Discussion Response- quality

1. Martha

The Impact of Evidence-Based Practices on Patient Fall Prevention

In the realm of healthcare, the application of evidence-based practices (EBPs) is a critical component that enhances the quality of care provided to patients while also promoting safety and efficiency within healthcare facilities. According to Melnyk and Fineout-Overholt (2022), evidence-based practice involves the integration of the best available research with clinical expertise and patient values to achieve optimal health outcomes. This discussion explores the issue of patient falls within healthcare settings, a prevalent concern that significantly affects patient safety and increases healthcare costs.

Patient falls are a common problem in healthcare facilities worldwide, leading to injuries, increased length of hospital stay, and higher healthcare expenses (Dabkowsk et al., 2022). The issue of falls is particularly critical in settings with elderly or vulnerable populations, where falls can lead to severe complications such as fractures, head injuries, and even increased mortality rates. Incorporating EBPs in fall prevention can significantly mitigate these risks by ensuring that interventions are both effective and tailored to meet the specific needs of the patient population.

The integration of evidence-based interventions for fall prevention typically involves several components, including risk assessment tools, multifactorial intervention plans, and staff education programs. For instance, the use of validated risk assessment tools allows healthcare providers to identify patients at high risk of falling and implement targeted interventions accordingly. Furthermore, multifactorial interventions that combine environmental modifications, patient education, and physical therapy have been shown to reduce fall rates effectively (Loureiro et al., 2021).

Adopting EBPs in the context of fall prevention not only benefits patients by reducing the incidence of falls and associated injuries but also supports healthcare staff by providing clear guidelines and protocols that enhance the care delivery process. Moreover, the facility itself benefits through the reduction in costs associated with fall-related injuries and potential litigation, as well as improved patient satisfaction and safety ratings, which are crucial for the reputation and financial stability of healthcare institutions.

From a biblical perspective, the principle found in Philippians 2:4, “not looking to your own interests but each of you to the interests of the others” (NIV), resonates deeply with the ethos of evidence-based practice. This verse underscores the importance of caring for others, placing their needs and safety above personal convenience or traditional practices. In the context of healthcare, this principle calls for the adoption of EBPs that safeguard the well-being of patients, aligning with the Christian duty to love and serve others selflessly. By implementing evidence-based interventions for fall prevention, healthcare providers demonstrate their commitment to patient welfare, reflecting Christ’s teachings on compassion and care for the vulnerable.

This alignment with biblical teachings not only fosters a deeper ethical commitment among healthcare providers but also strengthens the overall mission of healthcare facilities to serve as healing environments. By upholding these principles, the healthcare community can mirror the biblical example of service and stewardship, ensuring that every action taken is in the best interest of those they serve. As caregivers integrate these values into their professional practices, they create a compassionate and supportive atmosphere that honors both their faith and their professional responsibilities (Jemal et al., 2023). This holistic approach to healthcare, guided by both scientific evidence and spiritual conviction, greatly enhances the quality of care and the moral integrity of the healthcare system.

In conclusion, the issue of patient falls within healthcare facilities is a significant concern that can benefit immensely from the implementation of evidence-based practices. These practices not only enhance patient safety and care quality but also support healthcare staff and protect facility resources. The biblical call to look after the interests of others provides a strong moral foundation for embracing EBPs, ensuring that all actions in healthcare settings aim to promote the well-being and dignity of every patient. By integrating scientific evidence with clinical expertise and patient values, healthcare providers can create a safer and more effective environment for all.

References

Dabkowski, E., Cooper, S. J., Duncan, J. R., & Missen, K. (2022). Exploring Hospital Inpatients’ Awareness of Their Falls Risk: A Qualitative Exploratory Study. International journal of environmental research and public health20(1), 454. 

Jemal, K., Hailu, D., Mekonnen, M., Tesfa, B., Bekele, K., & Kinati, T. (2023). The importance of compassion and respectful care for the health workforce: a mixed-methods study. Zeitschrift fur Gesundheitswissenschaften Journal of public health31(2), 167–178. 

Loureiro, V., Gomes, M., Loureiro, N., Aibar-Almazán, A., & Hita-Contreras, F. (2021). Multifactorial Programs for Healthy Older Adults to Reduce Falls and Improve Physical Performance: Systematic Review. International journal of environmental researchand public health18(20), 10842. 

Melnyk, B. M., & Fineout-Overholt, E. (2022). Evidence-based practice in nursing & healthcare: A guide to best practice. Lippincott Williams & Wilkins.

New International Version. (2011). Philippians 2:4,. Bible Gateway. Retrieved from 

2. Elsa

Discussion Thread 1: Identifying Quality Issues

Definition. Evidence based research is a method of solving existing problems in healthcare that affect patient treatment and overall care. This method requires the integration of the expert opinion of the provider and various values that will help reach a treatment decision that best suits the needs for the patient (Melnyk & Fieout-Overholt, 2023). The goal is to provide the best care to the patients so that all aspects of the patients’ lives are improved. Health and wellness are not simply the absence of disease. When a patient comes in for care, the treatment must be multifaceted. Treatment should address the initial problem, of course, However, it should address mental and emotional health as well. There are non-medical aspects of social support, safe home environment and family support that also should be addressed. Unfortunately, “medical errors are the third leading cause of death in the United States…” (Melnyk & Fieout-Overholt, 2023, p.7).

Components. Components of evidence-based practice. Intense research is necessary to study a specific research question. Systematic reviews study literature to support the study. Randomized controlled trials (RCT) are considered level I evidence which are used to affect decisions made in the practice of healthcare (Melnyk & Fieout-Overholt, 2023). Evidence-based theories are those that have support from studies that should be included as part of the evidence. Patients should be asked what their preferences are as well as the clinicians. It is important to view healthcare as a partnership and team-based venture. Using PICOT (Population, Intervention, Comparison, Outcome, and Time) helps to set a well-rounded clinical question that is aimed at making change in patient care. Evidence based practice uses a seven-step plan: 0. Inquiry about problem.1. Use PICOT format. 2. Collect relevant evidence. 3. Appraise the evidence. 4. Make the best clinical decision using the expertise of the clinician, patient, and family preferences. 5. Evaluate the outcome. 6. Disseminate the outcome (Melnyk & Fieout-Overholt, 2023, p.9).

Quality Concern of Interest. One of the main issues that is seen in clinical practice is the increased occurrence of readmission. When patients are released from the hospital the facilities are given orders for continued care. Patients need anything from wound care, continued medical care, respiratory care, just to list a few. Nursing and other healthcare staff are ill equipped to meet patients’ basic needs after being released from the hospital. This is especially a concern in the skilled nursing and nursing home settings. There is a lack of clinical training in nursing education among nursing graduates. Basic clinical skills such as starting an IV are not seen. Since the Covid pandemic, a bulk of education has shifted to becoming online. This includes online virtual clinical skills performance. Graduates have few to no actual clinical, hands-on experience. They are then placed in hospitals or clinics with real patients. When patients are released from hospitals into the hands of healthcare staff who lack experience or education, it increases the rate of readmission. Unfortunately, patients do not get the care that is required, and patients are too often sent back to the hospitals. A 2021 article found that 25 percent of heart failure patients are readmitted within the first 30 days and close to 50 percent in the first six months of being discharged. The study found that 25 percent of all the readmitted cases could have been prevented (Khan, et. al., 2021).

Benefit of Evidence Based Research. This issue would benefit from evidence-based care in that if the reason for readmission can be identified, it can be corrected. This can be done by training the nursing and supporting staff appropriately, providing seminars and an increased frequency of physician visits. One article mentioned incorporating the family into the treatment plan. If family members can be adequately trained and equipped to care for their loved one, this will ensure they will receive better care at home than in a facility (Huryk, et. al., 2021). There was evidence that showed family-based treatments reduced the rate of readmissions (Huryk, et. al., 2021). It is also useful to mandate in-service, continued medical education or training seminars to bridge the educational gap seen in today’s graduates.

When a patient is readmitted within a short period of time, it creates a financial burden on the healthcare system. There is a penalty imposed on both the hospital and the facility that is sending the patient back. It would benefit the facility financially if patients were not readmitted. The patient would be able to remain in one setting rather than shuffled between different facilities with different health care teams. This could cause avoidable stress which can interfere with recovery. The staff would benefit by being able to build a rapport with their patients as they help in the recovery process.

Biblical Integration. In the book of Colossians 3:23 it states, “Whatever you do, work at it with all your heart, as working for the Lord, not for human masters” (New International Version, 1978/2011). Providing quality care should be the standard with which we practice healthcare. Regardless of our position as a nursing staff, administration, or leadership, we should aim to work to the best of our ability knowing that we are serving God. Although the educational system has changed drastically, we should still aim to be diligent learners of our skill. It may be easier to pass classes due to virtual skills, but in the field, we are not treating virtual people, but real ones. The writer of Hebrews states in 6:11-12, “We want each of you to show this same diligence…We do not want you to become lazy…” (New International Version, 1978/2011).

References

Huryk, K. M., Casasnovas, A. F., Feehan, M., Paseka, K., Gazzola, P., & Loeb, K. L. (2021). Lower rates of readmission following integration of family-based treatment in a higher level of care. Eating Disorders: The Journal of Treatment & Prevention, 29(6), 677-684. 

Khan, M. S., Sreenivasan, J., Lateef, N., Abougergi, M. S., Greene, S. J., Ahmad, T., Anker, S. D., Fonarow, G. C., & Butler, J. (2021). Trends in 30- and 90-Day Readmission Rates for Heart Failure. Circulation. Heart Failure, 14(4), 1. 

Melnyk, B. M., & Fieout-Overholt, E. (2023). Evidence-Based Practice in Nursing & Healthcare (5th ed.). Lippincott Direct. 

The Holy Bible. New International Version. (1978/2011). biblegateway.com

At least 2 scholarly citations in APA format. Each reply must incorporate at least 2 scholarly citation(s) in APA format. All
sources cited must be published within the last five years with the exception of the Bible.

Discussion Response- quality

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