Creating a Culture of Transformational Leadership to Decrease Inpatient Falls

dc.contributor.advisorWelch, Teresa
dc.contributor.advisorWadsworth, Barbara
dc.contributor.authorCusick, Frances
dc.contributor.otherUniversity of Alabama Tuscaloosa
dc.description.abstractIntroduction/ Purpose: Optimization of patient outcomes, with the absence of adverse events, is the epitome of quality healthcare and the focus of healthcare institutions. Falls have consistently been associated with the quality of nursing care in the acute care, inpatient setting. As one of the largest segments in healthcare, nursing, and in particular nurse managers, have a significant role in advancing organizational quality initiatives, therefore their leadership behaviors need to foster change and create a supportive work environment. The 370-bed community medical center, which consistently strives to achieve quality patient care with zero adverse events resulting in patient harm, has faced challenges particularly as it relates to inpatient falls. Despite the implementation of evidence-based prevention protocols the incidence of falls continued to exceed national and organizational benchmarks therefore an imperative existed to explore initiatives to drive quality patient care. Methods: An evidence-based nurse manager leadership development program was implemented, which included a nurse manager’s self-assessment of leadership behaviors along with a transformational leadership education course. Pre- and post-implementation aggregate data of fall rate per 1,000 patient days were utilized for measurement. Results: This quality improvement project resulted in an overall decrease of 44% in inpatient fall rates, within three months, as measured by inpatient fall rates per 1,000 patient days, on participating inpatient telemetry units. Results indicate that the overall fall rate for the three units with t = 2.623 and p = 0.015 demonstrated a statistically significant improvement in fall rates pre and post-project implementation. The Pearson correlation co-efficient (r = 0.45) also indicated a significant and positive relationship between pre & post-project implementation aggregate data. Discussion: Project outcomes indicated similar findings to the literature, that the adoption of transformational leadership behaviors and practices in acute care settings improves overall patient safety outcomes including inpatient falls. Each of the inpatient telemetry units, whose nurse managers participated in the project, exhibited a significant decrease in fall rates over the three months following program implementation, which suggests a correlation between the evidence-based leadership development program, transformational nurse managers, and an improvement in fall rates. Conclusion: Implementation of an evidence-based comprehensive leadership development program in this 370-bed community medical center, which utilized the transformational leadership theory as a framework, significantly decreased inpatient fall rates. Instituting this program throughout the organization with stakeholder engagement, as a component of both onboarding and continuing education, has the potential to improve quality patient care with a decrease in inpatient fall rates.en_US
dc.subjectInpatient falls
dc.subjectNursing leadership
dc.subjectQuality of care
dc.subjectTransformational leadership
dc.subjectPatient outcome
dc.titleCreating a Culture of Transformational Leadership to Decrease Inpatient Fallsen_US
dc.typeCapstone project
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