PROMPT
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.

RESPONSE


The best strategy to address the rising number of patient falls on the rehabilitation floor is quality improvement (QI). QI is a systematic, data-driven approach designed to enhance healthcare processes and outcomes, making it ideal for tackling specific issues like patient falls. It identifies root causes, implements evidence-based interventions, and continuously monitors outcomes to ensure sustained improvement. Unlike research or evidence-based practice, QI is action-oriented, allowing immediate, practical application. It also fosters a collaborative, multidisciplinary approach, engaging stakeholders such as nurses, therapists, physicians, and patients to develop tailored interventions (Wright et al., 2024). For example, implementing standardized fall risk assessment tools like the Morse Fall Scale or Hendrich II Fall Risk Model can help identify high-risk patients and guide targeted strategies (Strini et al., 2021). Environmental modifications, such as improving lighting or removing clutter, and staff education on fall prevention techniques, like proper patient transfers, can significantly reduce fall rates. QI initiatives, including fall prevention bundles and staff training, have effectively reduced falls in hospital settings. Using methodologies like Plan-Do-Study-Act (PDSA) cycles, the rehabilitation floor can test and implement sustainable solutions, addressing root causes and achieving lasting improvements in patient safety (Katowa-Mukwato et al., 2020).

References:

Katowa-Mukwato, P., Mwiinga-Kalusopa, V., Chitundu, K., Kanyanta, M., Chanda, D., Mwelwa, M. M., Ruth, W., Mundia, P., & Carrier, J. (2020). Implementing evidence-based practice nursing using the PDSA model: Process, lessons, and implications. International Journal of Africa Nursing Sciences, 14, 100261. https://doi.org/10.1016/j.ijans.2020.100261

Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall risk assessment scales: A systematic literature review. Nursing Reports, 11(2), 430-443. https://doi.org/10.3390/nursrep11020041

Wright, J. R., D’Ausilio, J., Cappaert, T., & Lau, J. D. (2024). Quality indicators prospectively associated with falls in inpatient rehabilitation facilities. American Journal of Physical Medicine & Rehabilitation. https://doi.org/10.1097/phm.0000000000002625