Fall Prevention in Older Adults

Background: Falls are a major safety concern for older adult patients in healthcare facilities. They can lead to injuries, loss of mobility and independence, and even death. Reducing falls has benefits for patients’ health and safety as well as healthcare costs.

Project Goal: Decrease the number of falls among patients aged 65 and older on a medical-surgical unit over a 6-month period.

Interventions: Implement a fall risk assessment tool to identify high-risk patients. Provide fall prevention education to patients and families. Ensure call lights and assistive devices are within reach. Improve night lighting levels. Provide regular rounding and toileting assistance.

Measures: Track number of falls before and after interventions using incident reports. Monitor fall-related injuries. Survey patients and nurses on falls knowledge and prevention practices.

Outcomes: By consistently implementing targeted fall prevention strategies, the unit saw a 20% reduction in falls and no fall-related injuries over the study period. Patient and nurse survey results demonstrated improved awareness of falls risks and prevention strategies.

Reducing Hospital-Acquired Pressure Injuries

Background: Pressure injuries cause pain and suffering for patients and increase length of stay and healthcare costs. timely risk assessment and skin monitoring are critical for prevention.

Project Goal: Decrease the hospital-acquired pressure injury rate by 15% over one year on a medical unit with historically high rates.

Interventions: Implement a valid and reliable Braden Scale-based risk assessment within 24 hours of admission and daily thereafter. Provide skin inspections at least once per shift. Utilize pressure-redistributing mattresses and cushions as needed. Educate nurses, patients, and families.

Measures: Track number of new hospital-acquired pressure injuries before and after project implementation via skin audits and incident reporting. Monitor compliance with risk assessment protocol.

Outcomes: Through diligent risk assessments, skin monitoring, and use of preventive measures, the unit saw a 25% decrease in pressure injuries after one year. This suggests the bundled interventions were effective in improving care processes and outcomes.

Reducing Central Line-Associated Bloodstream Infections in the ICU

Background: Central lines put critically ill patients at high risk for bloodstream infections, leading to increased mortality, costs, and lengths of stay. Adherence to evidence-based guidelines is key to prevention.

Project Goal: Decrease the central line-associated bloodstream infection (CLABSI) rate in the medical intensive care unit (MICU) by 50% over an 18-month period.

Interventions: Implement a checklist for central line insertion following best practices. Provide ongoing education on maximal barrier precautions and line maintenance. Perform audits to ensure compliance. Switch to antiseptic-impregnated dressings.

Measures: Compare CLABSI rates before and after implementing the checklist and education program using National Healthcare Safety Network (NHSN) definitions and tracking protocols. Monitor adherence to line care protocols through direct observation.

Outcomes: By reinforcing compliance with CLABSI prevention guidelines at insertion and during ongoing care, the MICU achieved a 58% reduction in its CLABSI rate. The project helped standardize practices and put systems in place to sustain lower infection rates long-term.

These are just a few examples of potential quality improvement projects that address common patient safety issues encountered in various healthcare settings. Each one outlines the background problem being addressed, specific measurable goals, evidence-based interventions implemented, metrics for monitoring outcomes, and expected results if successful. A nursing capstone project would expand on the details provided here by incorporating relevant literature, theoretical frameworks, comprehensive methodology, data analysis, and lessons learned from implementing and evaluating the quality improvement initiative. With thorough planning and execution, such projects have potential for improving clinical outcomes, care processes, and systems of care.