Capstone Project Dissemination of Change

Capstone Project Dissemination of Change

SECTION 1: DISCOVERY – Capstone Project Dissemination of Change

Patient falls.

Critical safety concern: injuries, extended hospital stay, and increased costs.

Falls continue despite fall prevention measures.

Affects many stakeholders.

Patients.

Healthcare staff.

Healthcare organization.

Patient falls in acute care settings are a critical safety concern that can lead to injuries, extended hospital stays, and increased healthcare costs. Patient fall rates range from 0.4 to 9 per 1000 patient days. About 25% to 50 of falls result in injuries. Despite existing fall prevention measures that target fall risk factors, falls continue to occur due to various factors, such as patient mobility, medication effects, and environmental hazards (Satoh et al., 2023).

The need to address patient falls is informed by the understanding that they affect many stakeholders. They affect patients through physical injuries, psychological impact, and mobility limitations. In addition, they affect healthcare staff, resulting in emotional distress and strain on relationships with patients. Besides that, they affect healthcare organizations by increasing costs, presenting potential for litigation, causing reputational damage, and highlighting a deficient safety culture (Takase, 2022).

 

SECTION 1: DISCOVERY cont’d – Capstone Project Dissemination of Change

P- (Population): Hospitalized adult patients

I- (Intervention): Hourly nursing rounds

C- (Comparison: Standard care without structured rounding

O- (Outcome): Reduction in patient falls during hospitalization

T- (Time frame in months): Over 3 months

The PICOT question is presented as: In hospitalized adult patients (P), does the implementation of hourly nursing rounds (I) compared to standard care without structured rounding (C) reduce the incidence of patient falls during hospitalization (O) over 3 months (T)?

The population was selected based on the high prevalence of falls in hospitalized adult patients, particularly those with mobility issues or at risk due to medications. The intervention, hourly rounding, was chosen because previous studies have demonstrated its effectiveness in reducing falls by proactively addressing patient needs. The outcome focuses on fall reduction, as it is a key indicator of patient safety. The 3-month timeframe allows for sufficient data collection to assess changes in fall rates.

 BUY AN ESSAY HERE

 

SECTION 2: SUMMARY – Capstone Project Dissemination of Change

Fall rates: 2.2 to 17.1 per 1,000 patient bed days.

Hourly rounding as a proactive strategy to address falls.

Every hour during the day and every 2 hours at night.

Ensure frequent interaction.

Minimize risk of high-risk activities without assistance.

Mant et al. (2012) examine the impact of hourly rounding on fall rates among adult patients in acute care settings. Falls remain a leading cause of injury in hospitals, with rates ranging from 2.2 to 17.1 per 1,000 patient bed days. The review identifies intrinsic factors such as age, cognition and mobility issues and extrinsic factors such as environment and medications contributing to falls. The review highlights hourly rounding as a proactive strategy that significantly reduces falls by addressing pain, toileting needs, repositioning, and personal item accessibility.

Pirrocco (2023) investigated fall reduction strategies in a medical-surgical unit in an urban hospital. The research directly applies to my PICOT question because it evaluates the impact of a structured hourly rounding approach combined with fall prevention tools in a population of hospitalized adults. The study implemented Patricia Dykes’ Fall TIPS tool alongside hourly rounding and found a 38% reduction in fall rates (p = 0.001). The project demonstrated that staff education and adherence to structured rounding logs significantly impacted fall prevention.

Based on the evidence reviewed, the selected intervention is hourly nursing rounds, where nurses proactively visit patients every hour during the day and every two hours at night. This structured approach reduces patient falls by ensuring frequent interactions and minimizing the need for patients to attempt high-risk activities without assistance. The intervention addresses common fall risk factors such as unmet toileting needs, medication side effects, and environmental hazards.  By decreasing the unmet needs of the patient, hourly rounding directly decreases the incidence of falls.

 

SECTION 3: TRANSLATION – Capstone Project Dissemination of Change

Hourly nursing rounds for hospitalized patients.

Improve patient outcomes and satisfaction.

Check basic needs, safety, and comfort.

Hospital inpatient unit.

 Result-driven culture of change.

SMART goals.

Clear expectations and accountability.

Performance measurement.

The evidence-based intervention involves implementing hourly nursing rounds for hospitalized patients. The purpose is to improve patient outcomes and satisfaction, address needs proactively, and enhance patient safety. The rounds are implemented as regularly scheduled visits that may occur every hour. The focus is on checking the patient’s basic needs, safety, and comfort, including toileting, positioning, pain management, and ensuring personal items are within reach. There are three elements in the nursing rounds. First, documentation of the rounds and interventions taken. Second, environmental assessment to ensure the patient’s environment is safe and conducive to comfort. Third, addressing the five Ps regarding personal care needs, the proximity of belongings, position, potty, and pain (Leamy et al., 2023).

The change project will be conducted in a hospital’s inpatient medicine unit. The unit provides comprehensive medical care to patients who require extended or overnight stays for diagnosis, treatment, or monitoring of chronic or acute medical conditions. It is designed to be a safe and comfortable environment for patients. Patient falls are a concern for the unit as they lead to psychological and physical harm, reduce quality of life, and increase healthcare costs. Implementing an effective fall prevention strategy that addresses the risk factors is expected to improve patient safety (Johnson, 2023). The organization adopts a result-driven culture of change. This culture focuses on tangible outcomes and motivates personnel to prioritize accountability and performance, which leads to higher organizational performance. It emphasizes achieving SMART goals rather than just focusing on processes or activities. In addition, there are clear expectations as the personnel understand what is expected of them and how they contribute to the organization’s overall success. Besides that, there is accountability as the personnel are held responsible for their actions and outcomes. This fosters a sense of ownership and pride in the work done. Additionally, performance measurement with regular feedback and performance evaluations tracks progress and identifies improvement areas. Focusing on results encourages continuous learning and improvement (Johnson, 2023).

 

SECTION 3: TRANSLATION cont’d – Capstone Project Dissemination of Change

Primary care physician.

Nurse.

Unit nurse manager.

Patient care representative.

Nurse informaticist.

An interprofessional hospital committee is needed to address patient falls as a safety issue. The committee, which has five members, is comprised of various health professionals who work collaboratively to identify, analyze, and implement interventions that enhance patient safety and reduce fall incidences. First, primary care physicians review the patient’s medical histories to identify those at risk of falls. They may recommend approaches to reduce fall risk, spot hidden injuries resulting from a fall, and evaluate medication side effects that may increase the risk of falling. Second, nurses who provide primary care conduct hourly rounds to assess patient needs and document findings. Third, the unit nurse manager provides leadership and supports the team, ensuring the project is aligned with the organizational goals, supports best practices, ensures compliance, and addresses any issues that arise. Fourth, a patient care representative who ensures the intervention is patient-centered and addresses their concerns. Fifth, nurse informaticist or quality improvement staff who provides expertise in data collection, analysis, and process improvement (Johnson, 2023).

 

SECTION 4: INTEGRATION – Capstone Project Dissemination of Change

Rate of total falls per 1,000 patient days.

Rate of injurious falls per 1,000 patient days.

Three phases

Phase one – 2 weeks – preparation and training.

Phase two – 9 weeks – implementation.

Phase three – 1 week – closing and evaluating performance.

Data tools.

EHR.

Data aggregation.

Analytics.

Two key performance indicators, identified by the National Database of Nursing Quality Indicators (NDNQI), will be tracked to monitor the progress of the change project. First, the rate of total falls per 1,000 patient days, and second, the rate of injurious falls per 1,000 patient days (Turner et al., 2022). The intervention is targeted at reducing the incidences of falls during hospitalization. It will be monitored and evaluated for effectiveness by evaluating data on fall incidences during the intervention. This will provide an overview of whether there have been any changes to fall incidences reported.  In addition, the nurses involved in implementing the intervention will be engaged to provide feedback that evaluates its effectiveness while making suggestions for improvements (Ogrinc et al., 2022). The change project’s progress will be tracked against established milestones by comparing performance against the established baseline data and goals. This will examine the patient-focused interventions regarding the changes in fall incidences and the number of nursing staff trained. It will apply a standardized system for reporting falls, including the date, time, location, patient details, and nature of the falls. This will then proceed to data analysis to identify trends, assess the effectiveness of the intervention, and make necessary adjustments. The tools used for tracking the progress are the fall risk assessment tools to assess fall risk and track changes over time, databases to organize and track fall data, and electronic health records (EHR) to store and track fall data (Ogrinc et al., 2022).

The project will be conducted in three phases over three months (12 weeks). Phase one, conducted over two weeks, will involve preparing a nurse hourly rounding schedule that identifies key focus areas and engaging nurse stakeholders to address their input and concerns. In addition, baseline data and goals regarding fall risk assessment will be established. Besides that, training is provided to ensure nurses understand the need for the project, what it entails, and their position in implementing it. Phase two, conducted over nine weeks, will involve project kick-off and performance, in which the nurse hourly rounding will be conducted, and feedback will be collected to understand areas that can be improved. Phase three, conducted over one week, will involve closing the project by evaluating the performance, consolidating findings and recommendations, and delivering the final report (Johnson, 2023).

Data tools will be leveraged to collect, aggregate, and analyze data using informatics effectively. In this case, electronic health records (EHR) will facilitate the digital storage and retrieval of patients’ fall data, enabling easier access and sharing. In addition, data aggregation will be applied by aggregating data from multiple sources to gain a more holistic view of the patients and identify trends and patterns that might not be visible otherwise. Analytics will also be applied to discover patterns and insights within the data sets (Miller, 2025).

 

SECTION 5: EVALUATION – Capstone Project Dissemination of Change

Client data privacy.

Data encryption.

Access control.

Data minimization.

Compliance with regulations.

Disseminate findings.

Presentation and posters.

Educational materials.

Social media and local media.

Next steps.

Continued implementation.

Ongoing evaluation.

Continuous improvement.

Client data privacy and security will be ensured in the project by implementing robust data encryption, enforcing strong access controls, conducting security audits, and complying with relevant protection regulations like HIPAA. Data encryption will be applied to protect data at rest and in transit by making it unreadable to unauthorized persons who may access or intercept the data. In addition, access control will be applied by limiting access to only authorized persons with a legitimate need to know. This will be through password policies, role-based access control, and multi-factor authentication. Besides that, data minimization will be applied by only collecting and storing the necessary data. All unnecessary data fields will be identified and eliminated. Additionally, compliance with regulations by ensuring adherence to relevant data protection laws and regulations, such as HIPAA (Miller, 2025).

Four strategies are identified for disseminating the outcomes of the change project. First, presentations to stakeholders and posters that inform them about the project results and present evidence that argues for change to improve outcomes. Second, creating and distributing educational materials, such as journal articles, that inform the scholarly community and other stakeholders about the project results. Third, utilizing social media and local media outlets to reach a wider audience with the project results and advocate for change (White et al., 2025).

After the project and outcome identification are completed, the next steps involve implementing the findings on a larger scale, evaluating their effectiveness, and using the information to continuously improve.  This targets continued implementation by disseminating the findings, developing and implementing evidence-based interventions, and adapting and modifying nursing care practices. In addition, it targets ongoing evaluation that assesses the impact of the intervention, uses data to inform future practice, and makes use of the plan-do-study-act (PDSA) model to test changes, analyze results, and make adjustments based on findings. Besides that, it targets continuous improvement by refining nursing practices, promoting evidence-based practice, and supporting nursing professional development (White et al., 2025).

REFERENCES

Johnson, D. (2023).
Hospital Quality: Implementing, Managing, and Sustaining an Effective Quality Management System
. Taylor & Francis.

Leamy, M., Sims, S., Levenson, R., Davies, N., Brearley, S., Gourlay, S., Favato, G., Ross, F., & Harris, R. (2023). Intentional rounding: a realist evaluation using case studies in acute and care of older people hospital wards.
BMC health services research, 23
(1), 1341.
https://doi.org/10.1186/s12913-023-10358-1

Mant, T., Dunning, T., & Hutchinson, A. (2012). The clinical effectiveness of hourly rounding on fall-related incidents involving adult patients in an acute care setting: a systematic review.
JBI Library of Systematic Reviews, 10
(56 Suppl), 1–12.
https://doi.org/10.11124/jbisrir-2012-258

Miller, K. S. (2025). 
Informatics and Nursing: Opportunities and Challenges
(4th ed.). Wolters Kluwer Health.

Ogrinc, G. S., Headrick, L. A., Barton, A. J., Dolansky, M. A., Madigosky, W. S., Miltner, R. S. & Mate, K. (2022).
Fundamentals of Health Care Improvement: A Guide to Improving Your Patient’s Care
. Joint Commission Resources.

Pirrocco, J. A. (2023). A Multi-Modality Approach to Reducing Falls in an Acute Care Community Hospital.
ProQuest Dissertations & Theses
.
https://chamberlain.primo.exlibrisgroup.com/permalink/01CUCON_INST/f6kb8f/cdi_proquest_journals_2800604148

Satoh, M., Miura, T., Shimada, T., & Hamazaki, T. (2023). Risk stratification for early and late falls in acute care settings.
Journal of clinical nursing, 32
(3-4), 494–505.
https://doi.org/10.1111/jocn.16267

Takase M. (2022). Falls as the result of interplay between nurses, patient and the environment: Using text-mining to uncover how and why falls happen.
International journal of nursing sciences, 10
(1), 30–37.
https://doi.org/10.1016/j.ijnss.2022.12.003

Turner, K., Staggs, V. S., Potter, C., Cramer, E., Shorr, R. I., & Mion, L. C. (2022). Fall Prevention Practices and Implementation Strategies: Examining Consistency Across Hospital Units.
Journal of patient safety, 18
(1), e236–e242.
https://doi.org/10.1097/PTS.0000000000000758

White, K. M., Terhaar, M. F., & Dudley-Brown, S. (Eds.) (2025).
Translation of Evidence into Nursing and Healthcare
 (4th ed.).Springer Publishing Company.

Capstone Project Dissemination of Change Instructions

Complete the Dissemination of the Change Project template by building on your selected nursing clinical practice problem and the feedback from previous assignments throughout the course.

The PowerPoint should be 7 slides in length (following the template).

In the notes section, on each slide, add speaker notes by answering each question on the template with explanation and detail. Click in the notes section where it says [TYPE HERE] and remove the words [TYPE HERE] to add your speaker notes.

The information on the slides should highlight important information from the speaker notes to accompany a presentation. On each slide, add bullets with key information from your speaker notes. Do not change the font size; ensure your information fits on the slide. Slides should be professional, uncluttered, and readable.

Correctly cite and reference information from at least three scholarly sources that help support the assignment. Sources should be no more than five years old unless they are historical references.

Follow rules of grammar, spelling, word usage, and punctuation consistent with formal, scientific writing.

Section 1: Discovery (See Week 2 assignment)

Discuss your selected nursing clinical practice problem.

Discuss why this selected problem is important in your current or past practice area.

State your PICOT question.

Section 2: Summary (See
Week 2 assignment
)

Discuss the findings from the selected systematic review.

Discuss the findings from the selected quantitative research study.

Explain why the evidence is relevant to your selected nursing clinical practice problem.

Section 3: Translation (See Week 4 assignment)

Discuss the intervention that will be implemented to address the clinical nursing practice problem.

Discuss the setting where the change project will occur, including the organization’s current culture of change.

Discuss the interprofessional committee needed to plan the implementation of the intervention. Explain how each team member will be involved.

Section 4: Integration (See
Week 4 assignment
)

Discuss the key performance indicators that will be tracked to monitor the progress of the change project.

Explain the anticipated timeline for implementing the change project.

Discuss how you will use informatics or healthcare technologies to collect, aggregate, and analyze data.

Section 5: Evaluation

Discuss how you will ensure the privacy and security of the client’s data during the evaluation of the change project.

Explain how you will disseminate the outcomes of the change project.

Describe the next steps for the use of the change project information

Capstone Project Dissemination of Change