Decision analysis using PDSA and Knowles
Agitation of resident in the long term care settings is a critical problem. Ranging from a resident exhibiting episodes of agitation almost daily. Following a micro assessment of the facility, 70% of the residents were found to have dementia and some kind of agitated behavior at one time or another. This makes the daily routines of nurses in the long term care setting more difficult compared to other settings. Based on the assessment, the majority of the residents have Alzheimer with agitation, and yet t much is done to educate the staff. Staff education is being done to satisfy the Department of public Health in required subject such as resident rights but not much, specific to nursing. In-services consist of a few questions given to the staff by the administrative assistant. Therefore my plan is an education and quality improvement project. The outcome is to decrease agitation, prevent falls and injuries due to agitation. Improve caregivers communication and approaches while caring for the agitated resident. Prevent harm to resident and staff by providing evidence based education to staff and family. and reduce risk of complication.
Knowles adult learning theory is being used to developed an evidence based practice education intervention. It is specified that in the process of learning an adult needs to be evaluated and judged by the educator in order to convey what is actually being taught (Knowles, 1978). When references to nursing Knowles theory of adult learning, it was verified that the leaning procedure somewhere lies between pedagogy and andragogy,howerever, the basic idea was found to be the dependence of the learner on the instructor, and the distinction of the educator which is necessary for any learning process Knowles,1978; Merriam,2002). Directed towards the 5th grade level, it can be elucidated that a challenge needs to be provided for evaluation of their self assessment and improvement abilities.
This can be done by the implementation of the PDSA (Plan, Do Study, Act) cycle in accordance to Knowles adult learning theory.
When an individual faces a situation in which various types of options and conditions are put forth for selection, such a process is mostly labeled as decision making or analysis. The process of coming to a decision regarding a subject may either be commenced through logical verification or commonsensical conjectures; where an individual takes risks being unaware of what the result or consequences might be. But in nursing, decision analysis is an essential component that needs to be focused on and verified. This process evaluates and affects the ability to prioritize intercessions as they are provided and to assess the varying probabilities of the situation. Decision analysis is such a vital process, that include gaining the philosophy, evaluating the theory, working on the methodology, and then implementing it into professional practice (Shamian, 2007).
The method of Plan, Do, Study and Act (PDSA) is considered to be an effective cycle in decision analysis. as it creates space for unremitting improvement and is effective for the nurses who are beginning a new clinical formulation(ASQ , 2004). The PDSA cycle develops and improves the design of the process of decision making as it advances an effective product or service of judgment. It was gained that the PDSA model holds up ground-breaking performance development as it helps nurses expound the work processes. This decision analysis used in study for the purpose of amalgamating various procedures of research and implementation for the betterment of the patient care system. This was revaluated to have resulted in the ability of nurses in gaining insights into their own care system which helped them implement any changes to make it better(Moule, Evans, and Pollard, 2012; Basso,2011).
1. As a CNL develop an Evidence Based Practice in-service to educate staff about strategies to prevent/manage agitation
2. Focus on improving staff awareness on quality and safety by posting
3. Involve all possible staff members in implementing the strategies
4. Identify and overcome barriers by exposing plan to the Administrator and the DON and presenting evidence of success to them
5. Develop an educational plan at 5th grade level of in-services and plays
6. Distribute pre-questionnaires to staff
7. Write a small skit for role playing