Quality improvement is among the most significant measures in the healthcare system as it helps healthcare providers assess and improve healthcare delivery. Patients who seek health services in health facilities expect to get high-quality care, and for that reason, healthcare providers must always come up with ways of enhancing the care delivery processes. Various problems can contribute to the need for quality improvement measures. For example, Bhattacharya and Mishra argue that pressure ulcers often occur among bedridden patients, and they can cause various complications such as sepsis. In such cases, preventing the occurrence of the problem can facilitate the recovery of patients and prevent them from developing pressure ulcers and their complications. I work in the geriatric setting that has patients who are at various risks including pressure ulcers and falls. The facility has attempted to engage stakeholders in preventing patient falls through multiple interventions. Although evidence-based sources have documented numerous interventions, the most appropriate one that was chosen was the use of bed alarms. The following is an  analysis of data and the initiative by quality custom essays, its success, interprofessional perspectives regarding it, and additional protocols to improve and expand the quality outcomes of the initiative.

Data Analysis

The health facility does not have exact figures regarding patient falls, and the associated complications since the problem occurs repeatedly, and some of the experiences regarding it are subjective. For example, some patients usually fall in the absence of healthcare providers. In one week, the health facility experienced seven accidental falls, which resulted in various health problems. For instance, three of the seven patients complained only of pain, which led to discomfort and prevented them from carrying out their daily duties. Three of the seven patients fell accidentally and experienced bruising, which required medical interventions to ensure that they recovered fully. Of the seven patients who fell in that one week, one of them developed a wound, and she was diabetic. The wound took a long to heal and almost led to complications, but fortunately, a collaborative approach to the management with physicians facilitated the recovery process. This data from the facility shows how 'patient falls' can cause different health problems that can increase the health issues that patients have. This data is only for one week, and therefore, it cannot be considered quality data to provide a real picture of the problem in the entire health facility. However, it provides crucial indicators regarding the issue of falls in the whole facility.

Evidence-based data also shows that 'patient falls' are common, and they can lead to various health issues that can increase the cost of care and further worsen the health outcomes of patients. For example, Gale, Cooper, and Sayer argue that the risk of falls increases in patients who are older than 65 years old. In my facility, almost all patients are over the age of 65 years, and therefore, they are more prone to falls. Additionally, Gale et al. assert that this problem can cause fractures and further lead to a significant loss of independence due to disability. This assertion shows that patients may seek health services when they have minor health issues, but they can develop additional illnesses in healthcare settings. This information is reliable and credible as it is documented in an evidence-based and peer-reviewed source. Thus, the focus of the facility to prevent patient falls was relevant and appropriately timed.

Quality Improvement Initiative: The Use of Bed Exit Alarms

Although various interventions exist to help prevent the occurrence of falls, the use of bed alarms was chosen by the facility’s administration since it was considered to be the most relevant and appropriate. For example, some patients fell in the absence of healthcare providers, and they could not call for help promptly. As a result, they could suffer health problems such as pain and fractures, and healthcare providers could realize the problem late. The leadership of the health facility in conjunction with nurses who managed the patients sought to come up with a method that would assist in the early identification of falls to prevent further injuries. Indeed, Mazur, Wilczyński, and Szewieczek confirm that patient falls have contributed immensely to fractures, pain, and disability. Therefore, early identification of this problem would prevent the worsening of these health complications. Eventually, the use of bed alarms was considered appropriate as it could help alert health professionals every time the patient fell.

All beds had to have bed pads that would be pressed together when patients stayed in bed. However, anytime patients attempted to get out of bed, pressure would be released from the bed pads. Consequently, the alarms would alert caregivers so that they could be vigilant to assess the physiological status of patients. According to Hempel et al. (2013), this method has been significant in assisting healthcare providers in preventing the occurrence of falls. Although Hempel et al. indicate that the intervention has been successful in combination with other interventions; its recognition reveals that it can be experimented on to determine the extent of its efficacy. In my facility, this single intervention has been in use and has been helping health professionals to identify cases of falls. The nurses, especially the ones who participated in initiating it, have found it appropriate as it helps them to be concerned about the overall health status of the patient. Overall, the selection of this intervention was appropriate considering the health problem and the evidence-based support for it.

Evaluation of Its Success

The current quality improvement initiative has not undergone any rigorous evaluation using a recognized benchmark. However, analysis of the current data in the facility about patient falls shows that the intervention has not been highly successful in preventing falls among the residents. For instance, nurses and other health professionals have been able to recognize falls in time. However, nurses often find patients when they have sustained some problems such as bruises and pain. Therefore, while evidence-based sources acknowledge that the use of bed exit alarms is useful in preventing the deterioration of the health status of patients who have experienced falls, further analysis of this intervention is needed. For instance, in one week, the alarms assisted in assessing all patients who got out of bed. However, no bed exit alarm helped to point out a patient who had additional health issues as a result of falling when out of bed. According to Stephenson et al., one approach is not enough in recognizing and preventing patient falls. Hempel et al. provide interventions that include rounding, ambulation, patient education, and the use of a wristband as useful approaches to preventing falls and reducing the associated exacerbations. These interventions justify the inefficiency of a single intervention, in this case, to prevent patient falls and the associated complications.

Although healthcare providers and the health facility have not come up with conclusive evidence regarding the efficacy of the bed exit alarm as a single intervention; other outcome measures can assist in justifying its importance. For example, this intervention helps in detecting when patients get out of bed. In the process, healthcare providers can begin monitoring patients to ensure that they do not experience the worst health outcomes due to falls. Hempel et al. argue that the intervention has been useful in fall prevention. Therefore, healthcare providers can make a comparison of the previous detections of patient falls and the current one after the implementation of the bed exit alarms. Although it may not significantly improve things such as preventing the worsening of complications, the measure may show how it is a useful approach to recognizing patient falls early.

Interprofessional Perspectives

Most health professionals in the health facility welcomed the idea of bed exit alarms even though it did not result in the significant prevention of falls and associated complications. For example, one nurse said that the Centers for Medicare and Medicaid Services had declined to cover costs for problems that patients experienced while in the inpatient setting. She further asserted that if the health facility failed to come up with a way of preventing patient falls, it would have to spend unnecessary money on a preventable problem. For that reason, the nurse supported the intervention and sought to find ways of using it to enhance the efforts of preventing patient falls. Two nurses within the health facility also indicated that the use of bed exit alarms was significant as it would help in assessing when patients tried to ambulate unaided. As a result, this process would provide a perfect opportunity for monitoring patients to prevent falls. According to Twibell, Siela, Sproat, and Coers, nurses spend most of their time with patients, and therefore, they can contribute immensely to identifying measures to prevent falls. Thus, the perspectives of these nurses show that the facility has enhanced readiness to prevent falls.

The physician who was present in the facility also confirmed that the quality improvement initiative was significant, but additional interventions in the form of a bundle were necessary to prevent falls. According to the physician, the use of bed exit alarms was appropriate, but in itself, it was inefficient to prevent patient falls. Indeed, the facility had not experienced significant changes since the inception of this quality improvement initiative. Hempel et al. argue that the prevention of falls is a multifactorial approach. Thus, the sentiments of the physician align with the available evidence-based information about patient falls. The statements of the physician helped in understanding that if nurses and physicians worked together to solve the problem of falls, they would come up with relevant, appropriate, and proactive measures to prevent the problem. Therefore, a collaborative approach to fall prevention is needed in the facility to ensure that patients experience improved health outcomes even when they fall.

Additional Indicators and Protocols

As identified in the literature, the prevention of pressure ulcers and its complications cannot be implemented using a single intervention. According to Kobayashi et al., patient identification using measures such as putting on wristbands can assist in recognizing high-risk patients. Patients should also have safety companions, and healthcare providers should implement safety rounds to check if all precautions to prevent falls are in place. In the health facility, bed exit alarms have facilitated the recognition of patients who get out of bed. The addition of these three interventions can assist healthcare providers in minimizing the occurrence of falls and their associated complications significantly.

Conclusion

Having bed exit alarms in any given medical home is a useful and relevant quality improvement initiative since elderly patients are at risk of falls. However, the implementation of this intervention in isolation cannot guarantee the prevention of falls and its complications. For example, in the health facility discussed, in this case, this intervention was implemented, and nurses had positive attitudes toward it. The physician also supported it. However, the physician recommended additional interventions. Three evidence-based interventions include having wristbands, having safety companions, and doing safety rounds. These measures, in addition to the bed exit alarm initiative, can help improve the outcomes of patients by preventing falls and the associated complications. A collaborative approach is needed to help in the implementation of these interventions before the performance of any evaluation.