Date of Award

5-2016

Document Type

Capstone

Degree Name

Doctor of Nursing Practice (DNP)

First Advisor

Gayle Casterline

Abstract

Healthcare facilities today are faced with many difficult patient care and safety challenges. In addition to providing immediate complex patient medical needs, healthcare staff must ensure patients are in a safe environment. Patient safety has become a major focus of many medical and long-term care facilities. An in-house reporting system of a medium size medical healthcare facility identified a patient safety issue. Multiple patient safety sentinel events have been reported; namely patient elopements (unauthorized missing patients) and high-risk patient falls. Certified nursing assistants were contracted to sit with these high-risk patients to alleviate these patient safety issues; nevertheless, these patient safety sentinel events have continued. An investigation identified these contracted certified nursing assistants needed more appropriate training to provide patient safety for high-risk patients. A two-day patient safety aide (sitter) training orientation and competency validation program to include a full day of Prevention and Management of Disruptive Behavior (PMDB) training was designed, developed, and implemented; retitling the role from sitters to patient safety aides. To evaluate the effectiveness of the program, all contract agency patient safety aides completed a descriptive pre-survey before participating in the training orientation and competency validation program followed by a post-survey after completing the program. A random selection of 132 facility staff completed a retrospective pre and post patient safety aide evaluation two months following the full implementation of the patient safety aide training program. Facility level outcomes analysis of monthly patient fall and elopement incidents three months before and three months after the program implementation. Following the program, patient safety aides (sitters) reported feeling significantly more prepared than before the training intervention (p< .001). The staffs’ perception on the sitters’ level of preparedness improved by nearly 38% after the training intervention. Patient fall rates showed a marginal but steady decline with a 54% decrease in patient falls in the presence of patient safety aides (sitters) and a 38% monthly average decrease after the training program intervention. Patient elopement rates showed a marginal but steady decline. High-risk patient safety skills training and competency education for patient safety aides (sitters) clearly identified roles, duties, functions, and responsibilities; resulting in cost-effective, proficient high-risk patient safety care.

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Nursing Commons

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