Capella FPX 4035 Assessment 3

Name

Capella university

NURS-FPX4035 Enhancing Patient Safety and Quality of Care

Prof. Name

Date

Improvement Plan In-Service Presentation

Welcome and Introduction

The session begins with a warm welcome by Brianna, who introduces the focus of the presentation: preventing patient falls, a significant issue in healthcare. This in-service training is designed to equip nursing staff with practical tools and collaborative strategies to improve patient safety and reduce fall incidences.

Part 1: Agenda and Outcomes

Purpose and Training Objectives

The primary aim of this session is to enhance the nursing staff’s competence in identifying fall risks and implementing preventive strategies to improve patient safety across the healthcare facility. Patient falls continue to be a critical issue in hospitals due to their association with severe injuries, prolonged hospital stays, and increased healthcare costs (Khawaja et al., 2023).

The training sets out to achieve three core objectives:

Goal 1: Analyze Root Causes of Patient Falls Participants will explore primary fall causes such as inconsistent fall risk assessments, environmental hazards, and communication breakdowns during shift changes (Takase, 2022).

Goal 2: Evaluate Evidence-Based Prevention Strategies The presentation includes a review of proven methods such as the Morse Fall Scale and modifications to the environment (Miura & Kanoya, 2025).

Goal 3: Demonstrate Implementation Skills Staff will practice skills to apply the safety improvement plan in real-life scenarios. These practical exercises aim to enhance the ability to detect risks and deploy appropriate interventions to improve safety outcomes.

Expected Learning Outcomes

By the end of the session, staff will:

Recognize fall risk factors and procedural weaknesses.
Gain knowledge of cost-effective strategies to lower fall rates.
Apply skills learned in training to daily workflows, fostering patient-centered safety practices (Takase, 2022).

Part 2: Safety Improvement Plan

Identifying the Current Issue

Patient falls are a persistent concern across healthcare organizations. According to Garcia et al. (2021), between 30-35% of falls result in injury. Factors contributing to falls include poor communication during handovers, sporadic assessments, and unsafe environments.

Environmental Factors Contributing to Patient Falls

#	Environmental Factor
1	Inadequate lighting
2	Cluttered pathways
3	Slippery or wet floors
4	Uneven flooring or rugs
5	Lack of handrails or grab bars
6	Improper height of beds or chairs
7	Defective or unmaintained equipment
8	Unsuitable footwear
9	Overcrowded rooms
10	Poorly placed call buttons or items

Research by Takase (2022) reveals that nearly 79% of patient falls occur unwitnessed, with 8.7% occurring during direct care. These statistics underline the urgency to address this challenge to maintain quality and patient trust.

Strategic Safety Improvement Plan

The organization proposes a multi-step plan:

Implement the Morse Fall Scale for consistent risk evaluations.
Improve environmental conditions, such as installing bed alarms and clearing pathways (Lakbala et al., 2024).
Train staff in the SBAR communication framework to enhance handoff efficiency (Mulfiyanti & Satriana, 2022).

Example of SBAR Use:

Situation: “The patient has a high fall risk due to dizziness.”
Background: “History of falls and uses sedatives.”
Assessment: “Unsteady gait, needs assistance.”
Recommendation: “Use bed alarms and hourly rounds.”

Importance to Organizational Success

Preventing falls is vital not only for patient safety but also for financial sustainability. Fall-related injuries cost the healthcare system significantly. Programs like Fall TIPS have reduced expenses by \$22 million (Dykes et al., 2023). Moreover, fall prevention supports The Joint Commission’s safety goals and boosts staff morale by enabling better patient outcomes (Ernstmeyer & Christman, 2021).

Part 3: Role of Nursing Staff

Staff Responsibilities in Implementation

Nurses are central to executing this plan. Key responsibilities include:

Conducting daily Morse Fall Scale assessments.
Reporting environmental risks immediately.
Utilizing SBAR during shift transitions for risk communication (Lakbala et al., 2024).

Critical Importance of Nursing Staff

Nurses are the frontline defenders of patient safety. Their ability to identify hazards and react promptly prevents falls. Effective communication and teamwork using SBAR strengthens fall prevention efforts (Mulfiyanti & Satriana, 2022).

Benefits of Role Ownership

Taking ownership of this role offers tangible benefits:

Improved patient outcomes and fewer injuries.
Reduced stress and more time for care.
Greater job satisfaction and sense of purpose (Ojo & Thiamwong, 2022).

Part 4: Skills Practice and Implementation

Introduction to New Skills

Participants will:

Learn to apply the Morse Fall Scale effectively.
Identify environmental hazards.
Practice structured communication via SBAR. These skills help maintain consistency across teams and reduce fall rates (Lakbala et al., 2024).

SBAR Role-Play Exercise

A practice activity will involve paired staff performing a handoff using SBAR:

Scenario: A 72-year-old patient with medication-induced dizziness and a recent fall.
Participants will have one minute to perform a handoff covering all SBAR components.
Immediate feedback will be provided to improve communication precision and confidence.

Conclusion

This training equips staff with the knowledge and tools to significantly reduce patient falls. With standardized assessments, environmental improvements, and SBAR communication, nurses can enhance safety, cut costs, and build patient trust. The implementation of these strategies depends on active participation, skill mastery, and team collaboration.

References

Dykes, P. C., Bowen, M. C., Lipsitz, S., Franz, C., Adelman, J., Adkison, L., … & Bates, D. W. (2023). Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum, 4(1), e225125. https://doi.org/10.1001/jamahealthforum.2022.5125

Ernstmeyer, K., & Christman, E. (2021). Chapter 5 Safety Introduction. Www.ncbi.nlm.nih.gov; Chippewa Valley Technical College. https://www.ncbi.nlm.nih.gov/books/NBK591826/

Garcia, A., Bjarnadottir, R. I., Keenan, G. M., & Macieira, T. G. R. (2021). Nurses’ perceptions of recommended fall prevention strategies. Journal of Nursing Care Quality, Publish Ahead of Print(3). https://doi.org/10.1097/ncq.0000000000000605

Khawaja, I., Awan, S. A., Azam, D., Zafar, A., & Javed, A. (2023). Fall prevention strategies and their effectiveness in reducing patient falls. International Journal of Nursing Studies, 135, 104312.

Lakbala, P., Abbasi, M., & Salari, H. (2024). The impact of nurse-led environmental safety programs on fall prevention. Journal of Patient Safety, 20(1), 11-18.