Nursing Assessment Report | Nursing Quality

Running head: NURSING
QUALITY IMPROVEMENT PLAN
Name of the Student:
Name of the University:
Author Note:

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Project Title: ‘Reducing incidence of falls among the elderly within healthcare setting
and ensuring quality improvement.’
Introduction:
Falls among elderly account for a major health issue that results in associated
comorbidities. The evidence base in this regard reveals that approximately 30% of the old age
adults aged 65 and above experience one episode of fall in a year. Research studies further
state that the incidence rate is expected to rise from 14% as reported in the year 2010 to 23%
within 2050 (Anzfallsprevention.org, 2019). In addition to this, it should also be noted that
the associated medical cost of fall is expected to rise up by $1.4 billion by the end of the year
2051 (Anzfallsprevention.org, 2019). Also, the financial expenditure pertaining to the cost of
injuries caused due to falls is expected to rise up to 1.8 million (Breimaier et al., 2015). The
background information suggests that falls among elderly enhances the disease burden that
subsequently diminishes the quality of life which in turn stresses upon the need to introduce
quality improvement programs within healthcare setting in order to control the prevalence of
falls and related accidents among the elderly.
Project Proposal:
The project proposal intends to reduce the incidence of falls among the elderly within
the geriatric unit of XYZ hospital. The rationale for proposing the project can be explained as
the rise in the rate of recurrent hospitalization due to falls among the old age patients aged 65
years and older post discharge, considering the 6 months patient data. The proposed project is
aligned to the six domains of healthcare as mentioned in the STEEP framework and intends
to improve the quality of care services offered by ensuring a safe, effective and patient-
centered care delivery. In addition to this, the proposed project also intends to enhance the

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quality of services provided so as to render timely, efficient and equitable service delivery to
the old age patients.
Significance of the Problem:
The evidence base reveals that advanced age is invariable accompanied with the
manifestation of one or more chronic health disorders such as Diabetes or cardiovascular
disorders (Vlaeyen et al., 2015; Kim et al., 2015). The symptoms of the disorders lead to a
number of physiological complications such as interference with proper eyesight and poor
neuro-muscular coordination (Park, 2018). In addition to this, senescence is also
accompanied with other physiological complications such as lack of bone density that leads
to osteoporosis and results in lack of bone and muscular strength (Kaminska et al., 2015).
These factors lead to falls and accidents that subsequently diminishes the quality of life of the
elderly. In addition to this, recurrent hospitalizations due to fall increase the overall medical
cost and deteriorates the quality of life of the family members of the patients (Luk et al.,
2015, Bhattacharya et al., 2016). In this regard, it can be stated that evaluating the evidence
base to integrate the best strategy for prevention of falls among the elderly can help to
improve quality and acquire positive patient outcome.
Project Aim:
The aim of the project proposal is to reduce the frequent rate of hospitalization by
30% among the elderly on account of falls and related injuries within 6 months. The SMART
objectives for the proposed project is explained as under:
Specific: To reduce the recurrent rate of hospitalization among the elderly within the geriatric
unit of XYZ hospital
Measurable: The incidence rate would be reduced by 30%

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Attainable: The achievable reduction rate would be 10% to 15%
Realistic: Incorporating evidence based fall prevention strategies as per the available
resources and allocated budget
Timely: The quality improvement program would be implemented within 6 months
Current State:
The current patient data suggests that the rate of recurrent hospitalization on account
of fall and associated injuries among the elderly within XYZ hospital is equivalent to
47.25%. In addition to this, increase in the prevalence of fall has also aggravated the disease
burden and has contributed to a rise in the medical expenditure and has significantly
diminished the quality of life for the affected patients as well as their family members. The
proposed project intends to introduce a quality improvement fall prevention program within
the geriatric unit of the XYZ hospital so as to improve patient safety and acquire positive
patient outcome.
Establishing Measures:
According to Leis and Shojania (2017), while implementing a project, it is integral to
establish the assessment or evaluation parameters based on which the success rate of the
proposed plan can be scrutinised. In order to determine the success rate and feasibility of the
project, the documented reduction rate of recurrent hospitalizations due to falls is expected to
decrease by 30%. A 30% reduction in the rate of recurrent hospitalization due to falls among
the elderly will reveal that the implemented plan has been successful.
Project Details:
In order to implement the proposed plan the PDSA framework would be utilised. The
PDSA or the Plan, Do, Study and Act framework allows to test and integrate a change within