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Introduction, Analysis of Existing Evidence, And Quality Improvement Process

Introduction, Analysis of Existing Evidence, And Quality Improvement Process

Introduction, Analysis of Existing Evidence, And Quality Improvement Process
QUESTION
Assignment: Capstone Paper, Part I: Introduction, Analysis of Existing Evidence, and Quality Improvement Process

The Assignment you will submit this week will combine the work you completed in Week 1 (Introduction) and Week 2 (Analysis of Existing Evidence) and this week’s assignment, the Quality Improvement Process. These three sections, when combined, will complete Part I of your Capstone Paper.
To prepare for this Assignment:
Review the Capstone Paper Assignment Guide
Locate the most current version of your Week 1 and Week 2 Assignment. You will add this section to that document.
Review the Academic Writing Expectations Checklist Capstone Level
Note the new expectations for Use of evidence and Credit to Source
Use a Scholarly Voice
http://academicguides.waldenu.edu/writingcenter/scholarlyvoice
http://academicguides.waldenu.edu/writingcenter/webinars/scholarlywriting#s-lg-box-2773859
Review the Walden University Writing Center webpage: Using Evidence: Synthesis
Review the Week 3 Assignment Rubric
Remember: Each section of the Capstone Paper must meet the Academic Writing Expectations for the Capstone Level.
For this Assignment
Describe the quality improvement process and the Quality model that will be used as a basis for the practice problem. Include a description of a quality improvement tool(s) that you will use in your quality improvement plan. See Spath, (2018) chapter 6 for examples.
Explain why the specific process was selected and document your explanation with references.
For the Week 3 Assignment, you will combine your Week 1, 2 and 3 assignments and submit a 3-4-page paper that addresses the following:
Practice Problem (Completed in Week 1)
State the practice problem in measurable terms.
State the data that suggests a practice problem exists
Include a purpose statement.
Analysis of the Existing Evidence (Completed in Week 2)
Summarize the findings from the evidence analysis that support your practice problem. Include minimum of at least 5 evidence-based practice sources that support your practice problem. Identify research, clinical guidelines, expert opinions, and other relevant information. You must include two-three research studies in your analysis. Using your own words synthesize the evidence that supports your identified practice problem. There should be no quotes or personal opinions included in this section.
Quality Improvement Process (Completed this Week) (Approximately 2-3 paragraphs)
Describe the quality improvement process and the quality model that will be used as a basis for the practice problem. This is not your entire quality improvement plan, only a description of the quality improvement process and the quality model you chose. You will develop your specific quality improvement plan in week 4. Include a description of a quality improvement tool(s) that you will use in your quality improvement plan. See Spath, (2018) chapter 6 for examples.
Explain why the specific process was selected and document your explanation with references.
Conclusion
Introduction, Analysis of Existing Evidence, And Quality Improvement Process

ANSWER
Capstone Paper, Part 1: Introduction, Analysis of Existing Evidence, And Quality Improvement Process

Student Name
Program Name or Degree Name, Walden University
COURSE XX: Title of Course
Instructor Name
November 01, 2020

Capstone paper, Part 1: Introduction, Analysis of Existing Evidence, and Quality Improvement process
Healthcare faces several challenges that affect the level of patient satisfaction, as well as patient recovery and trust. According to Charlotte and colleagues (2019), this accounts for every ten patients in an inpatient healthcare facility. Similarly, a different report indicated that in the U.S alone, 608 patient safety cases were reported by 475 clinicians over two years. This indicated the need to apply quality improvement in healthcare. Application of iterative quality improvement processes in healthcare has shown improvement in resolving the problems giving forth benefits like reduced patient readmissions, improved drug adherence, reduced cost of care delivery, and increased patient-care provider relationship. This paper aims to describe patient safety problems in an inpatient psychiatric facility (with a focus on patient falls), analyze the problem through literature review, hence device a quality improvement process and a reliable model that will increase patient satisfaction and the quality of care.

Analysis of Evidence to Support the Prevalence Of Decreased Patient Safety (Falls) Among Psychiatric Patients.
Quality improvement has been the driving force of quality delivery of care in the past decade. A lot has been done to maximize the delivery of care as well as patient satisfaction. However, less focus has been put on the reduction of the occurrence of falls among psychiatric patients. This is demonstrated by the reduced number of publications that directly target this problem. A few studies were found to show relevance in supporting the existence of the problem.
A report issued by the Joint Commission on Accreditation of Health Care Organizations in 1996 indicated that annually, out of all the reported fall cases, 18% involved mentally ill patients. Out of these cases, 77% of the patients involved had psychiatric problems from acute drug intoxication and chronic mental disease (Estrin et al., 2009). A study conducted in a state psychiatric hospital showed that 36% of patient safety incidences were falls in Singapore alone. Fall in psychiatric patients has received less attention as such; there are fewer fall-risk models to cub this problem (Xu et al., 2011). One study indicated that some of the key causes of falls in this class of patients include gait and balance problems, side effects of antidiabetics, confusion, the use of sedatives and hypnotics, and the general need to be assisted with day to day activities. A different study showed that falls were common among patients with increased anxiety, agitation, and bowel urgency but with impaired gait and balance being more statistically significant (Sano et al., 2013).
Rao and colleagues (2018) gave a report utilizing 39 studies that covered 204 234 psychiatric patients, which demonstrated the prevalence of falls. The report indicated that the prevalence of falls among these classes of patients in china to be 3% of adults and 7.3% of older adults (above 60 years). The report demonstrated that falls among psychiatric patients are significantly high, and this calls for the initiation of quality improvement processes in health facilities in china as well as the affected regions. In a separate report, Rao et al. conducted a meta-analysis focusing on the prevalence of falls among older adults globally. In the report, sixteen papers out of 2061 papers reviewed were found to be relevant, and it was found out a 17.25% prevalence of falls among older psychiatric adults.
A study conducted in 2016 with 93 psychogeriatric patients (46 women and 47 men) reported that 12 fall cases were reported. Out of this, 66% of the falls involved dementia patients. According to the study, women and patients with dementia had a higher risk of falls (Wong et al., 2019). This study illustrates that falls are common, with most of them being of high risk and tied to patients with particular mental illnesses.
Quality Improvement Process to Reduce Falls Among Inpatient Psychiatric Patients
Quality in healthcare setup revolves around patient satisfaction, adherence to medication, and competency in delivering care. It is a multidimensional concept that involves patients and healthcare practitioners. Furthermore, patient safety is paramount in delivering quality care since the primary goal of care delivery is to save lives and restore the patients’ normal functionality. This is possible if the existing problems are identified and rectified accordingly. Quality improvement is best defined as a well-structured technique that involves the in-depth evaluation of processes, identification of flaws and necessary interventions, and the ultimate application of the interventions to eliminate the problems, resulting in increased efficiency (Balakrishnan, 2015). The success of quality improvement majorly relies on collecting and analyzing data, which results in the formulation of desirable intervention. In healthcare setup, Health Resource and Service Administration consider the quality improvement process as an approach targeting a particular set of patients and involving systematic and continuous actions that result in measurable improvements in service delivery (Brixey et al., 2016). Quality improvement tools simplify the analysis of particular interventions’ practice performance, making it possible to adapt the intervention for better service delivery.
Introduction, Analysis of Existing Evidence, And Quality Improvement Process
In this paper, the PDSA (Plan-Do-Study-Act) model will solve falls among psychiatric patients in an inpatient setup. This model has the advantage of demonstrating rapid cycle improvement to assess change by allowing the application of small changes for every cycle before initiating a system-wide change. PDSA model does not have a high cost and results more rapidly (Brixey et al., 2016). Furthermore, the model provides detailed clarity of all attributes, including each person’s role in the team, the timing of each intervention, and the resources needed at each stage, hence aid in the adoption or change of a particular intervention. The intervention’s small-scale application clarifies to everyone that the test is a pilot, thus eliminating anxiety or resistance to disregard or modify the chosen intervention. PDSA model also helps the participants acquire knowledge and fresh experience, thus enhancing the likelihood of success (King and Wheeler, 2016).
Conclusion
The reduced focus on quality improvement in psychiatric facilities has resulted in increased problems majorly with patient safety. Even though most psychiatric patients tend to be violent or aggressive, there is a need to try and eliminate the problems. Existing data indicate that globally, falls among psychiatric patients in inpatient setup are common. Therefore, it is necessary to develop a quality improvement process to enhance the recovery of patients and increase patient satisfaction.

Reference
Balakrishnan, N. (2015). Dependability in medicine and neurology: Using engineering and management principles for better patient care.
Brixey, J. J., Brixey, J. E., Saba, V. K., & McCormick, K. A. (2016). Essentials of the nursing informatics study guide.
Charlotte Wåhlin, Susanne Kvarnström, Annica Öhrn & Emma Nilsing Strid (2020) Patient and healthcare worker safety risks and injuries. Learning from incident reporting, European Journal of Physiotherapy, 22:1, 4450, DOI: 10.1080/21679169.2018.1549594
Estrin, I., Goetz, R., Hellerstein, D. J., Bennett-Staub, A., & Seirmarco, G. (2009). Predicting falls among psychiatric inpatients: a case-control study at a state psychiatric facility. Psychiatric services (Washington, D.C.), 60(9), 1245–1250. https://doi.org/10.1176/ps.2009.60.9.1245
Gaal, S., Verstappen, W., Wolters, R., Lankveld, H., van Weel, C., & Wensing, M. (2011). Prevalence and consequences of patient safety incidents in general practice in the Netherlands: a retrospective medical record review study. Implementation science : IS, 6, 37. https://doi.org/10.1186/1748-5908-6-37
King, T. E., & Wheeler, M. B. (2016). Medical management of vulnerable and underserved patients: Principles, practice, and populations.
Rao, W. W., Zeng, L. N., Zhang, J. W., Zong, Q. Q., An, F. R., Ng, C. H., Ungvari, G. S., Yang, F. Y., Zhang, J., Peng, K. Z., & Xiang, Y. T. (2019). Worldwide prevalence of falls in older adults with psychiatric disorders: A meta-analysis of observational studies. Psychiatry Research, 273, 114–120. https://doi.org/10.1016/j.psychres.2018.12.165
Rao, W. W., Zong, Q. Q., Lok, G., Wang, S. B., An, F. R., Ungvari, G. S., Ng, C. H., & Xiang, Y. T. (2018). Prevalence of falls in adult and older adult psychiatric patients in China: A systematic review and comprehensive meta-analysis of observational studies. Psychiatry Research, 266, 18–25. https://doi.org/10.1016/j.psychres.2018.05.016
Sano, T., Harada, M., Sugawara, T., Isaka, N., Masuoka, A., Mikami, A., Shimamori, Y., & Kurosawa, N. (2013). Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan, 133(8), 897–903. https://doi.org/10.1248/yakushi.13-00003
Xu, C., Audrey, T. X., Loh, S., Shanel, Y. W., Tan, J., Premarani, K., & Parasuram, R. (2011). Effectiveness of interventions for the assessment and prevention of falls in adult psychiatric patients: A systematic review. JBI Library of systematic reviews, 9(64 Suppl), 1–17. https://doi.org/10.11124/01938924-201109641-00026

Introduction, Analysis of Existing Evidence, And Quality Improvement Process

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