Project Charter
Part 1 |
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| Project Charter Information | |||||||||||||||
| Project Name | Hourly rounds to prevent patient falls | ||||||||||||||
| Project Site | White Plains Hospital | ||||||||||||||
| Contact at site | Name with credentials:
Organizational Email: Phone Number: |
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| Preceptor | Name with credentials: Margaret Brock DNP, NEA- BC Assistant VP of Quality & Magnet Program
Email: Phone Number: |
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| Executive Sponsor | Identify this person by role and title (no names) and briefly describe why this person was selected (rationale for the selection). | ||||||||||||||
| Gap Analysis | Worrying trends in patient falls raise concerns about the levels of vigilance and effectiveness of human, technical, and administrative measures adopted across the facility. Falls as a result of patient frailty cause prolonged hospitalization, premature placement in nursing homes, anxiety, and increased medical costs. Fall risks are multifactorial, hence, the need for evidence-based assessment and prevention (LeLaurin & Shorr, 2019). In this sense, increasing patient falls raises questions about the facility’s ability to balance patient prevention with other safety and quality prioties for patients. | ||||||||||||||
| Evidence to Support the Need | Falls are among the most reported safety incidents. A significant number of falls result in physical injuries, fractures, and other adverse outcomes that undermine patients experiences. Affected patients may experience declining confidence, delayed functional recovery, prolonged hospital stays, and additional costs (Francis et al., 2019). Thus, accurate and complete identification of underlying risk factors is necessary to reduce the incidence of falls and nurture a culture of vigilance across the care continuum. Hourly rounds are among the viable and sustainable interventions that enable the care team to assess patients based on their needs and assistance (King et al., 2018). The processes entail effective use of falls prevention checklists to examine factors such as bed positioning, bathroom condition, pain control, call lights, and access to personal items associated with falls (Wash et al., 2018). Thus, hourly round is an evidence-based approach that the nursing team can use to avoid fall injuries, maximize patient satisfaction, and reduce medical costs. | ||||||||||||||
| PICOT | In patients admitted in an acute care nursing unit (P) does hourly round (I) compared to no rounding (C), reduce rate of falls (O) over a period of four weeks (T)? | ||||||||||||||
| Project Aim | The aim of the project is to reduce patient falls by implementing hourly rounding. Patient falls increase hospitalization stay, medical costs, and emotional, physical, and mental distress. In this case, hourly rounds are among the tailored prevention interventions that enable the care team to capture and respond to factors that increase the risk of falling. Insituting hourly rounds will encourage the nursing team to respond to a patient’s needs by assessing the level of pain, position, access to washrooms, and other aspects associated with falls. | ||||||||||||||
Part II |
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| Stakeholders | |||||||||||||||
| Stakeholder | Identify the key stakeholders for your project. Think of key stakeholders (internal and external). This might include patients/clients, families, community leaders and organizations, health agencies, systems within the organization etc. List between 3-4 potential stakeholder members | ||||||||||||||
| Initials or ficitious name | Title, Role or Affiliation. | Connection to the project. | Potential impact (how affected). | Contribution to the project. | Barriers or anticipated challenges if any | ||||||||||
| Team Leader | Identify the team leader by initials and/or fictitious name and primary role within the organization. Be sure to complete the interactive media in Week X before completing this section. Include the following:
· Why you selected this person to lead the team. · Useful qualities this leader might leverage for success (consider emotional intelligence and communication/collaboration attributes). · Discuss how an effective leader in this context might address ethical practices, diversity, equity, and inclusion in leading the team and the quality improvement effort. · Leadership style(s) or approach(es) to be utilized. · Identify two different leadership approaches that might be utilized to lead the team. Briefly describe the approaches using 1-2 citations/references (published within the last five years) for support. · Explain why you selected these two approaches. · Think about your own experience and leaders that have been most effective. Assess when different situations might necessitate different approaches in developing and implementing your Project Charter. Provide an example of how the leader might utilize each of the approaches you selected in practice.
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| Team Members | Identify 4-6 team members (initials or fictitious name), department or affiliation and credentials or qualifications. Think about how a diverse set of individuals (demographics, disciplines, experiences, knowledge) will add to the team!
Describe each team member’s title, department or affiliation, qualifications/credentials and the rationale for inclusion and how the person contributes to the project’s success. |
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| Title | Department or Affiliation | Credentials or Qualifications | Rationale for selection/Contribution to the project | ||||||||||||
| Communication Plan | |||||||||||||||
| Develop a communication plan for each person associated with the Project Charter, e.g., Executive Sponsor, Stakeholders, Team Leader, Team members. | |||||||||||||||
| Team Member/Stakeholder. | Purpose of communication (Inform, share, engage, solicit information?). | Frequency and timing of communication. (How often, specific stages of project?) | Method of communication (consider audience, method, culture, language, inclusion). | Who is responsible for the communication to this member? (Why is it important who delivers the message?) | Potential challenges/ barriers or assets with communication (barriers, language, culture, different disciplines, best practices (cite the literature 1-2 sources as needed). | ||||||||||
Intervention and Measurement |
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| Planned Intervention | Evidence supporting the intervention needs to be provided. A minimum of five evidence- based resources required (for example, research articles, clinical practice guidelines, consensus statements). Describe the planned intervention including:
· Describe 2-3 interventions that can be applied in this practice change · Interventions identified are consistent with the synthesis of the literature. · There is logical progression from the synthesis of the literature to the practice recommendation to the proposed intervention of the project. · Defines the intervention very specifically and operationally so that anyone replicating this project could apply the same intervention. · Scope of work detailing week by week what will be done and estimated hours (include as appendix). · Appropriate appendices are included.
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Improvement Model / Framework |
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| Identify and briefly describes theoretical framework or conceptual model for improvement. Provide rationale for why the model was chosen and how it is a good fit for the project (you will be connecting this to the project intervention later in 9901). | |||||||||||||||
Proposed Outcomes |
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| Metric (What is being measured to determine success): | Outcome Measure (What is the desired outcome in measurable terms): | Process Measure (Are you doing the right things to get to the outcome? Are the steps in the process leading to the planned outcome?): | Balancing Measure (Are the changes being made causing problems in other areas?): | ||||||||||||
Part III |
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| Data Collection & Management | |||||||||||||||
| Develop a plan for the collection, management, and stewardship of the data you will collect for your Project Charter. | |||||||||||||||
| Describe the data to be collected | Who will collect it? | When will it be collected? Develop a timeline. | How will the data be stored? | How will the data be protected? Who will have access? | Consider aspects related to diversity, equity, and inclusion. Is the data stratified by gender, race, ethnicity, age, disability, socioeconomic status? How might this information be utilized to address population health, equity and health disparities? Use citations as needed to support your conclusions. | ||||||||||
| Data Anaylsis | |||||||||||||||
| · Describes project design (example: quality improvement project).
· For each outcome measure define method of analysis. · Describe the psychometric properties (reliability and validity) of any instruments, tools, surveys, or questionaires used; status of permission to use instruments. If the instrument is not public, permission to use the instrument is attached as an appendix. |
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| SWOT Analysis and Business for Project | |||||||||||||||
| Think about how this project benefits the target population, the organization, and those served. Complete the SWOT Analysis. | |||||||||||||||
| Strengths | |||||||||||||||
| Project strengths: What are the assets of the organization that will help it achieve a successful outcome, e.g., knowledge, support, resources, funding, etc.? | |||||||||||||||
| Weaknesses | |||||||||||||||
| Potential obstalces or challenges: What are the potential barriers that might interfere with success? In the past, what factos were aligned with lack of success, and obstacles to change? | |||||||||||||||
| Opportunities | |||||||||||||||
| Opportunities to facilitate project success: What are the strengths? How might these translate into opportunities for change? | |||||||||||||||
| Threats | |||||||||||||||
| Potential threats: Identify potential threats to the success of the project, e.g., competition, factors beyond your control, etc. | |||||||||||||||
References
Francis, K., Kurtsev, A., Walter, D., Steele, C., Staines, C. (2019). Nurses’ experiences and perceptions of hourly rounding: A private Australian Catholic hospital single case study. International Archives of Nursing and Health Care, 5(125), 1-6. https://clinmedjournals.org/articles/ianhc/international-archives-of-nursing-and-health-care-ianhc-5-125.pdf
King, B., Pecanac, K., Krupp, A., Liebzeit, D., Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. The Gerontologist, 58(2), 331-340. https://academic.oup.com/gerontologist/article/58/2/331/2736326
LeLaurin, J., Shorr, R. (2019). Preventing falls in hospitalized patients: State of the science. Clinics in Geriatric Medicine, 35(2), 273-283. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6446937/
Wash, C., Liang, L., Grogan, T., Coles, C., McNair, N., Nuckols, T. (2018). Temporal trends in fall rates with the implementation of a multifaceted fall prevention program: Persistence pays off. The Joint Commission Journal on Quality and Patient Safety, 44(2), 75-83. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6736680/pdf/nihms-1044644.pdf