Quality Improvement Proposal

Quality Improvement Proposal
The health care system ensures that patients receive the correct and quality treatment and care for quick, complete, and quality recovery. However, this is not always the case as the care system faces challenges such as limited resources resulting in misdiagnoses, poor quality care, delayed treatment, and the spread of hospital-related infections among the patients and their caregivers. Since the main objective of nursing is providing quality care, there is a need for improvements in the environmental, social, and medical aspects.
Nursing homes are facilities that provide skilled nursing care for patients with either long or short-term medical issues. The patients in nursing homes are in urgent need of 24-hour medical surveillance and supervision. Additionally, nursing homes provide rehabilitation services such as occupational, speech, or physical therapy. The recovery of patients in nursing homes highly depends on the quality of care accorded. However, these care homes face a myriad of challenges that put their services in jeopardy. Among them are patients falling in the care facilities. This study assesses the rates of patients falling in the care facilities and explains why a quality improvement initiative is needed for this challenge.
Falls in Nursing Homes
It is common knowledge that hospitals and care homes are places individuals go to get better. However, most injuries and infections are acquired in hospitals. In the U.S., between 700,000 and 1,000,000 patients fall in hospitals and care homes (Weil, 2015). These falls increase a patient's hospital stay by 6.3 days and result in either mild or fatal injuries. Hitcho et al. (2004) argued that falls in nursing homes are frequent, and most are not reported. Additionally, the article highlights that 79% of the falls are unassisted, 59% occur at night, and 85% occur inside the patients' rooms. Therefore, their main argument centered on improving the immediate environment to reduce falls.
CDC (2020) highlights that falls in nursing homes are a common occurrence and are a leading cause of non-fatal and fatal injuries among patients. Falls in nursing homes are a serious problem, as about 1,800 people in care homes die from falls. 20% of falls result in serious injuries such as disabilities, reduced quality of life, and functional decline, while 6% of falls result in fractures. The fear of falling among the patients causes loss of functionality, feeling of helplessness, social isolation, and depression.
Falling is common in nursing homes because older patients are frailer than those in the community, have chronic illnesses, memory or thought problems, and have difficulty walking and performing daily tasks. These factors are closely linked to falling. The common causes of falling are environmental hazards, medication, and muscle weaknesses. Gait problems or muscle weakness amounts to 24% of falls in nursing homes. 27% are due to environmental hazards such as incorrect bed height, poor lighting, ill-fitted wheelchairs, uneven floors, missing equipment parts, inaccessible personal items, hard-to-manage clothing, cluttered living spaces, improper footwear, and wet surfaces. Medications such as anti-anxiety drugs and sedatives increase the risk of falling among nursing home patients (CDC & NCIPC, 2012).
Quality Improvement Initiative
The literature above indicates that falls are a serious public health issue. They increase the patient's stay in hospitals and care homes, resulting in a decline in functionality. They also reduce the quality of life, increase the fear of falling, and restrict participation in physical activities. Besides, falls cause fractures and other severe injuries and increase the risk of death. All these impacts of falls in the care facilities reduce the quality of the services provided by the healthcare practitioners by increasing the recovery period of the patients or death. Additionally, falls result in lawsuits against the care facilities and staff members, resulting in high insurance premiums and loss of large sums of money. Therefore, there is a need to introduce a quality improvement initiative that will aid in reducing or otherwise eliminating the instances of patients falling in the care centers.
Many healthcare facilities have fall initiatives but still, acknowledge the need for improvements. However, Tricco et al. (2019) argue that despite having measures to reduce falls in hospitals and care homes, falls are still a significant concern in the United States. The quality improvement initiative aims to reduce falls in nursing homes by implementing evidence-based strategies. Taylor et al. (2005) argue that the most effective quality improvement strategy is instilling a safety culture among staff members and patients. The quality improvement initiatives aid with implementing evidence-based practices by targeting patients, healthcare facilities, and staff members (CDC, 2016).
Among the quality improvement initiative is the Falls Management Program (FMP). The program is designed to assist the nursing care centers in providing personal-centered and individualized care by improving fall care outcomes and processes via quality improvement and educational tools. The FMP entails two approaches. The first approach seeks to immediately screen and assess a fall when it occurs. This approach leads to identifying the risk and implementing strategies to avoid a similar fall in the future. The second approach of the FMP entails long-term fall management initiatives such as screening patients upon admiss...