Answer 2 for DNP 801 Describe your proposed practice site and a potential patient practice problem that you are interested in exploring for your project
My proposed site for my Direct Practice Improvement Project is Cedars-Sinai Medical Center, which is in Los Angeles, California. Cedars-Sinai is licensed for about 880 beds, but the hospital’s daily census averages to about 950 and have reached over 1,000 on given days. When inpatient rooms are not available, Cedars-Sinai activates the Alternate Care Units (ACU) to decompress the emergency room, initiate patient care to avoid delays, and accommodate the growing census. The ACUs utilize various spaces throughout the medical center such as post-anesthesia care units (PACU), the gastrointestinal lab (GI LAB), post-partum, and pediatrics. The ACU is budgeted for 24 beds, yet the ACU’s daily census is about 70 patients on average. At the height of the coronavirus pandemic (COVID-19), ACU’s daily census was about 110 patients.
There has been a dramatic increase in falls on the ACUs over the last few years. Falls can potentially lead to injuries, extend the length of stay, and affect the hospital’s budget and finance (Ward, 2021). When conducting a complete analysis and review of the fall event, the common thread includes the lack of initiating safety measures (i.e., bed alarms, placing beds in the lowest position, ensuring call lights are within reach), educating patients (especially those who are high fall-risk), and a lack of hourly and purposeful rounding. Nurses are well aware of fall prevention and interventions, but there still seems to be a disconnect. Organizations continue to implement fall prevention protocols and need to provide new innovative ideas to prevent such events Hakvoort et al., 2021).
At Cedars-Sinai, units with inpatient private rooms utilize the Responder 5 system to help prevent falls. When the nurse activates a bed alarm and the patient attempts to get out of bed, the physical bed alarms, the patient’s notification light right outside their room flashes for all staff to see, the primary nurse, clinical partner (equivalent to a certified-nursing assistant) and the charge nurse’s Voalte (iPhone) alarms, and the call light at the nursing station alarms as well. Unfortunately, the ACUs do not utilize this system. My goal is to find innovative ways and implement other fall prevention protocols to decrease our fall rates.
References:
Hakvoort, L., Dikken, J., van der Wel, M., Derks, C., & Schuurmans, M. (2021). Minimizing the knowledge-to-action gap; identification of interventions to change nurses’ behavior regarding fall prevention, a mixed method study. BMC Nursing, 20(1), 1–13. https://doi-org.lopes.idm.oclc.org/10.1186/s12912-021-00598-z
