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- All Subjects: Accidental Falls
- All Subjects: Vaccination
- Creators: Blythe, M. Lindsay
Description
Falls in hospitalized patients are a widespread occurrence in the United States, resulting in unfavorable outcomes amongst patients, healthcare providers, and hospital organizations. Current fall prevention efforts have failed to adequately reduce patient fall rates. Nursing peer review (NPR) seeks to refine the quality and safety of patient care, making its use applicable in post-fall reviews. This evidenced-based quality improvement project implements a post-fall NPR program to examine patient falls in an inpatient setting, in addition to the facilitation of patient safety culture education. The Hospital Survey on Patient Safety Culture was used to assess nurses’ perceptions of their units’ patient safety culture. The pre- and post-survey results were analyzed using a two-tailed Mann-Whitney U test, determining significant differences in event (U=2033, z=-2.81, p=.005) and learning (U=1196, z=-2.52, p=.012). No significant differences were noted in support (U=1587, z=-0.05, p=.959), prevent (U=1369, z=-0.70, p=.485), and rate (U=1355.5, z=-0.34, p=.737). Post-fall NPR participation survey results were analyzed using descriptive statistics, showing that it improved patient safety culture (n=10, 91%), reduced “blame & shame” culture (n=9, 82%), and was a non-punitive learning method (n=10, 91%). Reviewing falls through NPR and educating nurses on patient safety culture can create a positive environment to learn from falls. Additional research is needed to determine the impact on patient fall rates.
ContributorsBlythe, M. Lindsay (Author) / Morgan, Michelle (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2022-04-28
Description
Background: Vaccination is an effective public health tool; however, immunization rates are low in American adults, with disparities existing for Hispanics compared to non-Hispanic Caucasians, uninsured individuals, undocumented immigrants, and low-income individuals (Lu et al., 2014; Lu et al., 2015; Williams et al., 2016). Consequently, 42,000 adults still die each year in the United States (US) from vaccine-preventable diseases, and nine billion dollars are spent on associated healthcare costs and lost productivity (ADHS, 2015; Wilson et al., 2019). To improve adult vaccination rates, the National Vaccine Advisory Committee recommends the Standards for Adult Immunization Practices, including regular assessment, recommendation, delivery or referral, and documentation during follow-up on vaccination (Orenstein et al., 2014; CDC, 2016).
Local problem: A free clinic in Arizona serving uninsured, undocumented Latin American immigrants had low vaccination rates and a deficiency in vaccination documentation in electronic medical records.
Methods: An evidence-based quality improvement project was conducted to address low vaccination rates and provider practices using a multi-component intervention. The effect and usage were evaluated through chart audits and pre- post-intervention surveys.
Interventions: A vaccination questionnaire was administered at all in-person primary care visits. Brief educational videos were provided to providers and office staff before the intervention addressing the questionnaire's use, purpose, and goals. Adult immunization schedule printouts were made available in all patient rooms and provider charting areas. Additionally, a resource sheet on local free immunization programs was created for providers and patients.
Results: The intervention's effect was unable to be determined due to a breakdown in the protocol after the second week of implementation. However, 92% of completed questionnaires reviewed indicated the patient needed one or more vaccination. Sixty-five percent of electronic medical records reviewed had no vaccination documentation historically for assessment, recommendation, referral, follow-up, or scanned vaccination records. No charts reviewed had these areas documented regularly.
Conclusion: Vaccination rates and the Standards of Adult Immunization Practices are low at the free clinic. Further quality improvement measures are indicated addressing barriers present.
ContributorsDukes, Alyssa (Author) / Ochieng, Judith (Thesis advisor) / Arizona State University. College of Nursing & Healthcare Innovation (Contributor)
Created2021-04-27