NURS FPX 8045 Assessment 7 Literature Review

Name

Capella university

NURS-FPX 8045 Doctoral Writing and Professional Practice

Prof. Name

Date

Conceptualizing a Potential Project-Signature Assessment

The assessment aims to create a coherent body of evidence, interventions, and feedback from previous assessments to address a practice gap in Cass Regional Medical Center (CRMC). The paper guides the development of a doctoral project and highlights the need to use research-based practice to enhance outcomes and efficiently address practice challenges.

Introduction and PICO(T) Question

A practice gap in the care of patients at CRMC is related to inconsistent communication practices among healthcare teams regarding patients’ fall risk. A study reveals that about 18% of inpatient fall events are caused by staff and communication factors (Lakbala et al., 2024). Implementing the TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) developed by the Agency for Healthcare Research and Quality (AHRQ) can help foster inter-team communication and enhance patient safety (AHRQ, n.d.). Improving communication in CRMC will improve collaboration, decrease the number of falls, and promote a patient safety culture.

PICO(T) inquiry for the project is: For nursing staff working in emergency and inpatient departments (P), how does implementing AHRQ’s TeamSTEPPS communication toolkit (I), compared to the current practice of no structured communication protocols (C), affect the rate of patient falls (O) within twelve weeks (T)? The expected outcome measures are decreased fall rates and improved care team communication, guaranteeing long-term patient safety improvements.

Analysis and Synthesis of Research

Several literature studies support the identified practice gap of poor communication between care teams, resulting in ineffective fall risk management at the CRMC. For example, Albertini and Peduzzi (2024) reveal that insufficient communication in the healthcare team that deals with hospitalized patients increases the probability of falls. Baumann et al. (2022) have mentioned that an important factor for implementing successful fall prevention strategies is proper communication at healthcare teams and caregiver levels, achieved through appropriate protocols.

The article supports the practice gap, stating that a lack of standard communication leads to an increase in fall rates and thus compromises patient safety. Garcia et al. (2021) note that communication failure is one of the barriers to patient safety, including fall risk. A study by Lakbala et al. (2024) shows that 18% of fall incidents result from communication breakdowns among healthcare professionals. Singh et al. (2020) further associated poor communication with fall events, stressing the communication policies about patient care after and before falls.

NURS FPX 8045 Assessment 7 Literature Review

The information gathered supports the identified practice deficit in communication about fall-risk management at CRMC. Albertini and Peduzzi (2024) give level III evidence regarding interprofessional communication and collaboration. On the positive side, the qualitative design provides rich information; conversely, the results cannot be generalized. Baumann et al. (2022), also level III, have messages about interprofessional collaboration and standardized tools, but nonprobability sampling reduces its generalizability. Garcia et al. (2021) is level V evidence, which outlines the challenges to communication in fall prevention.

The major limitation is the absence of a formal quality assessment, even though it is comprehensive. Lakbala et al. (2024) present level V evidence by a narrative review, which does not include the primary data collection. Singh et al. (2020), level IV, offers good ideas on implementing fall prevention policies; however, the study is tailored to hospitals only. Altogether, these sources provide robust evidence of the need to enhance communication interventions, although the studies have some methodological flaws.

NURS FPX 8045 Assessment 7 Literature Review

Although evidence can be found for the practice gap of ineffective communication in managing fall risks, the study questions are still present about the communication difficulties the healthcare teams have in sharing fall risk information with other team members, particularly in emergent circumstances or handoff. Gaps in the literature involve the lack of identification of organizational culture and how it impacts communicative behaviors about fall prevention.

There is limited research on how different care settings, such as emergency departments versus inpatient units, experience and address communication gaps. More studies must be conducted to understand how these gaps are closed using other digital technologies like electronic health records. Knowledge of these aspects will help better to understand the practice gaps in the communication at CRMC when developing solutions.

Recommendations to Stakeholders

The recommended intervention to fill the practice gap of poor communication at CRMC is the TeamSTEPPS toolkit. The AHRQ designed the evidence-based intervention to improve team communication, collaboration, and patient safety, making it well-suited for CRMC’s needs. Several literature studies proved the efficiency of TeamSTEPPS in preventing falls and promoting a safety culture. A systematic review by Costar and Hall (2020) concluded that checklist and staff training programs of the TeamSTEPPS intervention reduce fall rates and enhance teamwork and patient safety.

The study supports the use of TeamSTEPPS at CRMC for fall prevention. Cunha et al. (2021) agree that TeamSTEPPS does improve communication, decision-making, and risk management, consequently boosting fall prevention practice within inpatient facilities. One of the studies demonstrates that TeamSTEPPS interventions enhance the effectiveness of communication, cooperation, and teamwork among the healthcare teams (DM & Yuanasika, 2023), which makes the intervention applicable to the CRMC’s departments’ heterogeneity.

NURS FPX 8045 Assessment 7 Literature Review

Hassan et al. (2024) found a large effect of TeamSTEPPS introduction to training for newly graduated concerning the staff attitude toward teamwork and patient safety. Shi et al. (2024) also write that clinical implementation of TeamSTEPPS aimed at enhancing patient safety leads to better outcomes and lesser adverse events. Thus, managing CRMC’s practice gap through the TeamSTEPPS toolkit will enhance cooperation by providing the most appropriate communication patterns and lessen patient fall rates in inpatient and emergency departments within the healthcare setting.

Therefore, using the articles’ findings, the TeamSTEPPS toolkit should be adopted in CRMC to prevent falls. Consequently, it is recommended that CRMC incorporate TeamSTEPPS into the proposed fall prevention program whereby the organization’s healthcare team is trained on communication, leadership, mutual support, and risk management. Planned actions and steps include the incorporation of TeamSTEPPS in the staff induction process, recurrent training for the existing workforce, and using checklists that will help maintain compliance with implemented safety measures (Costar & Hall, 2020; Hassan et al., 2024). To ensure the appropriateness of this initiative, CRMC should assess the readiness of its staff for TeamSTEPPS implementation, considering their current communication patterns, teamwork dynamics, and familiarity with patient safety practices. 

NURS FPX 8045 Assessment 7 Literature Review

Key areas to evaluate the projected outcomes include the possible reduction in the rates of falls. It is imperative to weigh the incidence of falls before and after implementing TeamSTEPPS in patient safety. Another type of outcome measure is enhanced team communication. Assess improvements in teamwork and communication through surveys and feedback tools involving more nurses and aides whenever transition is underway (Garcia et al., 2021). These criteria will be useful in evaluating the efficacy of the intervention within CRMC and skill in making necessary modifications.

However, some limitations to the evidence can still be identified. TeamSTEPPS should be implemented at CRMC to improve teamwork and decrease fall rates, but some questions remain. For example, although Costar and Hall (2020) showed that TeamSTEPPS could enhance patient safety outcomes, the durability of these positive changes in various healthcare organizations and over the long term has not been established.

Cunha et al. (2021) discussed improved communication and decision-making regarding fall prevention. The findings should be extended to study the sustained effects on the fall rates of elderly patients in various hospital settings. DM and Yuanasika (2023) concluded that there was a positive enhancement of teamwork and safety culture. However, more research is required to evaluate the patient outcomes other than the safety culture and communication. Hassan et al. (2024) and Shi et al. (2024) reported improved nurse perceptions and teamwork. Further research on how such changes are reflected in clinical practice and the specific area of fall reduction is still lacking.

Communication with Stakeholders

Communication of the project with the implementation team is very important to gain support and facilitate the implementation process. The message needs to be constructed with precision to indicate clear and straightforward meanings and to apply to the group’s membership by recognizing the input and specialization of the group, as well as respecting the roles assigned to different members.

Communication and feedback with the stakeholders will enhance teamwork and cooperation and decrease patient fall incidence at CRMC. The audiovisual presentation strategy will involve giving a clear introduction to the TeamSTEPPS toolkit and its evidence-based advantages. Non-text elements like infographics or slides will stress the implementation plan and make it easier to follow verbal descriptions and texts (Hafner et al., 2022). Another one will involve decomposing the implementation plan into a set of achievable and measurable tasks and making sure that people involved comprehend their tasks.

NURS FPX 8045 Assessment 7 Literature Review

Another strategy will be to involve the implementation team through the use of participative workshops. The workshops will enable those in the team to physically understand how to utilize the tools in TeamSTEPPS through role-play and rehearsal, enhancing the confidence to use the strategy in a real context (Arrogante et al., 2023). Another action plan is to develop a system of mentors or buddies who can work alongside relatively inexperienced colleagues using the toolkit. The content should be well-written and easy to understand, with quick references in case the learner forgets what has been covered. Semiannual meetings will be set to review the team’s progress and make modifications as needed based on the team’s feedback.

To address potential conflict of interest or resistance, especially with the employees, it is necessary to understand how the plan can be implemented to overcome the resistance that may be as a result of new rules and regulations that may be adopted alongside the new protocols that are likely to lead to increasing workload. Accept staff difficulties and demonstrate how TeamSTEPPS can help make the work less complicated and more efficient, decrease the occurrence of communication failures, and improve patient safety and staff satisfaction (Hassan et al., 2024). The available literature that proves that TeamSTEPPS enhances approaches to communication and collaboration to underscore this tool is supportive rather than cumulative. 

NURS FPX 8045 Assessment 7 Literature Review

Lack of compliance may well be addressed through requisite training, education, and implementation programs whereby in other studies, Costar and Hall (2020) and Hassan et al. (2024) revealed that TeamSTEPPS training enhances the perception of nurses regarding teamwork and safety, as it positively influenced. Nurse and team leader participation will be described as productive and constant key stakeholder communication essential in sustaining the efforts and guaranteeing effective implementation. Education and follow-up of the program by all the team members and constantly reminding them of the program’s benefits to the patient safety and the overall team will help the program stay on track with the organizational goals and objectives for the long term.

Using Feedback to Improve Writing

Throughout the course, writing feedback has been an important means of development when it comes to writing skills. The input stressed organization, grammar, and style, especially in APA writing. Among the areas of improvement that were pointed out, the problem of weak connection between concepts was noted, which requires a better connection between sources.

To counter this, attempts were made to find connections between the sources and the themes to improve the coherence and cohesion of the information presented. Opinions and ideas were criticized for misquoting current and relevant literature when supporting arguments. Some of these approaches that were found useful include the MEAL plan to assist in delimiting arguments and peer reviews or self-editing activities. In addition to writing resources and workshops, the steps enabled the application of technical critical writing skills and confidence.

NURS FPX 8045 Assessment 7 Literature Review

Feedback will be crucial in a professional career throughout one’s practice. Feedback will enable constant communication, decision-making, and performance assessment to be embraced. The capacity to use feedback positively can improve personal and team performance. For example, comments on the project reports, patient care documents or joint work can give clues about what may require improvement. Time and suggestions from peers, supervisors, and subordinates will be crucial to developing blinders and enhancing professional abilities. Approaches for feedback integration will include timely feedback on performance, asking for feedback, and feedback self-reflection. Applying feedback to improve decision-making and to ensure that the quality of the care provided to patients remains high will be an important issue in practice.

Conclusion

In conclusion, the present study aims to address the practice gap in communication at Cass Regional Medical Center (CRMC) and, thus, enhance patient safety with a focus on decreasing fall rates. Based on the PICO(T) question, adopting TeamSTEPPS, a structured communication tool, was necessary to improve interprofessional relations. The literature reviewed shows that inadequate communication within care teams is a major factor in falls, and TeamSTEPPS has been found to enhance communication, teamwork, and patient safety.

The intervention is suggested for CRMC to promote a safety culture and decrease the rates of falls by using the protocols for communication. The most important factors that will help implement TeamSTEPPS will be the engagement of the stakeholders, and communication plans. For that reason, more studies are needed to ascertain the long-term effects of TeamSTEPPS for fall prevention and additional clinical improvement. Accountability and refinements will be critically important after ongoing program implementation and delivery. By applying methods learned through TeamSTEPPS focusing on communication and teamwork, there will be a reduction in fall incidences, and therefore, patient care and safety will be enhanced in CRMC.

References

AHRQ. (n.d.). TeamSTEPPS (Team Strategies & Tools to Enhance Performance & Patient Safety). Www.ahrq.gov. https://www.ahrq.gov/teamstepps-program/index.html

Albertini, A. C. da S., & Peduzzi, M. (2024). Interprofessional approach to fall prevention in hospital care. Revista Da Escola de Enfermagem Da USP, 58. https://doi.org/10.1590/1980-220X-REEUSP-2023-0239en

Arrogante, Ó., Raurell-Torredà, M., Zaragoza-García, I., Sánchez-Chillón, F. J., Aliberch-Raurell, A. M., Amaya-Arias, A., & Rojo-Rojo, A. (2023). TeamSTEPPS®-based clinical simulation training program for critical care professionals: A mixed-methodology study. Enfermería Intensiva (English Edition), 34(3), 126–137. https://doi.org/10.1016/j.enfie.2022.10.002 

Baumann, I., Wieber, F., Volken, T., Rüesch, P., & Glässel, A. (2022). Interprofessional collaboration in fall prevention: Insights from a qualitative study. International Journal of Environmental Research and Public Health, 19(17), 10477. https://doi.org/10.3390/ijerph191710477 

NURS FPX 8045 Assessment 7 Literature Review

Costar, D. M., & Hall, K. K. (2020). Improving team performance and patient safety on the job through team training and performance support tools: A systematic review. Journal of Patient Safety, 16(3), S48–S56. https://doi.org/10.1097/pts.0000000000000746 

Cunha, L. F. C. da, Baixinho, C. L., Henriques, M. A., Sousa, L. M. M., & Dixe, M. dos A. (2021). Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly people. Revista Da Escola de Enfermagem Da USP, 55. https://doi.org/10.1590/s1980-220×2019031403695 

DM, R. R., & Yuanasika, D. (2023). Team effectiveness intervention using TeamSTEPPS in healthcare: A literature review. Jurnal Aisyah: Jurnal Ilmu Kesehatan, 8(3). http://dx.doi.org/10.30604/jika.v8i3.2199 

Garcia, A., Bjarnadottir, R. (Raga) I., Keenan, G. M., & Macieira, T. G. R. (2021). Nurses’ perceptions of recommended fall prevention strategies. Journal of Nursing Care Quality, Publish Ahead of Print(3). https://doi.org/10.1097/ncq.0000000000000605

Hafner, C., Schneider, J., Schindler, M., & Braillard, O. (2022). Visual aids in ambulatory clinical practice: Experiences, perceptions and needs of patients and healthcare professionals. PLOS ONE, 17(2), e0263041. https://doi.org/10.1371/journal.pone.0263041 

Hassan, A. E., Mohammed, F. A., Zakaria, A. M., & Ibrahim, I. A. (2024). Evaluating the effect of TeamSTEPPS on teamwork perceptions and patient safety culture among newly graduated nurses. BMC Nursing, 23(1). https://doi.org/10.1186/s12912-024-01850-y 

Lakbala, P., Bordbar, N., & Fakhri, Y. (2024). Root cause analysis and strategies for reducing falls among inpatients in healthcare facilities: A narrative review. Health Science Reports, 7(7). https://doi.org/10.1002/hsr2.2216

NURS FPX 8045 Assessment 7 Literature Review

Shi, Y., Miao, S., Fu, Y., Sun, C., Wang, H., & Zhai, X. (2024). TeamSTEPPS improves patient safety. BMJ Open Quality, 13(2), e002669–e002669. https://doi.org/10.1136/bmjoq-2023-002669 

Singh, H., Flett, H. M., Silver, M. P., Craven, B. C., Jaglal, S. B., & Musselman, K. E. (2020). Current state of fall prevention and management policies and procedures in Canadian spinal cord injury rehabilitation. BMC Health Services Research, 20(1). https://doi.org/10.1186/s12913-020-05168-8