Improvement Plan Toolkit Your Name School Of Nursing

Improvement Plan Tool Kit Your Name School of Nursing and Health Sciences

This improvement plan tool kit aims to enable nurses to implement and sustain safety improvement measures in health care settings in a geropsychiatric unit. The tool kit has been organized into four categories with three annotated sources each. The categories are as follows: general organizational safety and quality best practices, environmental safety and quality risks, staff-led preventive strategies, and best practices for reporting and improving environmental safety issues.

Sample Paper For Above instruction

Improving patient safety and quality of care in geropsychiatric units is crucial given the vulnerabilities of the patient population, especially older adults with cognitive impairments. An effective improvement plan requires a comprehensive understanding of organizational practices, environmental risks, staff-led initiatives, and reporting mechanisms. This paper synthesizes current evidence and best practices across these domains to propose a detailed safety improvement strategy tailored for geropsychiatric settings.

Organizational Safety and Quality Best Practices:

A foundational component of safety improvement involves developing a reflective organizational culture that emphasizes continuous learning and quality enhancement. Sherwood and Horton-Deutsch (2015) describe the paradigm shift necessary for organizations to successfully adopt Quality and Safety Education for Nurses (QSEN). They advocate for pedagogical approaches like facilitative teaching and visual thinking strategies that foster engagement and self-reflection among staff, ultimately promoting a safety culture. Reflective practice enables nurses to evaluate their actions critically, facilitating learning that can lead to systemic improvements. Such a culture is particularly vital in geropsychiatric units where complex patient behaviors and safety challenges demand adaptive and reflective healthcare practices.

Supporting this, Fleiszer et al. (2016) highlight the importance of sustainability in safety initiatives. Their case study underscores how benefits such as decreased fall rates, routinization of best practices, and adaptability to environmental changes underpin long-term success. They identify seven key factors that promote sustainability, such as leadership support, staff engagement, and organizational processes. Emphasizing such factors ensures that safety improvements are not transient but embedded within the organizational fabric, fostering ongoing quality enhancement in geropsychiatric care.

Furthermore, promoting effective teamwork is pivotal for quality improvement. Kossaify et al. (2017) outline how team-based efforts, grounded in ethical principles and positive communication, improve care quality and safety outcomes. Strong interprofessional collaboration reduces preventable errors and sentinel events, which are prevalent in high-risk environments. Leadership plays a crucial role in moderating team dynamics and reinforcing a culture of safety. This aligns with the need for multidisciplinary engagement in maintaining and improving safety standards in geropsychiatric settings.

Environmental Safety and Quality Risks:

Addressing environmental risks such as patient falls requires targeted intervention based on understanding specific risk factors. Powell-Cope et al. (2014) investigated falls in inpatient mental health units, identifying infrastructural elements including geriatric-friendly fixtures that can mitigate fall risks. Their study advocates for infrastructure modifications, like installing raised toilet seats, as feasible measures to reduce falls. Although not all strategies may be practical everywhere, the findings serve as a guide for adapting environmental modifications tailored to geropsychiatric units.

Similarly, Wong Shee et al. (2014) evaluated electronic sensor alarms as a fall prevention measure for cognitively impaired patients. Their preliminary findings indicated that sensor alarms are acceptable and effective in alerting staff to patient movement, thereby preventing falls. However, challenges such as hazardous cords and false alarms necessitate further refinement. Incorporating technological solutions, combined with staff training, can create a safer environment, especially when tailored to patient needs and cognitive levels.

Night lighting is another critical environmental factor influencing fall risk. Chari et al. (2016) describe a pilot study assessing modified night lighting with LED fixtures around beds and toilets, highlighting its potential to reduce falls among older adults with cognitive impairments. Although this approach requires further validation, its implementation is feasible and aligns with environmental risk reduction strategies in geropsychiatric wards.

Staff-Led Preventive Strategies:

Proactive staff engagement through targeted strategies significantly contributes to fall prevention. Morgan et al. (2016) demonstrate the effectiveness of intentional rounding—a systematic, routine check on patients at predetermined intervals. Their study reported a 50% reduction in falls, emphasizing the impact of structured communication and teamwork. Implementing such staff-led interventions requires staff training, protocol development, and leadership support to be sustainable and effective in geropsychiatric environments.

Moreover, multifactorial assessment tools and individualized care plans are essential. Moncada and Mire (2017) recommend annual screening for fall risk factors in older adults, integrating interventions like balance exercises, vitamin D supplementation, and medication management. Such comprehensive approaches, when adapted for psychiatric units, can mitigate the multifaceted causes of falls among vulnerable patients.

The engagement of family or carers is also invaluable. Isaac et al. (2018) introduce the TOP5 intervention, which involves gathering detailed patient histories from carers to personalize care plans. This individualized approach has been shown to significantly decrease falls and improve overall patient well-being by addressing specific needs and emotional factors.

Best Practices for Reporting and Improving Environmental Safety Issues:

Accurate and transparent reporting of safety concerns is integral to continuous quality improvement. Tan (2015) highlights bedside reporting as an effective method for enhancing communication during shift changes, especially in sensitive environments like geropsychiatric units. Open, patient-centered communication ensures staff are aware of behavioral changes or safety issues, enabling prompt intervention.

In addition, addressing underreporting of adverse events, such as medication errors, is critical. Stergiopoulos et al. (2016) identify barriers like lack of training and standardized procedures that hinder reporting. Implementing structured electronic reporting systems and fostering a culture that encourages "good catches" can enhance incident detection and prevention.

Lozito et al. (2018) describe the "Good Catch" campaign, emphasizing proactive error reporting to prevent adverse events. Such programs cultivate a safety-focused environment where staff feel empowered to identify and report potential hazards, thereby reducing likelihood of sentinel events like falls.

In addition to reporting systems, continuous staff education is essential. Training nurses on the importance of medication safety (e.g., vigilant adverse drug event reporting) and environmental hazard identification perpetuates a safety-oriented mindset. These practices, combined with leadership support and organizational commitment, foster ongoing safety improvements in geropsychiatric care facilities.

Conclusion:

Developing a comprehensive safety improvement plan for geropsychiatric units necessitates integrating organizational culture, environmental modifications, proactive staff interventions, and robust incident reporting mechanisms. By adopting reflective practices, promoting teamwork, implementing environmental safeguards like improved lighting and alarms, and fostering a culture of transparency and continuous learning, healthcare providers can significantly reduce incidents such as falls. Sustained commitment from leadership, ongoing staff education, and engagement of patients and families are fundamental to creating a safe and supportive environment that promotes optimal patient outcomes and quality of care.

References

• Chari, S. R., Smith, S., Mudge, A., Black, A. A., Figueiro, M., Ahmed, M., . . . Haines, T. P. (2016). Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: A protocol for a pilot trial. Pilot and Feasibility Studies, 2(1).
• Fleiszer, A. R., Semenic, S. E., Ritchie, J. A., Richer, M.-C., & Denis, J.-L. (2016). A unit-level perspective on the long-term sustainability of a nursing best practice guidelines program: An embedded multiple case study. International Journal of Nursing Studies, 53, 204–218.
• Isaac, L. M., Buggy, E., Sharma, A., Karberis, A., Maddock, K. M., & Weston, K. M. (2018). Enhancing hospital care of patients with cognitive impairment. International Journal of Health Care Quality Assurance, 31(2), 173–186.
• Kossaify, A., Hleihel, W., & Lahoud, J.-C. (2017). Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: Monitoring and management strategies to enhance teamwork. Public Health, 153, 91–98.
• Lozito, M., Whiteman, K., Swanson-Biearman, B., Barkhymer, M., & Stephens, K. (2018). Good catch campaign: Improving the perioperative culture of safety. AORN Journal, 107(6), 705–714.
• Moncada, L. V. V., & Mire, G. L. (2017). Preventing falls in older persons. American Family Physician, 96(4), 240–247.
• Powell-Cope, G., Quigley, P., Besterman-Dahan, K., Smith, M., Stewart, J., Melillo, C., & Friedman, Y. (2014). A qualitative understanding of patient falls in inpatient mental health units. Journal of the American Psychiatric Nurses Association, 20(5), 328–339.
• Sherwood, G., & Horton-Deutsch, S. (2015). Reflective organizations: On the front lines of QSEN and reflective practice implementation. Retrieved from proquest.com.library.capella.edu/lib/capella/detail.action?docID=#
• Stergiopoulos, S., Brown, C. A., Felix, T., Grampp, G., & Getz, K. A. (2016). A survey of adverse event reporting practices among US healthcare professionals. Drug Safety, 39(11), 1117–1127.
• Wong Shee, A., Phillips, B., Hill, K., & Dodd, K. (2014). Feasibility, acceptability, and effectiveness of an electronic sensor bed/chair alarm in reducing falls in patients with cognitive impairment in a subacute ward. Journal of Nursing Care Quality, 29(3), 253–262.