- NURS FPX 9903 Assessment 4 Reflection.
Reflection
Hello, my name is XYZ. The project I am developing involves implementing a standardized communication handoff tool and involving the resident in the SBAR while taking the Patient handoff in skilled nursing facilities. The aim is to enhance the adverse event report rate for 12 weeks. The interventions to be planned entail lowering the advent report by streamlining the patient handoff and increasing the assertiveness in verbal communication.
Reflection of Data Analysis
Indeed, my project’s success in bridging the identified gap with reference to the practice could be attributed to the suitability of the SBAR tool. A year after implementation, the data revealed significant enhancements; the compliance of the SBAR components was significantly enhanced. The project was implemented under the guidelines of the Plan-Do-Study-Act procedure.
This is comprised of staff education using the SBAR toolkit, the incorporation of the facility’s electronic medical record system, and other critical methods for sustaining enhanced hand-off practices in the long run (Coolen et al., 2020). Such a marked improvement indicates that the application of the SBAR framework has helped in improving the nursing staff’s ability to provide recommendations that are clear, unambiguous, and achievable during handover processes, which play a critical role in communication and interprofessional collaborative practice.
This negative slope is in line with the project’s goal of enhancing patients’ safety through the improved communication brought by the SBAR tool. For the serious fall-related injury in the form of the G-chart, a majority of the figure’s data points lie within the control limits; however, some points considered outliers presented concerns that still need follow-up examination and constant monitoring (Chen et al., 2022).
To measure the success of the project, improvements in the nursing staff’s perceived knowledge of SBAR, along with their perceptions of handoff quality, were recorded. It can be noted that the mean of the SBAR knowledge score raised from 5. 2 to 8. 6 after the intervention, and regarding communication, the perceived quality of handoffs as well as the understanding of care plans increased on a five-point Likert scale as well (Greenland, 2023).
Such findings suggest the relevance of staff education and all clarity of particular formalities to improve the patient’s safety and the quality of their treatment. This project as a lead nurse has proved to be very informative.
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Context and Significance
Drawing lessons from the implementation process and the findings of my doctoral project. Research also revealed the following areas for improvement regarding patient handoff communication. There was only 60% compliance with protocols that were already in place to reduce the adverse event rates.
The introduction of the SBAR tool produced positive outcomes in the area of compliance, as well as a reduction in the fall rate by 27 percent. For me, it brought home the need for protocols in the care of patients, most especially in the transmission of information. The increase in knowledge among the staff and the quality of handoffs praise the application of focused training and constant assessment of the staff’s knowledge (Lo et al., 2021).
Reflection of Draft of Final Doctoral Project
At the ‘end’ of this scholarly work. I ponder on the process, result, successful and unsuccessful endeavors, strengths, and areas for improvement in my proposed doctoral study focusing on patient safety and quality of care in practice through effective communication. The main aim of the project was to ensure that patient handoffs were standardized in a skilled nursing facility.
This inconsistency was also a significant factor that led to high rates of adverse events ranging from falls from 2. 20 to 3. Hospitals are readmitting patients at a higher rate when there is a lack of effective communication by handoff, which is 60 per 1000 patient days, therefore matching national data.
The use of the SBAR tool in the conceptualization and structuring of handoffs served as one of the significant interventions. Competent staff education with the incorporation of SBAR in the EMR significantly supported the use of a standardized method for handoffs during shift transfer, improving inter-shift communication (Coolen et al., 2020).
There were some positive results seen in the incidences of successful SBAR handoffs and fewer adverse events in the hospital. These changes were identified as PB, where specific positive findings of the intervention included achieving better compliance with SBAR and a reduction in the fall rate.
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Enhancement for Subsequent Revisions
There are also places where performance can be improved. It is suggested that subsequent revisions concentrate on frequent coverage and multiple changes in response to opinions from staff members and statistical results.
Moreover, creating awareness of culturally appropriate communication preferences and involving patients in the handoff process will probably enhance the effectiveness of the outcomes (Greenland, 2023). Realization of these goals would go a long way in establishing a patient-centered and quality improvement-reducing culture at the skilled nursing facility.
Reflection on Collaboration and Other Related Work
In terms of the HEART model, while analyzing the project in terms of the process and result, I understand that the primary stimulus for achieving it was collaboration. Right from the beginning, I considered it wise to encourage teamwork because I knew that to reach most of the goals I set, I could not do it alone but with the help of the stakeholders. This strategy made it easier to implement the project and also made it easy for all the members to be on the same page.
The most significant accomplishment of this project was the observed increase in patient safety and the quality of care due to changes in the levels of communication. I ensured that there was uniformity in the manner in which patient hand-off information was being relayed, hence diminishing the various gaps and infections.
Thus, multiple aspects of the project were successful in terms of the top outcomes completed by the participants at the site of the study; notably, there was enhanced compliance to SBAR protocols on the part of the staff, as well as reduced fall rates (Greenland, 2023). Two common themes emerged that I had the time to consider: several successes that I successfully managed to turn into achievements [11] and areas that could be improved.
The final area of change is the mental model of the organization and team, which requires embracing the concept of the process of continual improvement. In order to address the end-user’s needs, I intend to provide formal feedback and make modifications on a consistent basis with direction from the staff and data collected. This will assist me in being more alert of any arising complications so that I can put measures in place to ensure that the achievements an organization has attained are not eroded.
It is crucial to record and assess the best practices applied throughout the project at this stage. Besides, it also leads to better results for future projects and the constant process of developing and updating strategies and protocols. Through consistent and structural identification and documentation of such challenges as bottlenecks, mistakes, and inefficiencies in an organization’s processes, proper and strategic measures can be put in place in order to prevent their recurrence in future projects and initiatives (Chen et al., 2022).
My reflection implicates the need to embrace shared responsibility, the concept of constant process improvement, and the benefits of the sharing of lessons regarding project implementation to improve the outcome of projects and, thus, the quality of caring health facilities.
To better understand the relationship between perception and assumptions in this study, operational definitions are required for the following concepts:
On self-analysis here, I appreciated that my prejudices, presuppositions, and biases always interfere with my work. These biases can influence how I perceive, reason, and even engage with people. Because of preconceptions, it is possible to bias the evaluation in favor of some methodologies or miss other perspectives.
Conclusion
Applying the process with the help of the SBAR tool provided better outcomes, which were proved by increased adherence to the handoff protocols and a decrease in the rate of adverse events, including patient falls. The data thus revealed that through the standardization of handoffs, communication went a notch higher, and a safer atmosphere was created for patients. Read more about our sample NURS FPX 9904 Assessment 4 Evidence-Based Handoff Procedures for Nursing Staff to Reduce the Risk of Adverse Events for complete information about this class.
References
Bailey, M. K., Weiss, A. J., Barrett, M. L., & Jiang, H. J. (2019). Characteristics of 30-Day all-cause hospital readmissions, 2010–2016: Statistical brief# 248. AHRQ.
Burke, R. E., Xu, Y., & Rose, L. (2022). Skilled nursing facility performance and readmission rates under value-based purchasing. JAMA Network Open, 5(2), e220721-e220721.
http://:Doi:10.1001/jamanetworkopen.2022.0721
Chen, S., Hua, L., Jin, Q., & Wang, H. (2022). Correlation of ICU nurses’ cognitive level with their attitude and behavior toward the prevention of ventilator-associated pneumonia. Journal of Healthcare Engineering, 2022, 8229812.
https://doi.org/10.1155/2022/8229812
Coolen, E., Engbers, R., Draaisma, J., Heinen, M., & Fluit, C. (2020). The use of SBAR as a structured communication tool in the pediatric non-acute care setting: Bridge or barrier for interprofessional collaboration? Journal of Interprofessional Care, 1-10.
https://doi.org/10.1080/13561820.2020.1816936.
Greenland, S. (2023). Divergence versus decision P-values: A distinction worth making in theory and keeping in practice: Or, how divergence P-values measure evidence even when decision P‐values do not. Scandinavian Journal of Statistics, 50(1), 54–88.
https://doi.org/10.1111/sjos.12625
Lo, L., Rotteau, L., & Shojania, K. (2021). Can SBAR be implemented with high fidelity, and does it improve communication between healthcare workers? A systematic review. BMJ Open, 11(12), e055247.
https://doi.org/10.1136/bmjopen-2021-055247
Nguyen, H. Q., Vallejo, J. D., Macias, M., Shiffman, M. G., Rosen, R., Mowry, V., Omotunde, O., Hong, B., Liu, I. A., & Borson, S. (2021). A mixed‐methods evaluation of home‐based primary care in dementia within an integrated system. Journal of the American Geriatrics Society, 70(4), 1136–1146.