NUR 674: Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

NUR 674: Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

NUR 674: Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics

Nursing students undertake practicum projects as part of their training to enhance leadership capabilities and solve quality of care problems or issues in healthcare. The practicum experience through designing and implementing a project means that they attain the American Organization of Nurse Executives (AONE) (2018) competencies as clinical leaders in the practice environment. Adverse events like hospital-acquired infections (HAIs) and falls impact the quality of care and increase the cost burden of care provided to different patient populations. The practicum experience presents opportunities for nurses to plan the project and prepare resources to implement them in different sites with the focus of addressing quality and safety needs (Andrew et al., 2022). Through the implementation of my practicum project, I developed nursing competencies required to offer leadership in mitigating patient falls, the risks associated with falls, and developing organizational capacities to enhance their management (Wagner, 2018). The purpose of this paper is to assess my practicum experience through the implementation of the falls prevention project at my practicum site.

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Leadership Project, Its Focus & Site of the Implementation

The leadership project was about the prevention of falls in a long-term care facility for the elderly. The project’s main focus was to explore how various multifactorial interventions can be applied in the long-term care facility for the elderly to prevent and reduce the occurrence of falls. Evidence from available long-term care Minimum Data Set (MDS) and staff perception demonstrated that cognitive impairment and mobility and functionality issues were the common risks for falls in the residence. Before the initiative, the facility recorded 15 to 17 falls each month except for the one-month duration of the practicum where falls were reduced to 8 (Cameron et al., 2018). The 30-day duration following the implementation of the initiative led to a significant reduction of falls which suggests that having a fall prevention program can decrease the number of such events in the facility. Compliance with a protocol that identifies falls and entails a fall risk assessment as a component of an effective multifactorial fall prevention initiative can lower the financial cost burden of falls and help elderly patients in long-term care facilities enjoy a quality life.

Discovering the Need for the Project

The need for the project emanated from existing data and evidence from not just the facility but general literature in healthcare which shows falls as some of the safety and quality care events that impact patients’ experience. The elderly long-term care population is at an increased risk for falls and fall-associated injuries that can lead to costly interventions and poor quality of life. Falls pose a critical risk for the elderly living in long-term care settings with evidence suggesting that nearly 1 in every 4 older individuals fall each year. It is projected that by 2030, over 49 million older adults will experience a fall and out of these, 12 million will sustain injuries. The rise in the trend in falls among the elderly presents a growing burden as the costs of falls billed to programs like Medicare have been rising in recent years. For instance, fall-related costs accounted for about $31 billion in reimbursements to health care facilities (Igharosa, 2021). Falls can lead to serious effects like death and make the elderly more anxious, depressed, and suffer irreparably when there are no effective interventions. The implication is that the need for fall prevention and reduction programs continues to rise due to more people that will require such interventions.

The need for the project also arises from the predisposal factors among the elderly that include unsteady gait and balance, weak muscles, poor vision as well as medications, and impaired or diminishing cognitive abilities leading to different types of dementias (Cameron et al., 2018). Other factors contributing to the situation include poor lighting, loose rugs, and floor clutter as well as beds and washrooms that may lack handrails (Igharosa, 2021). The need for the project also emanated from the increasing level of evidence that suggests that having multifactorial interventions can help prevent falls. These include general medical assessment and risk management, assessment of patient falls history and medication intake as well as evaluation of mobility and the use of assistive and protective aids.

A core aspect of the need to have the project was also to develop skills and motivation among staff members by the leaders in the organization (Cameron et al., 2018). The staff members could benefit from exercise programs comprising muscle strengthening in the lower extremities, a warm-up, static stretching, toe exercise, and proprioceptive neuromuscular facilitation to increase their motivation and caregiving skills. As such, the program required effective leadership approaches as it involved both providers and patients to reduce and prevent falls in the facility.

Measuring the Outcomes of the Project and Its Sustainability

Project outcomes are essential to ascertain the effects of an initiative, especially in fall prevention and reduction in this long-term facility. The outcomes of the project would be measured by its scope, a reduction in the number of falls, increased skills level and understanding of the interventions by the nursing staff, and a more inter-professional and multifactorial approach to falls in the facility. The scope of the project would entail ensuring that the nursing staff manages falls intending to reduce them to lower the overall cost burden (Errida & Lotfi, 2021). As observed, the initiative led to a reduction in falls from an average of 16 to about 8, meaning that it is effective. Further, as part of the motivation for the elderly and the nursing staff, the incorporation of exercise programs and the use of effective leadership styles like transformational would be critical in attaining better outcomes and measuring their impact on patient experience and satisfaction. Outcome measures entail the results of a program based on its impact on mitigating the issue of falls among the elderly in the facility.

The sustainability of a quality and safety program in fall prevention and reduction is critical for long-term outcomes and patient experience. Sustainability requires the implementation of participatory processes and assessment of the overall effect of an initiative on the targeted patient population (Caeiro et al., 2020). In this case, the need to reduce falls in the elderly long-term facility is a long-term intervention given the fact that more Americans are aging. The aging population will place an increased cost burden due to the need for care in long-term elderly facilities. Further, the susceptibility of the elderly to patient falls implores healthcare providers to develop and sustain such initiatives to reduce the number of falls and their associated adverse events like serious injuries and even deaths.

Real and Potential Barriers

Planning, designing, and implementing evidence-based practice (EBP) interventions or practicum projects in any healthcare-related setting can face significant barriers and challenges that one must overcome or find strategies to address. In this case, real and potential barriers can affect the attainment of set goals and delay the overall quality of the intervention. The barriers encountered in implementing the project included limited resources and time since the facility did not have sufficient funds to conduct the evaluation and risk assessment (Errida & Lotfi, 2021). Secondly, getting effective support from all stakeholders required more information and engagement. The leadership and management support were critical to the success of the project.

Further, being a practicum student in the facility was also a barrier as it meant that I had to attain buy-in from nurses who were not willing to change the status quo. I did not enjoy any privileges offered to members of the facility as I was considered an outsider. The other barrier was time limitation since I had a certain duration at the facility to implement these interventions. The other barrier was the need to integrate all stakeholders, especially the nurses in the facility who required effective leadership approaches (Wagner, 2018). I also had to conduct some sessions virtually due to the need to reduce vulnerabilities to the elderly because of their weakened immunity, especially in line with the COVID-19 pandemic protocols.

Success of the Project

The implementation of this project was successful based on the outcomes that it had on patient falls and safety. A core aspect of the project was to ensure that the elderly patients in the facility had limited falls. The project attained success in integrating leadership approaches to reduce falls in the long-term facility (Wagner, 2018). The success is illustrated by the significant reduction in falls among the elderly, the increased motivation from the nursing staff to incorporate the multifactorial interventions, and the use of the exercise initiative to reduce and prevent falls. Falls in the facility were reduced by close to 50% in the initial month to demonstrate that the initiative was a success for the organization.

Goals Set for Myself and AONE Competencies

The goals I set for the project included reducing and preventing falls by 90%, and increasing leadership competencies to help me enhance communication, professionalism, and knowledge of the healthcare environment. The AONE asserts that a collaborative approach to work allows nurses in executive roles and practice to improve patient care experience that includes quality and satisfaction, improve the health of the population and reduce the per capita cost of health care (AONE, 2018). The increased cost burden associated with falls leads to more expenses for the elderly and the need for reimbursement from Medicare and other programs. However, the implementation of this initiative would ensure that nurses have effective competencies and the organizational leadership and management implement interventions aimed at reducing costs by applying business skills and principles.

Summary of Project Experience Related to the Goals and AONE Competencies

The project provided me an opportunity to nurture effective leadership skills like communication, and the development of effective relationships in care provision as it entailed the implementation of multifactorial interventions which need collaboration among providers and professionals in the facility. The project’s experience shows that nurse executives can create change and develop interventions based on the AONE competencies as effective leaders in their practice environment (Wagner, 2018). The project also helped me to understand the healthcare environment, especially the increased demand for care due to an aging population and the susceptibility and cost burden that it constitutes for the healthcare system in general and the long-term care facilities in particular.

The AONE (2018) asserts that as an advocate for community and patient health needs, the nurse executive serves as a change agent in this strategic endeavor. The AONE competencies are based on the domains of communication and building relationships as well as knowledge of the health care environment. It also focuses on leadership and professionalism as well as business skills. The implementation of this project demonstrates that nurses play a critical role in population health management in their care settings for improved quality and patient safety.

Conclusion

Leadership projects like the practicum in the long-term facility demonstrate the need for providers to set safety and quality care goals to enhance patient satisfaction and experience. The practicum project provided me with an opportunity to understand the different aspects of fall prevention and initiatives that are based on evidence to reduce these events. The practicum project initiative illustrates the need to use AONE competencies to offer quality interventions in healthcare settings for elderly patients in long-term facilities.

References

American Organization of Nurse Executives (AONE) (2018). AONE Nurse Executive

Competencies. Chicago, IL: Author. http://www.aone.org/resources/nurse-leader-competencies.shtml

Andrew, L., Dare, J., Robinson, K., & Costello, L. (2022). Nursing practicum equity for a

changing nurse student demographic: a qualitative study. BMC nursing, 21(1), 1-8. DOI: 10.1186/s12912-022-00816-2

Caeiro, S., Sandoval Hamón, L. A., Martins, R., & Bayas Aldaz, C. E. (2020). Sustainability

assessment and benchmarking in higher education institutions—A critical reflection. Sustainability, 12(2), 543. doi:10.3390/su12020543

Cameron, I. D., Dyer, M., Panagoda, E., Murray, R., Hill, D., Cumming, G., & Kerse, N.

(2018). Interventions for preventing falls in older people in care facilities and

hospitals. The Cochrane Database of Systematic Reviews, 9(9), CD005465.

https://doi.org/10.1002/14651858.CD005465.pub

Errida, A., & Lotfi, B. (2021). The determinants of organizational change management success:

Literature review and case study. International Journal of Engineering Business Management, 13, 18479790211016273. https://doi.org/10.1177/18479790211016273

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A., & Morris, M. (2019). Educating

hospital patients to prevent falls: Protocol for a scoping review. BMJ Open. e030952.

DOI: 10.1136/BMJ open-2019-030952

 Igharosa, M. O. (2021). Implementation of a Fall Prevention Program for the Elderly in a Long-

            Term Care Facility. Walden Dissertations and Doctoral Studies. 9749.

https://scholarworks.waldenu.edu/dissertations/9749

Wagner, J. (2018). Leadership and influencing change in nursing. University of Regina Press.

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Assessment Description
Throughout your practicum experience, you have been designing and implementing a project. You will now assess that experience. Prior to beginning this paper, discuss the topics below with your preceptor. Include their feedback as well as your own. In a 1,500-1,750-word document, discuss the following topics:

Describe your leadership project, its focus, and the site where it was implemented. How did you discover the need for this project?
Discuss how the outcomes of your project will be measured? Is your project one that is sustainable or is it designed to be a single occurrence?
Did you encounter any real or potential barriers during your practicum experience related to your project?
Evaluate the success of your project. If you were not able to implement your project, discuss why. What are the next steps for the project?
What were the goals you set for yourself and the AONE competencies you hoped to achieve?
Summarize your project experience related to those goals and AONE competencies.
Use a minimum of two peer-reviewed resources (published within the last 5 years) as evidence to support your views.

Prepare this assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center.