Scenario In the spring of the year,

Scenario In the spring of the year, a sentinel event at a brand-new rehabilitation facility occurred. The event was brought to the Department of Health after the patientdied after a fall in which the client suffered a femur fracture after hip replacement surgery and sepsis. Fall incidence reports in the media were prominent in nursing homes at this time. In an effort to stay out of the media, administration at the nursing home implemented every 15-minute rounding during the night shift as evidence of reports of falls occurred between midnight and 0500. One nursing assistant was scheduled for the night shift; the nurse was informed that they needed to assist in the rounding schedule. The night shift nurses shared their frustration as this took away from other important work obligations required of them on the shift. Nurses were not provided the process in which to round, what documentation was needed from them, or the purpose of the new policy. After a week, the night shift nurses stopped rounding and had the nursing assistants’ document all rounding as they were being stretched to get all of the required care and obligations completed without having to stay longer than shift end, as overtime needed prior approval. At the monthly staff meeting, the policy was reiterated with nursing. Administration also stated that those that did not follow the policy would face disciplinary action related to not documenting required rounding. This stress and pressure on night nurses at the meeting was evident. They shared that they were not consulted, were provided no direction on process and outcomes, and that this policy was not evidence-based. Administration listened to the concerns, but felt they were not asking too much for patient wellbeing and safety and that disciplinary action would solve the issue with the nursing staff. The nurses left the meeting discouraged, resentful, and some were considering leaving employment. 1. What are the primary underlying concerns of administration, the nurses and patients in this scenario? 2. After the staff meeting, what are the challenges that administration now face? What are the challenges nursing now faces? .3. What actions could the administration take to make a more supportive environment for utilizing EBP? How would these actions help shift the culture from blame to civility, respect, and safety? 4. Discuss how time constraints, nurses themselves, lack of communication and lack of incentives can be barriers to implementing EBP. Suggest viable ways the rehab facility could address these challenges.

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