there is a high potential for patients to fall (Tzeng, Hu, & Yin, 2016). HOSPITAL FALLS: AN ONGOING PROBLEM 4 Implications to Nursing Poorly implemented programs, failure to follow recommendations, and quality of delivery of fall risk programs can explain why falls continue to occur (Morello et al., 2017). Studies show that fall programs are effective if carried out as it should. A study of the 6PACK falls program includes assessing patients daily using fall risk scales, placing a “Falls Alert” sign outside the door, and at least one of the 6-PACK recommended strategy: a) assisting patients to bathroom, b) bed at lowest level, c) mobility aids within reach, d) planned toileting, and e) using bed/chair alarms (Morello et al., 2017). Conclusion Preventive measures that are based on evidence-based practice are implemented to ensure the safety of patients during their stay. It is up to the organization as a whole to collaborate to ensure that programs are adhered to. Nurses musts be consistent with shift assessments and required interventions, handoff should be at the bedside, and management should provide resources and support to ensure that interventions are not missed due to overwhelming workload. HOSPITAL FALLS: AN ONGOING PROBLEM 5 References Arau?jo, J., Fernandes, A., Moura, L., Santos, M., Ferreira, M., & Vitor, A. (2017, May). Validation of nursing outcome content fall prevention behavior in a hospital environment. Revista da Rede de Enfermagem do Nordeste, 18(3), 337-344. http://dx.doi.org/10.15253/2175-6783.2017000300008 Babine, R., Hyrkas, K., Bachand, D., Chapman, J., Fuller, V., Honess, C., & Wierman, H. (2016, May/June). Falls in a tertiary care hospital – Association with delirium: A replication study. The Academy of Psychosomatic Medicine, 57, 273-282. Assignment: Change Project Proposal Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Haines, T., Lee, D., O’Connell, B., McDermott, F., & Hoffmann, T. (2012). Why do hospitalized older patients take risks that may lead to falls? Health Expectations, 18, 233-249. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Hoffman, V., Neumann, L., Golgert, S., & Von Renteln-Kruse, W. (2015, November 10). Proactive fall-risk management is mandatory to sustain in hospital-fall prevention in older patients – Validation of the Lucas fall-risk screening in 2, 337 patients. Journal of Nutrition Health and Aging, 19, 1012-1018. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Morello, R., Barker, A., Ayton, D., Landgren, F., Kamar, J., Hill, K., … Stoelwinder, J. (2017). Implementation fidelity of a nurse-led falls prevention program in acute hospitals during the 6-PACK trial. BMC Health Services Research, 17(383). http://dx.doi.org/10.1186/s12913-017-2315-z Office of Statewide Health and Planning Development. (2015). Hospital discharge summary report. Retrieved from http://gis.oshpd.ca.gov/atlas/topics/use/inpatient#charts HOSPITAL FALLS: AN ONGOING PROBLEM Oliveira, D. M., Hammerschmidt, K. S., Schoeller, S. D., Girandi, J. B., & de Paula, N. F. (2016). Assessment instrument for falls among the hospitalized elderly (Hospital AIFE): Nurse analyzing vulnerability and mobility. Journal of Nursing, 4065-4074. http://dx.doi.org/10.5205/reuol.9881-87554-1-EDSM1011201631 Thomas, S., & Mackintosh, S. (2016, June). Improvement of physical therapist assessment of risk of falls in the hospital and discharge handover through an intervention to modify clinical behavior. Physical Therapy, 96(6), 764-773. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org Tzeng, H., Hu, H., & Yin, C. (2016, July-August). Understanding inpatient injurious fall rates using Medicare’s hospital compare data. MedSurg Nursing, 25(4), 255-269. Retrieved from http://eds.a.ebscohost.com.lopes.idm.oclc.org 6 Running head: PICOT STATEMENT PAPER PICOT Statement Paper Grand Canyon University – NRS 490 December 3, 2017 1 PICOT STATEMENT PAPER 2 PICOT Statement Paper Background Hospital falls have become a common occurrence for inpatients due to poor compliance and general neglect by medical and nursing staff to utilize tools and perform frequent risk assessments and safety checks as supported by evidence. The underlying causative factors are issues pertaining to mobility of patients and their physiological wellbeing. Despite the looming challenges posing as risk factors for patient falls, intervention measures and best practices have been put forth … Get a 10 % discount on an order above $ 100 Use the following coupon code : NURSING10

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