You are assigned to a quality team on a rehabilitation floor where patient falls are on the rise. What strategy would be best to approach this issue quality improvement, evidence-based practice, or research? Support your choice with one or two examples and one or two references.

Discussion 1-1: Patient Falls

   Patient falls in healthcare organizations undermine patient safety. Nurses play a crucial role in identifying the causes of patient falls and in implementing interventions to address them (Agency for Healthcare Research and Quality, 2018). Therefore, it is highly imperative that nurses be able to differentiate whether strategies to minimize patient falls in their healthcare settings are classified as quality improvement, evidence-based practice, or research.

The best strategy to be utilized by a nurse who has been appointed to be part of a team that is working on a rehabilitation floor in an organization where patient falls are on the rise is the quality improvement strategy. According to Backhouse and Ogunlayi (2020), quality improvement entails redesigning processes of work in a healthcare organization to improve patient safety, experience, and outcome. Quality improvement initiatives are implemented at the organizational level to address the unique patient care issues faced by facilities (Agency for Healthcare Research and Quality, 2018). They differ from evidence-based practice (EBP) in that EBP entails the application of best evidence and professional expertise to inform decision-making regarding the care of an individual patient or a group of patients with similar health problems. Again, quality improvement is different from research which entails conducting an investigation to generate new knowledge. The strategy employed on a rehabilitation floor where patient falls are on the rise is unique to an organization based on the prevailing circumstances and it, therefore, fits better as a quality improvement initiative than evidence-based practice or research.

The performance of quality measures guides quality improvement initiatives in healthcare organizations. For example, rates of patient falls are an outcome measure of healthcare quality (Agency for Healthcare Research and Quality, 2022). Therefore, high rates of patient falls should direct a healthcare organization to implement a quality improvement approach but not an EBP or research. In another example, the Agency for Healthcare Research and Quality emphasizes that quality improvement initiatives in healthcare organizations should be tailored to an organization, probably at a unit-level to address a hospital’s priorities regarding what is best for patients (Agency for Healthcare Research and Quality, 2018). Since a quality team on a rehabilitation floor where patient falls are on the rise will focus on an issue that is considered to the organization’s priority at the unit level, it is highly recommended that the team implements a quality improvement project but not research or EBP.

References

Agency for Healthcare Research and Quality. (2018). Preventing falls in hospitals. https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/practices.html.

Agency for Healthcare Research and Quality. (2022). Types of health care quality measures. https://www.ahrq.gov/talkingquality/measures/types.html.

Backhouse, A., & Ogunlayi, F. (2020). Quality improvement into practice. BMJ (Clinical research ed.), 368, m865. https://doi.org/10.1136/bmj.m865.