Level of Risk in Practicum Project

Level of Risk in Practicum Project


Level of Risk in Practicum Project

Quality improvement and patient safety are essential aspects of effective care delivery for patients in different health situations and nursing practice, especially in neuroscience unit where patients are susceptible to falls. Assessing the level of risk to enhance patient safety in nursing organizations is essential to the overall quality improvement and ensuring that an organization is a high reliability entity (Gliner et al., 2021). High reliability organizations are entities with an organizational culture that focuses on attainment of error-free or zero-harm performance and safety in every process, procedure all the time while operating in complex, high risk or hazardous settings (AHRQ, 2019). The purpose of this paper is to evaluate the risk level for reducing and preventing the number of falls in a neuroscience unit and ascertaining if the practicum site for the proposed project is a high-reliability organization.

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Brief Description of the Quality/Safety Improvement Project

Falls are a prevalent quality issue and lead to adverse effects on patients, particularly in critical care settings like a neuroscience unit. Strategies to prevent and reduce falls and susceptibility in healthcare settings focus on quality and safety improvement for patients and effective care delivery for healthcare providers. The proposed quality improvement intervention is implementing purposeful hourly rounding to reduce and prevent the number of falls in the neuroscience unit. Safety and quality improvement projects focus on enhancing the possibility of attaining desired health outcomes and are consistent with a set of professional standards and founded on knowledge and evidence from research (Khan & Tidman, 2022). Therefore, purposeful hourly rounding will help the nursing team to identify patients that require support and other interventions to reduce their susceptibility to falls while in the facility.

Categories of Enterprise Risk Management

Enterprise risk management (ERM) represents a critical paradigm that supports organizations in identifying, evaluating, and managing risks at the enterprise level. Organizations engage in the ERM process for different reasons that include improving quality and patient safety, expanding their growth opportunities and reducing overall costs while improving profitability (Pelletier & Beaudin, 2018). The quality and safety improvement project in this case focuses on reducing and preventing falls in the neuroscience unit and can be impacted by different aspects of the ERM process. The ERM process entails 13 categories aimed at risk reduction and mitigations in organizations. The risk categories include operational risk, budget risk, technical environment risk, schedule risk, business risk, information security risk, programmatic risk, technology risk, resource risk, supplier risk, infrastructure risk, quality and process risk, and project planning risk (Pelletier & Beaudin, 2018).

These categories impact the implementation of the proposed project in different dynamic ways. Firstly, operational risk emanates from losses arising due to improper implementation of processes, external issues like weather. The risk can impact this project due to insufficient resources in the organization. Budget risk to the implementation will entail improper allocation and estimation of funds allocated to the process to enhance quality and patient safety (Pelletier & Beaudin, 2018). Budget risk will be critical as it will imply that the unit will not have a quality improvement project to reduce falls and risk of falling among the elderly patients.

Technical environment risk will impact the project due to the need to comply with existing regulations on quality improvement by bodies and agencies like The Joint Commission and AHRQ. Schedule risk may arise due to the timelines given to complete the project while business risk will impact the process if inputs from clients and customers will be insufficient (Khan & Tidman, 2022). The need to leverage data from the recorded falls in the unit may constitute information security risk for the proposed project as data confidentiality and privacy is critical. Violation of these provisions can cause a huge risk for the entity and lead to compliances issues with regulatory bodies and agencies. The project may also suffer due to programmatic risk arising from changes in government regulations as well as technology risk because of alterations in new technology needed to attain its objectives.

Resource risk involves ineffective management of organizations’ resources like staff. In this case, the project may not suffer as resources are a fundamental part of its execution. Further, the project may also not suffer from supplier risk owed to third-party supplier interference since it does not involve such entities in its implementation (Marisa, 2019). The infrastructural risk may not suffice as the project entails a multidisciplinary approach with effective planning among the stakeholders. Quality and process risk is relevant to the project since it is a quality improvement undertaking. Therefore, it requires well-trained and skilled nurses and nurse leaders to leverage EBP to improve overall quality care. Project planning risk may affect its attainment as it needs effective approach to attain the desired outcomes.

Mitigate Risks through the Practicum Project

The practicum project focuses on improving quality care and patient safety through effective purposeful hourly rounding in the facility. Enterprise risk management is about reducing potential risks that can affect the delivery of quality care. Risk management in this case will entail reduction of falls, increased surveillance of patients, and better coordination in the inter-professional and multidisciplinary team to deliver patient-centered care. The practicum project will mitigate these risks through effective quality improvement planning, use of technology, and deployment of organizational resources including human resources and funding to implement better hourly rounding (Khan & Tidman, 2022). Leveraging assistive technologies will mitigate risks like schedule, technical environment risks, and ineffective planning. The practicum project will focus on improving overall care outcomes and ensuring that susceptible individuals do not encounter adverse events and outcomes.

High-Reliability Organization & Being Mindful

Quality improvement is a core piece of organizational evolution and development. High-reliability organizations (HROs) focus on quality improvement initiatives aimed at reducing the occurrence of adverse events and harms in their processes and procedures. These organizations operate in complicated, high-hazard areas for longer periods with no serious accidents and catastrophic failures. The implication is that high-reliability goes beyond attainment of acceptable standards but a continual condition of persistent mindfulness within the organization based on a set culture and values. The concept of mindfulness is critical for high-reliability organizations because of the need to maintain and even improve on quality standards and prevention of adverse events, especially in healthcare settings (Veazie et al., 2019). High-reliability organizations should be mindful because of the need to create an environment where possible problems are anticipated, identified early, and virtually addressed early to avoid, and prevent catastrophic effects on the stakeholders.

Practicum Site Being a High-reliability Organization (HRO)

A core aspect of high-reliability organizations is being mindful. High-reliability organizations need a leadership team committed to zero harm, a fully functional and effective safety culture, and utilization of Robust Process Improvement (RPI) approaches. Therefore, the practicum site can be categorized are a high-reliability organization because of its efforts to enhance quality care by mitigating adverse events like falls (Marisa, 2019). The use of purposeful hourly rounding will improve its position as a HRO because it will improve patient safety and quality of care through components of enterprise risk management (ERM). The practicum site has quality improvement initiatives which ensure that it offers quality care to all patients.


Quality care and patient safety are important in delivery of patient-centered care as they allow patients to get the best interventions to improve their quality of life. The quality improvement project in the practicum site will leverage aspects of ERM and HRO to reduce harm, risks, and susceptibility of patients to falls. The initiative will be critical in improving overall patient outcomes and qualifying the facility as a high-reliability organization.




Agency for Healthcare Research and Quality (AHRQ) (2019). High Reliability.


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Agenda for Future Research. Journal Risk and Financial Management. https://doi.org/10.3390/jrfm13110281

Gliner, M., Dorris, J., Aiyelawo, K., Morris, E., Hurdle-Rabb, D., & Frazier, C. (2021). Patient

falls, nurse communication, and nurse hourly rounding in acute care. Journal of Public Health Management and Practice, Publish Ahead of Print. https://doi.org/10.1097/phh.0000000000001387

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Veazie, S., Peterson, K. & Bourne, D. (2019). Evidence Brief: Implementation of High

Reliability Organization Principles. Department of Veterans Affairs.https://psnet.ahrq.gov/primer/high-reliability

The purpose of this assignment is to assess the level of risk for the issue of focus in the practicum project and to determine if the practicum site is a high-reliability organization.

Include the following in a 1,000-1,250 word paper:

Briefly describe your quality/safety improvement project.
Assess the 13 categories of enterprise risk management, as mentioned by Beaudin and Pelletier (2018) in the textbook. Provide the rationale why each category does or does not apply to your project.
Describe how the practicum project will help to mitigate one or more of these risks.
Discuss what a high-reliability organization is.
Describe why it is important for high-reliability organizations to be mindful.
Explain whether the practicum site is a high-reliability organization. Provide your rationale.
APA format is not required for the body of this assignment, but solid academic writing is expected. All citations and references must be written in APA format.

This assignment uses a rubric. Review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.

You are required to submit this assignment to Lopes Write. A link to the Lopes Write technical support articles is located in Class Resources if you need assistance.

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