week 14 response on SWOT |

Reply Posts

1.  
2. Using the SWOT Analysis Resource, review two classmates’ posts.
3. Identify two items from each of the four components (S, W, O, T) that are relevant to the problem your classmate identified. Explain your reasoning for each.

To reply to the example in the initial post, you could select advantages of the proposition and financial reserves from the Strengths quadrant. Elaborate on the advantages of following the recommendations—for example, following professional standards of equal care, decreasing cost by not ordering unnecessary diagnostic tests, and increasing revenue from shorter visit times.

Items you might identify from the Weakness quadrant could include processes and systems, and morale commitment and leadership. These items are weaknesses because of the need to train providers on national recommendations and to create a system within the EMR to track PAP smears.

You should then choose two items from both the Opportunities quadrant and the Threats quadrant and include them in your reply post.

Response 1 by Kait D

After reviewing the QSEN Graduate Competencies I believe a quality and or safety issue that I have seen is related to the bathrooms in patient rooms for the inpatient side of the hospital only has one side rail versus two or a pull down one if needed. We have a lot of patients who have orthopedic surgery for total joints and lowering themselves down on a toilet can be extra difficult with mobility changes. Some of these patients have had to put their hand on the toilet seat as an extra support as they sit down. Theaker et al. (2022) discusses that “total hip replacement has many associated risks, one of which is dislocation of the new prosthesis, with reported incidence in the weeks following surgery ranging from 1% to 3%”. Physical Therapy works extensively with these patients on the proper techniques and exercises to provide the best possibility of positive outcomes. Being able to also provide a high-quality safety measure is something that can make a huge difference for these patients.As much as a safety concern this can be for the patients, this is also a concern for the staff as well. Teeple et al. (2017) states, “Among the occupational factors presenting injury risks for healthcare workers, patient handling and mobilization activities are of particular concern. Lifting demands for patient care workers frequently exceed the 35-pound safe lifting limit recommended for patient handling activities”. Some potential negative outcomes can be a result of poor transfers from the grab bars not being in place. These could include injuring their new joint or damaging a different body part from poor body mechanics trying to maneuver without the proper equipment. One study I found discussed the fact that bilateral grab bars are more effective (Lee et al, 2018).

References

Lee, S. J., Sanford, J., Calkins, M., Melgen, S., Endicott, S., & Phillips, A. (2018). Beyond ADA accessibility requirements: Meeting seniors’ needs for toilet transfers. HERD: Health Environments Research & Design Journal, 11(2), 32-44.Teeple, E., Collins, J. E., Shrestha, S., Dennerlein, J. T., Losina, E., & Katz, J. N. (2017). Outcomes of safe patient handling and mobilization programs: a meta-analysis. Work, 58(2), 173-184Theaker, J., Oldham, J., Callaghan, M., & Parkes, M. (2022). Assessment of patients’ self-reported levels of adherence to postoperative restrictions following total hip replacement. Physiotherapy.

Response 2 by Lau T

There are numerous quality/safety issues in home-based hospice. Many can be attributed to the inability of clinicians to be present 24/7. One common issue that I have seen in my practice are falls. While falls are well studied in the hospital setting, there is little research in the home setting or long-term care (LTC) setting, where home hospice patients receive care (Floyd, 2020; Chowa, 2021). Patients in hospice have varying levels of mobility, making it challenging to create standardized fall prevention plans. Some are bedbound, while others are independent with assistive devices. Baseline functional ability also varies. All these patients, regardless or physical and functional status, are at risk of falling. I have seen countless patients in hospice suffer unnecessary injury and premature decline related to falls. Falls in the elderly population, especially those in hospice, often lead to a decline in functional ability (Ho et al., 2022). Falls in this population also contribute to increased mortality and healthcare costs (Floyd, 2020). Some injure themselves so badly they are forced to forfeit hospice services in order to seek treatment. The system, as I have seen it, tends to be more reactive than proactive. Hospice providers must be knowledgeable of strategies to prevent falls in this patient population. Proper assessment of individual fall risk is the primary focus (Chowa, 2021). A solid knowledge base on proactive interventions is crucial for hospice providers, patients, families, and LTC staff. Applying proactive skills and efforts can reduce falls and improve quality of life at the end of life (Chowa, 2021). The attitudes that clinicians must possess to successfully reduce falls in hospice include a commitment to positive changes targeting individualized fall prevention plans and accepting but maximizing their limited role in fall prevention in the home setting.

References

Chowa, L.-S. (2021). Introducing an evidence-based protocol to reduce and prevent fall events among elderly hospice patients. Patient Safety & Quality Improvement Journal, 9(2), 109-119. https://doi.org/10.22038/psj.2021.49691.1277

Floyd, A. (2020). Reducing the rate of falls in hospice patients: A fall prevention pilot program [Unpublished manuscript]. Department of Nursing, University of San Diego.

Ho, V. P., Bensken, W. P., Koroukian, S. M. (2022). Palliative care and aggressive interventions after falling: A nationwide inpatient sample analysis. Palliative Support Care, 20(1), 1010-106. https://doi.org/1