Introduction
This paper will use the high reliability theory (HRT) in the design and implementation of the safety program. According to Huber (2017), it relies on interdisciplinary teams to introduce an organizational commitment to safety and create backup protection steps in their accident prevention systems. The result is a robust framework that can reliably prevent most accidents, which is what gives the theory its name. The high reliability approach has been increasingly seeing adoption in healthcare, as the ideas of interdisciplinary care spread and increased in depth as well as scope. It offers an improved capacity for safety through the combination of the expertise of medical workers across the world and their experience of practical initiative implementation. As such, its application in the project is warranted, as will be shown below through evidence.
The high reliability theory has been applied broadly across the entire framework of healthcare. The potential for safety improvement that it creates can be beneficial for most patient environments, as the nature of healthcare means that there are always health risks present. Babyar (2020) recommends the usage of HRT in many different organizations, including hospitals, nursing homes, and ambulatory clinics. The second category is particularly pertinent because the residents of these facilities usually remain there for extended periods and vary substantially in their health and independence. As such, nursing homes have to be prepared to accommodate all of these various conditions and ensure that their stay is safe and associated with as few incidents, including falls, as possible. The high reliability theory contributes the most to this paradigm by addressing as many potential problems as possible and creating supplementary protective measures to ensure that falls are minimized and cause little to no damage.
Evidence-Based Safety Program Design
The program that is proposed by the author is a multifactorial intervention that aims to prevent falls and minimize the damage if any occur. It will involve regular assessments of patients’ condition and the risk factors that are associated with it to deploy proactive measures to protect them from harm. Moncada and Mire (2017) supply evidence for exercise, vitamin D supplementation, minimization of medications (particularly psychoactive ones), modification of the environment for those most at risk, management of foot problems and footwear, and postural hypotension management among other approaches. Most of these interventions should not be excessively costly in terms of money, though they will require an additional time commitment on the part of the workers. The new program will be integrated into the home’s current fall prevention framework, which incorporates some elements described while omitting others.
The facility already utilizes exercise programs that aim to improve the patients’ physical capabilities such as strength and balance, helping them avoid situations where they are at risk for a fall. The exercise program is not achieving the required results, but that result is likely due to the lack of other pertinent interventions, particularly psychoactive medication withdrawal. Many of the patients have pain issues, which the home manages through the use of painkillers, which sometimes impairs their functioning. Additionally, while the facility tries to supply environmental fall protection measures to the patients, it does so indiscriminately and not necessarily effectively. As such, the program will incorporate vitamin D supplementation, medication intake reduction, environment adaptation, and management of foot problems and hypotension. The specific treatment that is provided to each patient will be based on the results of an evaluation that will be conducted regularly.
The analysis will be conducted using the BRIGGS assessment tool due to its excellent suitability for the purpose. Jackson (2016) supplies substantial evidence for the tool’s effectiveness as a part of a comprehensive approach to fall prevention in nursing homes. It will be used every two weeks, and the results will be recorded in the institution’s database along with the history of falls. The institution’s team will meet at the time of each evaluation and decide on the treatments that will be administered to each patient. The history of falls, the damage from them, and the results of the past, as well as recent, medical assessments will be used as factors for the decision. The information will also be used to track the outcomes of the program and propose further improvements for testing and adoption throughout the facility.
Outcomes and Sustainability
Due to the program’s relative simplicity, its outcomes should not be complicated, particularly when compared to many other medical environments. Per Gulanick and Myers (2016), they should involve improved fall prevention behavior, knowledge, success, and increased competency in risk detection and control. The facility will take a more active approach to fall prevention and attempt to eliminate the factors that cause the incidents. It will do so through improved knowledge of the factors that cause falls and increase their severity, which will, in turn, enable superior responses that minimize the number of falls. The personnel will supplement their theoretical understanding of fall hazards with practical experience of detecting active risk hazards, which will enable them to identify the need for an intervention. Moreover, they will understand the simplest and most effective ways of managing these risks through practice, which will enable them to deliver excellent results. All of these outcomes can be measured through appropriate evaluation tools, which will be used to determine the initiative’s success.
Another question is whether the program will prove to be sustainable in the long term. Failure to improve results after the initial period indicates the existence of some flaw in the initiative that needs to be corrected before it can be put into practice or admitted as an evidence-based practice. Roussel (2019) highlights the role of mindful leadership in creating a culture of sustainable improvement through the usage of behavioral and social sciences to ensure that the other staff members reliably and consistently adopt and embrace the new methodology. The goal is for them to incorporate the new ideas into their regular practice so that they do not abandon the approach once it is no longer actively promoted. As a nursing leader, it is the author’s responsibility to ensure that this process occurs smoothly and verify the results a year after the new intervention’s implementation.
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