Sample Technology Paper on Targeted Solutions Tool (TST technology)

Targeted Solutions Tool (TST technology)

Technology can either expedite or halt successful implementation of evidence-based solutions in many projects. One technology that could improve the implementation process and guarantee positive outcomes in reducing patient falls is the use of Targeted Solutions Tool (TST). It is a quality improvement tool or technology proposed and created by The Joint Commission (2016). The tool has an online application which requires the organization to enter the fall incidents at the microsystem level. The TST fall incident can either be completed online or in a paper document. The purpose of entering the information online is to ensure the production of accurate data analysis and suggestion of targeted solutions. The technology ensures easy implementation of the targeted solution. For example, in this project (reduction of patient falls), if the project team had used the TST technology to suggest the recommended solution (educating patients and caregivers), the implementation process becomes easy and guaranteed.

Although the TST technology is realistic and applicable in the EBP project, there are numerous that may hinder its application. One major barrier that could hinder the implementation process as reckoned by TJC (2016) is training and educating the project team or staff on how to use this technology. Staffs are already dealing with updating their competencies and skills, and may, therefore, resist other changes. The use of TST is a health information technology (HIT) change and, therefore, is in itself an obstacle. The TST technology will need a transformation of the HIT and allow the staff to access this online application via a link. The process of teaching the staff on how to use the TST is a challenge because the staff will be required to record the fall events online.

Reference

The Joint Commission. (2016). NEW! Targeted solutions tool for preventing falls. Retrieved       from http://www.centerfortransforminghealthcare.org/tst_pfi.aspx

 

The Problem

            Patient falls is one of the most exigent challenges experienced in clinical settings. The Agency for Healthcare Research and Quality estimated that approximately one million people fall in hospital in the USA every year (Ganz et al., 2013). Falls could result in internal bleeding, injuries, fractures, and lacerations that increase the costs of healthcare. Different strategies have been identified to help reduce the risk of and prevent patient falls (Ryu et al., 2009). However, most empirical studies conducted on the topic suggest that education and training strategies and evidence-based mechanisms could be used to help reduce the risk of patient falls (Jang & Lee, 2015). Different studies conducted on the impact of education and training programs on patient falls affirm that these mechanisms are relatively more effective in preventing patient falls. Hence, the problem chosen for the project is “patient falls” while the suggestion to resolve it is “education and training strategies.”

The Context and Settings of the Problem

            According to Ishikuro et al. (2017), patient falls occur in different settings and contexts. Although the majority of the patient falls occur in hospital settings, other cases of patient falls have been reported and documented in assisted living homes, residential homes, and rehabilitation centers. In hospitals and other clinical contexts, patient falls occur mainly when the individual seeks to move about without assistance (Kuhlenschmidt et al., 2016; Silva, 2017). Notably, the risk factors of falling exist in different contexts including in residential homes (Ishikuro et al., 2017). Ganz and his colleagues (2013) note that the risk factors of falls include but are not limited to age, cognitive dysfunction, wheelchair use, history of falling, need for help to move, types of medications, and obstructive objects in the care environment. Therefore, the patient falls occur in different contexts although the hospital and clinical settings are the most common settings where they occur (Hayakawa et al., 2014). Above all, the incidence of patient falls correlates directly with the presence of the risk factors in the respective context (Ishikuro et al., 2017). Therefore, education strategies are directed towards reducing the risk of patient falls after an assessment of the care context and setting.  

The Details of the Problem and Suggestion

            Patient falls increase the costs of healthcare because they typically exacerbate a patient’s condition sometimes even leading to death. Consequently, researchers have shown great interest in studying mechanisms that could be used to reduce the risk of and prevent patient falls. Hourly rounding and educational strategies are the most recommended solutions to the challenge of patient falls (Ganz et al., 2013). However, most studies recommend education and training as the main evidence-based practice that reduces the risk of patient falls. Empirical studies conducted to test the impact of different educational and training models on patient falls have affirmed both the feasibility and effectiveness of educational strategies in reducing the risk of patient falls (Jang & Lee, 2015). On the one hand, patients need to be taught and ought to learn the different tactics, practices, and activities that they can engage to reduce the chances of falling (Kuhlenschmidt et al., 2016). On the other hand, caregivers, especially nurses, should enhance their skills in both preventing and responding to patient falls to mitigate the consequences.

Impact of the Problem and Suggestion

            Patient falls negatively affect the quality of life and unnecessarily increase the costs of health care. To the patient, falls lead to fractures, injuries, internal bleeding, wounds, and lacerations that compromise their journey to full recovery. To the hospital and the caregivers, Zimmerman et al. (2017) acknowledge that patient falls increase costs and significantly sever the reputation of a healthcare facility. However, educational and training strategies as detailed above can significantly turn-around these negative consequences. According to Jang & Lee (2015), educational and training strategies are designed to increase awareness about patient falls to make the care environment not only safer but also supportive of the patient’s journey to recovery. Furthermore, in their study, Kuhlenschmidt and others (2016) claim that these evidence-based practices significantly enhance the quality of care provided because both the staff and the patients have an increased understanding of the need for patient safety and how it can be achieved. Consequently, Ryu and his colleagues (2009) affirm that education, as an evidence-based practice of reducing falls, enhances the quality of life and improves the odds of full recovery by advocating for a safer, secure, and well-protected care environment.

The Significance of the Problem and Suggestion

            The cost of patient falls cannot be underestimated and remains a major concern for stakeholders in the healthcare industry. The fact that patient falls lower the quality of life of the patients and reduces their independence while increasing healthcare costs, demands that stakeholders must be proactive in implementing evidence-based practice (Zimmerman et al., 2017). Current empirical research affirms the need to utilize educational and training strategies for both patients and caregivers to reduce the incidence of patient falls (Jang & Lee, 2015). As an evidence-based practice, patient education is a feasible and effective solution that could be implemented to mitigate the costs and negative consequences of patient falls.

A Proposed Solution to the Project Topic

            Preliminary studies on the topic have identified different educational strategies that could be used to reduce patient falls. Therefore, education for both the patients and the caregivers is the identified solution to the problem of patient falls. Pamphlets, video lessons, one-on-one learning sessions, guided reflection, and discussions are some of the most recommended educational strategies to reduce patient falls. Nevertheless, Silva (2017) proposes that; given that the causes of patient falls are multifactorial, educational strategies should be designed according to each risk factor to enhance efficacy.

References

Ganz, A. D., Huang, C., Saliba, D., Shier, V., Berlowitz, D. Lukas, C., Pelczarski, K., Schoelles, K., Wallace, C. L., & Neumann, P., (2013). Preventing falls in hospitals: A toolkit for improving quality of care. Rockville, MD: The Agency for Healthcare Research and Quality.

Hayakawa, T., Hashimoto, S., Kanda, H., Hirano, N., Kurihara, Y., Kawashima, T., & Fukushima, T. (2014). Risk factors of falls in inpatients and their practical use in identifying high-risk persons at admission: Fukushima Medical University Hospital cohort study. BMJ Open Access, 4(8), e005385.

Ishikuro, M., Ubeda, S. R. G., Obara, T., Saga, T., Tanaka, N., Oikawa, C., & Fujimori, K. (2017). Exploring risk factors of patient falls: A retrospective hospital record study in Japan. The Tohoku Journal of Experimental Medicine, 243(3), 195-203.

Jang, M., & Lee, Y. (2015). The effects of an education program on home renovation for fall prevention of Korean older people. Educational Gerontology, 41(9), 653–669.

Kuhlenschmidt, M. L., Reeber, C., Wallace, C., Yanwen Chen, Barnholtz-Sloan, J., & Mazanec, S. R. (2016). Tailoring education to perceived fall risk in hospitalized patients with cancer: A randomized, controlled trial. Clinical Journal of Oncology Nursing, 20(1), 84–89.

Ryu, Y. M., Roche, J. P., & Brunton, M. (2009). Patient and family education for fall prevention: Involving patients and families in a fall prevention program on a neuroscience unit. Journal of Nursing Care Quality, 24(3), 243-249.

Silva, K. B. (2017).Continuous Quality Improvement. Fall prevention: Breaking apart the cookie cutter approach. MEDSURG Nursing, 26(3), 198–213.

Zimmerman, S., Greene, A., Sloane, P. D., Mitchell, M., Giuliani, C., Nyrop, K., & Walsh, E. (2017). Feature article: Preventing falls in assisted living: Results of a quality improvement pilot study. Geriatric Nursing, 38, 185–191.