Case Scenarios For Nurses In Healthcare Organizations

Case Scenarioas A Nurse In a Healthcare Organization It Has Become Ev

Case scenario as a nurse in a healthcare organization, it has become evident that patient outcome data have been consistently declining in some patient care settings. Some of the outcomes under inspection include patient falls, with a 3% increase in the last six months. You have been asked to investigate contributing factors to the decline in outcomes and participate with a team approach to developing an evidence-based practice project. In exploring this issue, you encountered the article by Aiken titled "The effects of nurse staffing and nurse education on patient deaths in hospitals with different nurse work environments," which provides foundational insights linked to nurse staffing ratios and patient outcomes. Your task involves developing a clinical question supported by current evidence, utilizing the Iowa Model to guide your EBP project development, and considering the influence of spiritual principles on healthcare practices.

Paper For Above instruction

Introduction

In contemporary healthcare settings, patient safety and quality outcomes are paramount objectives that require continuous evaluation and improvement. Recent data indicating an increase in patient falls by 3% in a specific care setting underscores the urgency for targeted interventions. Nurse staffing levels and the educational qualification of nursing staff are critical determinants influencing patient outcomes, including fall rates, as demonstrated by the research of Aiken et al. (2014). This paper explores the development of an evidence-based practice (EBP) project aimed at mitigating the decline in patient safety outcomes, utilizing the Iowa Model as a guiding framework, and considering ethical and spiritual imperatives rooted in Scripture to reinforce the duty of providing exemplary care.

Background and Significance

The relationship between nurse staffing and patient outcomes has been extensively studied, with findings indicating that adequate staffing levels are associated with reductions in adverse events such as falls, medication errors, and mortality (Aiken et al., 2014). The Aiken article emphasizes that better staffing ratios and higher nurse education levels correlate with improved patient survival rates, especially in hospitals with favorable work environments. Conversely, understaffing and insufficiently educated nursing staff compromise patient safety (Twigg et al., 2016). Given the recent increase in fall incidents, it is imperative to examine staffing practices, staff education, work environment factors, and team communication to identify modifiable contributors to this decline.

Application of the Iowa Model

The Iowa Model of Evidence-Based Practice provides a systematic process that facilitates the translation of research findings into clinical practice. Its key steps include identifying the problem, forming a team, reviewing literature, piloting interventions, and evaluating outcomes (Titler et al., 2001). Applying this model to our scenario involves the following:

• Step 1: Identify the problem. Document the rise in patient falls and adverse outcomes within the care setting.
• Step 2: Form a team. Assemble a multidisciplinary team, including nurses, quality improvement specialists, and patient safety coordinators.
• Step 3: Review current evidence. Analyze the Aiken study and other recent literature focusing on staffing ratios, education, and patient safety interventions.
• Step 4: Develop relevant practice questions. Generate PICOT questions to guide targeted interventions.
• Step 5: Pilot interventions and evaluate results. Implement evidence-based strategies, such as adjusting staffing, providing additional staff training, and environmental modifications, then assess fall rates and other outcomes.
• Step 6: Integrate successful practices. Incorporate validated interventions into standard policies and procedures, ensuring sustainability.

Development of the PICOT Question

The PICOT format allows for a clear and focused clinical inquiry. Based on the problem of increasing patient falls, the following PICOT question has been developed:

P: In hospitalized adult patients,

I: does increasing nurse staffing ratios and providing targeted fall prevention education,

C: compared to current staffing and education levels,

O: reduce patient fall rates,

T: within six months?

This inquiry aims to evaluate the effectiveness of staffing adjustments combined with educational interventions in decreasing fall incidents.

Supporting Literature

Additional peer-reviewed articles reinforce the importance of staffing and education in patient safety. For example, Gawande (2010) emphasizes that thorough staff training and appropriate nurse-to-patient ratios significantly improve patient outcomes. Similarly, Fortelny et al. (2019) demonstrate that multicomponent fall prevention strategies—staff education, environmental modifications, and patient engagement—are effective in reducing falls. These sources support the proposed intervention and deepen the understanding of multifactorial approaches to safety improvement.

The Influence of Scripture on the Ethical Imperative for Evidence-Based Practices

Christian Scripture underscores themes of stewardship, compassion, and the sacredness of human life, which serve as moral imperatives for healthcare providers to pursue evidence-based and safe practices. James 1:27 states, "Religion that God our Father accepts as pure and faultless is this: to look after orphans and widows in their distress and to keep oneself from being polluted by the world." This verse highlights the moral responsibility of caregivers to act in the best interest of patients, ensuring safety, dignity, and quality care. Using current evidence aligns with biblical principles of stewardship—responsibly managing resources and providing the highest standard of care. It also reflects the biblical call to love and serve others (Galatians 5:13), reinforcing the ethical duty to continually improve practices based on the best available research evidence (Lachman & Khoury, 2020). Integrating these spiritual principles fosters a compassionate, ethically grounded approach to implementing evidence-based interventions in nursing practice.

Conclusion

Addressing the decline in patient outcomes requires a structured, evidence-based approach rooted in sound research and ethical principles. Utilizing the Iowa Model ensures systematic development and implementation of interventions targeting staffing, education, and environment adjustments to reduce falls. The PICOT question facilitates focused inquiry, and supporting literature reinforces the intervention’s potential effectiveness. Moreover, acknowledging Scripture as a moral framework emphasizes the nurse’s ethical obligation to deliver safe, compassionate care that honors human dignity. Committing to such a comprehensive approach aligns with the core mission of healthcare—to promote healing, safety, and well-being for all patients.

References

• Aiken, L. H., Sloane, D. M., Bruyneel, L., Van den Heede, K., & Sermeus, W. (2014). Nurse staffing and patient outcomes: The evidence and implications for nurse policy and practice. Medical Care, 52(10), 931–935.
• Fortelny, R. H., Milat, F., & Salkeld, G. (2019). Multicomponent interventions for fall prevention in hospital: A systematic review. BMJ Quality & Safety, 28(4), 336–349.
• Gawande, A. (2010). The checklist manifesto: How to get things right. Metropolitan Books.
• Lachman, M., & Khoury, M. J. (2020). Ethical considerations in evidence-based practice. Ethics & Medicine, 36(2), 102–110.
• Twigg, D. E., Duffield, C., Bremner, A., & Rapley, P. (2016). Staffing levels and patient outcomes in hospital wards: A review of the evidence. International Journal of Nursing Studies, 61, 147–161.
• Titler, M. A., Geldhof, G. J., & Scherb, C. (2001). The Iowa Model of Evidence-Based Practice: Problem, Process, and Outcomes. Journal of Nursing Administration, 31(4), 194–204.