Assessment Policy Proposal Paper

Assessment Policy Proposal Paper

The healthcare organization’s dashboard indicated underperformance in some areas, including the safety of care and patient experience, are not meeting the organization’s target and the set national benchmark. On the other hand, the hospital’s failure to meet the safety of care is reflected in the high rate of patient falls in three departments, including medical, surgical, and medical-surgical units. These underperforming areas compromise patient care’s safety, quality, and efficiency. Therefore, a healthcare organization should implement a policy to address the underperforming areas. This paper presents need for creating a policy and practice guidelines for the organization; organization’s current benchmark; benchmark underperformance potentially impacting organization’s performance, potential repercussions if no changes are made, including evidence supporting the claims; recommended ethical, evidence-based practise guidelines for improving targeted benchmark performance; evidence-based strategies for improving performance; how the proposed approaches ensure performance improvement; application of these strategies in the context of the selected clinical practice, potential impacts of environmental factors on the recommended practice guidelines;  regulatory considerations that would impact the recommended guidelines; resources that might affect the recommended guidelines, reasons for involving a particular stakeholders in developing and implementing the proposed procedures, significance of engaging the stakeholders, and ho their participation can lead to a stronger policy and support its adoption to the practice setting Assessment Policy Proposal Paper.

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The Significance of Creating a Policy and Practice Guidelines

ABC hospital should create a policy and practise guidelines to improve underperforming areas. One of these areas is the high rate of patient falls in three departments, including medical, surgical, and medical-surgical units. The second underperforming area in the hospital is the high rate of catheter-associated urinary tract infections (CAUTIs)Assessment Policy Proposal Paper. Underperformance in these areas compromises the hospital’s capacity to meet benchmark metrics recommended by local, state, or federal health care policies. Therefore, developing and implementing an appropriate policy will improve the underperforming areas, enabling the hospital to meet quality benchmarks.

Organization’s Current Benchmark and the Numeric score for the Underperformance

            The underperforming areas in the healthcare organization include the high rate of patient falls in three departments and the high speed of CAUTIs. The hospital reported a high rate of patient falls in three units, including medical, surgical, and medical-surgical, representing about 24 falls per 1000 patient days. The second underperforming area in the hospital is the high rate of catheter-associated urinary tract infections (CAUTIs), representing 6.5 per 1,000 urinary catheter days.

The Impact of the Benchmark Underperformance on Organization’s Performance

            High rates of patient fall and CAUTIs compromise healthcare organizations’ performance. These underperforming results in adverse health incomes, including high readmission rates and longer stays, increasing the number of patients requiring medical care services. According to Briatte et al. (2019)Assessment Policy Proposal Paper, a high workload among nurses reduces the quality of patient care in healthcare organizations. The quality of care is affected since a single nurse is allocated more patients than recommended. Thus, adverse outcomes in the hospital result in delayed healthcare service and poor-quality care.

The Potential Repercussions if no Changes are made

Failure to make changes to address the underperforming areas, including a high rate of CAUTIs and high rates of patient falls, might result in adverse health outcomes, including longer stay, high readmission rate, and high cost of care. Stevens and Lee (2018) reported that a high patient fall rate imposes a huge financial burden on individual patients, their families, and healthcare organizations. Therefore, failure to make any changes to resolve the current state would result in negative patient outcomes in the selected clinical setting.

Recommended Ethical and Evidence-Based Practice

Ethical guidelines and evidence-based practices can improve the targeted benchmark performance. First, the ethical principles of beneficence and maleficence can be used to resolve the high rate of CAUTIs and patient falls in the healthcare organization. The ethical guideline of beneficence states that healthcare providers should focus on benefiting the patients, while the ethical consideration of maleficence holds that medical professionals should not harm their patients (Varkey, 2021)Assessment Policy Proposal Paper. Thus, healthcare providers should protect their patients from CAUTIs and falls, upholding these ethical principles. Additionally, adopting evidence-based interventions can reduce the high rate of CAUTIs and falls in the hospital.

Potential Interventions for Improving Underperforming areas from Evidence-Based Literature

The underperforming areas include a high rate of patient falls and a high rate of CAUTIs. These areas can be improved by adopting evidence-based intervention. The healthcare organization’s high rate of patient falls can be enhanced by implementing hourly rounding (LeLaurin & Shorr, 2019)Assessment Policy Proposal Paper. Healthcare providers identify patients’ needs during hourly rounding and assist the patient, reducing fall risk. On the other hand, the high rate of CAUTIs can be reduced by replacing indwelling catheters with external ones (Zavodnick et al., 2020). External catheters limit the transmission of disease-causing micro-organisms from healthcare providers’ hands and the environment to the patient’s body, reducing the risk of contracting CAUTIs.

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How would these Approaches ensure Performance Improvement?

The first intervention involves adopting hourly rounding to reduce patient falls. According to LeLaurin and Shorr (2019), scheduled hourly rounding is an effective intervention for reducing falls among the geriatric population. Healthcare providers identify patients’ needs during hourly rounding and address them, reducing the high risk of falling. Additionally, replacing indwelling catheters with external ones would reduce the high rate of CAUTIs (Zavodnick et al., 2020)Assessment Policy Proposal Paper. These measures would improve healthcare organizations’ performance.

Proposing Application of these Strategies in the Selected Practice Setting

The proposed evidence-based measures, including hourly rounding and replacing indwelling catheters with external catheters, can be applied in the practice setting by presenting statistics, indicating the effectiveness of the proposed interventions in addressing underperformances. According to Walsh et al. (2018), hourly rounding effectively reduces the high rate of falls among hospitalized patients. Thus, this approach should be implemented in the healthcare organization to reduce the high rate of patient falls.

Ensure that the Strategies are Ethical and Culturally Inclusive

The applied approaches should consider ethical principles, including patient autonomy, beneficence, maleficence, justice, confidentiality and non-disclosure. Additionally, the interventions should consider cultural guidelines to ensure they cater to the healthcare needs of diverse ethnic groups, including minorities.

Environmental Factors Impacting the Strategies

The proposed guidelines focus on reducing the high rate of falls and CAUTIs. The high rate of falls can be reduced via hourly rounding. However, environmental factors can affect this approach, including high beds and slippery floors. Additionally, the high rate of CAUTIs can be reduced by replacing indwelling catheters with external devices. However, this intervention can be compromised by contaminated healthcare providers’ hands and external devices Assessment Policy Proposal Paper.

Regulatory Considerations

The recommended guidelines, including hourly rounding and external devices, can be affected by regulatory measures. First, they will be affected by the proposed regulatory measures for reducing patient falls, such as installing bed alarms. On the other hand, using external devices can be affected by regulatory measures supporting indwelling devices.

Recommended Guidelines

The recommended guidelines can be affected by staffing and finances. More healthcare workers, especially nurses, are needed to implement hourly rounding. Additionally, finances will be required to purchase external devices, which would replace indwelling devices.

Significance of Involving Stakeholders

Stakeholders, particularly the management, should be involved in implementing the proposed guidelines. The management would approve the procedures to be implemented in the healthcare organization. Additionally, it would provide the necessary support, including finances. Therefore, it is important to engage the management to implement the proposed approach successfully. Management’s participation can result in a stronger policy and facilitate its implementation by providing ideas about the most effective policy and offering required resources, including finances Assessment Policy Proposal Paper.

Conclusion

Underperforming areas in the healthcare organization include a high rate of patient falls and high rates of CAUTIs. Developing and implementing evidence-based practices and guidelines can improve performance in these areas. The healthcare organization’s high rate of patient falls can be enhanced by implementing hourly rounding. Additionally, the high rate of CAUTIs can be improved by replacing indwelling devices with external catheters. Adopting these evidence-based interventions in the selected healthcare organization will result in safe patient care and positive health outcomes. Stakeholders, particularly the management, should be involved in developing and implementing the proposed policy guidelines. During policy development, the management will give ideas regarding the most effective policies for improving underperforming areas. Additionally, the management will approve the proposed policies before being implemented in the hospital. Therefore, involving the management will result in the development and successful implementation of the most appropriate policy in the healthcare organization.

References

Briatte, I., Allix-Béguec, C., Garnier, G., & Michel, M. (2019). Revision of hospital work organization using nurse and healthcare assistant workload indicators as decision aid tools. BMC health services research19(1), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4376-7

Stevens, J. A., & Lee, R. (2018). The potential to reduce falls and avert costs by clinically managing fall risk. American journal of preventive medicine55(3), 290-297. Doi: 10.1111/jgs.15304.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice30(1), 17-28. https://doi.org/10.1159/000509119.

Walsh, C. M., Liang, L. J., Grogan, T., Coles, C., McNair, N., & Nuckols, T. K. (2018). Temporal trends in fall rates with the implementation of a multifaceted fall prevention program: persistence pays off. The Joint Commission Journal on Quality and Patient Safety44(2), 75-83. Doi: Assessment Policy Proposal Paper 10.1016/j.jcjq.2017.08.009

Zavodnick, J., Harley, C., Zabriskie, K., & Brahmbhatt, Y. (2020). Effect of a female external urinary catheter on the incidence of catheter-associated urinary tract infection. Cureus12(10). Doi: 10.7759/cureus.11113

Assessment 2: Policy Proposal

The healthcare organization’s dashboard indicated underperformance in some areas, including the safety of care and patient experience, are not meeting the organization’s target and the set national benchmark. On the other hand, the hospital’s failure to meet the safety of care is reflected in the high rate of patient falls in three departments, including medical, surgical, and medical-surgical units. These underperforming areas compromise patient care’s safety, quality, and efficiency. Therefore, a healthcare organization should implement a policy to address the underperforming areas. This paper presents need for creating a policy and practice guidelines for the organization; organization’s current benchmark; benchmark underperformance potentially impacting organization’s performance, potential repercussions if no changes are made, including evidence supporting the claims; recommended ethical, evidence-based practise guidelines for improving targeted benchmark performance; evidence-based strategies for improving performance; how the proposed approaches ensure performance improvement; application of these strategies in the context of the selected clinical practice, potential impacts of environmental factors on the recommended practice guidelines;  regulatory considerations that would impact the recommended guidelines; resources that might affect the recommended guidelines, reasons for involving a particular stakeholders in developing and implementing the proposed procedures, significance of engaging the stakeholders, and ho their participation can lead to a stronger policy and support its adoption to the practice setting.

The Significance of Creating a Policy and Practice Guidelines

ABC hospital should create a policy and practise guidelines to improve underperforming areas. One of these areas is the high rate of patient falls in three departments, including medical, surgical, and medical-surgical units. The second underperforming area in the hospital is the high rate of catheter-associated urinary tract infections (CAUTIs)Assessment Policy Proposal Paper. Underperformance in these areas compromises the hospital’s capacity to meet benchmark metrics recommended by local, state, or federal health care policies. Therefore, developing and implementing an appropriate policy will improve the underperforming areas, enabling the hospital to meet quality benchmarks.

Organization’s Current Benchmark and the Numeric score for the Underperformance

            The underperforming areas in the healthcare organization include the high rate of patient falls in three departments and the high speed of CAUTIs. The hospital reported a high rate of patient falls in three units, including medical, surgical, and medical-surgical, representing about 24 falls per 1000 patient days. The second underperforming area in the hospital is the high rate of catheter-associated urinary tract infections (CAUTIs), representing 6.5 per 1,000 urinary catheter days.

The Impact of the Benchmark Underperformance on Organization’s Performance

            High rates of patient fall and CAUTIs compromise healthcare organizations’ performance. These underperforming results in adverse health incomes, including high readmission rates and longer stays, increasing the number of patients requiring medical care services. According to Briatte et al. (2019)Assessment Policy Proposal Paper, a high workload among nurses reduces the quality of patient care in healthcare organizations. The quality of care is affected since a single nurse is allocated more patients than recommended. Thus, adverse outcomes in the hospital result in delayed healthcare service and poor-quality care.

The Potential Repercussions if no Changes are made

Failure to make changes to address the underperforming areas, including a high rate of CAUTIs and high rates of patient falls, might result in adverse health outcomes, including longer stay, high readmission rate, and high cost of care. Stevens and Lee (2018) reported that a high patient fall rate imposes a huge financial burden on individual patients, their families, and healthcare organizations. Therefore, failure to make any changes to resolve the current state would result in negative patient outcomes in the selected clinical setting.

Recommended Ethical and Evidence-Based Practice

Ethical guidelines and evidence-based practices can improve the targeted benchmark performance. First, the ethical principles of beneficence and maleficence can be used to resolve the high rate of CAUTIs and patient falls in the healthcare organization. The ethical guideline of beneficence states that healthcare providers should focus on benefiting the patients, while the ethical consideration of maleficence holds that medical professionals should not harm their patients (Varkey, 2021)Assessment Policy Proposal Paper. Thus, healthcare providers should protect their patients from CAUTIs and falls, upholding these ethical principles. Additionally, adopting evidence-based interventions can reduce the high rate of CAUTIs and falls in the hospital.

Potential Interventions for Improving Underperforming areas from Evidence-Based Literature

The underperforming areas include a high rate of patient falls and a high rate of CAUTIs. These areas can be improved by adopting evidence-based intervention. A healthcare organization’s high rate of patient falls can be enhanced by implementing hourly rounding (LeLaurin & Shorr, 2019). Healthcare providers identify patients’ needs during hourly rounding and assist the patient, reducing fall risk. On the other hand, the high rate of CAUTIs can be reduced by replacing indwelling catheters with external ones (Zavodnick et al., 2020)Assessment Policy Proposal Paper. External catheters limit the transmission of disease-causing micro-organisms from healthcare providers’ hands and the environment to the patient’s body, reducing the risk of contracting CAUTIs.

How would these Approaches ensure Performance Improvement?

The first intervention involves adopting hourly rounding to reduce patient falls. According to LeLaurin and Shorr (2019), scheduled hourly rounding is an effective intervention for reducing falls among the geriatric population. Healthcare providers identify patients’ needs during hourly rounding and address them, reducing the high risk of falling. Additionally, replacing indwelling catheters with external ones would reduce the high rate of CAUTIs (Zavodnick et al., 2020). These measures would improve healthcare organizations’ performance.

Proposing Application of these Strategies in the Selected Practice Setting

The proposed evidence-based measures, including hourly rounding and replacing indwelling catheters with external catheters, can be applied in the practice setting by presenting statistics, indicating the effectiveness of the proposed interventions in addressing underperformances. According to Walsh et al. (2018)Assessment Policy Proposal Paper, hourly rounding effectively reduces the high rate of falls among hospitalized patients. Thus, this approach should be implemented in the healthcare organization to reduce the high rate of patient falls.

Ensure that the Strategies are Ethical and Culturally Inclusive

The applied approaches should consider ethical principles, including patient autonomy, beneficence, maleficence, justice, confidentiality and non-disclosure. Additionally, the interventions should consider cultural guidelines to ensure they cater to the healthcare needs of diverse ethnic groups, including minorities.

Environmental Factors Impacting the Strategies

The proposed guidelines focus on reducing the high rate of falls and CAUTIs. The high rate of falls can be reduced via hourly rounding. However, environmental factors can affect this approach, including high beds and slippery floors. Additionally, the high rate of CAUTIs can be reduced by replacing indwelling catheters with external devices. However, this intervention can be compromised by contaminated healthcare providers’ hands and external devices.

Regulatory Considerations

The recommended guidelines, including hourly rounding and external devices, can be affected by regulatory measures. First, they will be affected by the proposed regulatory measures for reducing patient falls, such as installing bed alarms. On the other hand, using external devices can be affected by regulatory measures supporting indwelling devices Assessment Policy Proposal Paper.

Recommended Guidelines

The recommended guidelines can be affected by staffing and finances. More healthcare workers, especially nurses, are needed to implement hourly rounding. Additionally, finances will be required to purchase external devices, which would replace indwelling devices.

Significance of Involving Stakeholders

Stakeholders, particularly the management, should be involved in implementing the proposed guidelines. The management would approve the procedures to be implemented in the healthcare organization. Additionally, it would provide the necessary support, including finances. Therefore, it is important to engage the management to implement the proposed approach successfully. Management’s participation can result in a stronger policy and facilitate its implementation by providing ideas about the most effective policy and offering required resources, including finances.

Overall, the underperforming areas in the healthcare organization include a high rate of patient falls and high rates of CAUTIs. Developing and implementing evidence-based practices and guidelines can improve performance in these areas. Stakeholders, particularly the management, should be involved in developing and implementing the proposed approach, resulting in the organization’s successful adoption of the policy Assessment Policy Proposal Paper.

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References

Briatte, I., Allix-Béguec, C., Garnier, G., & Michel, M. (2019). Revision of hospital work organization using nurse and healthcare assistant workload indicators as decision aid tools. BMC health services research19(1), 1-9. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-019-4376-7

Stevens, J. A., & Lee, R. (2018). The potential to reduce falls and avert costs by clinically managing fall risk. American journal of preventive medicine55(3), 290-297. Doi: 10.1111/jgs.15304.

Varkey, B. (2021). Principles of clinical ethics and their application to practice. Medical Principles and Practice30(1), 17-28. https://doi.org/10.1159/000509119.

Walsh, C. M., Liang, L. J., Grogan, T., Coles, C., McNair, N., & Nuckols, T. K. (2018). Temporal trends in fall rates with the implementation of a multifaceted fall prevention program: persistence pays off. The Joint Commission Journal on Quality and Patient Safety44(2), 75-83. Doi: 10.1016/j.jcjq.2017.08.009

Zavodnick, J., Harley, C., Zabriskie, K., & Brahmbhatt, Y. (2020). Effect of a female external urinary catheter on the incidence of catheter-associated urinary tract infection. Cureus12(10). Doi: 10.7759/cureus.11113 Assessment Policy Proposal Paper