HS499 Unit 8 Seminar Reflection Example

Two Lifts and a Night Team Went In, One Staging Rule Came Out: A Unit 8 Capstone Seminar Reflection on Sizing a Recommendation

[Student Name]

Purdue University Global

HS499: Bachelor's Capstone in Health Science

Unit 8 Seminar Reflection

[Instructor Name]

[Date]

Brookmere Care Center, the classmates, costs and every figure are composite; the sources cited are real.

What I Proposed

I brought this recommendation to the seminar: purchase two additional full-body lifts at about 6,200 dollars each, buy a correctly sized sling for each of the 41 residents care-planned for a lift at about 95 dollars each, and create a two-person lift team on nights to perform full-body transfers across the building. The total first-year cost was about 16,300 dollars in equipment plus the cost of two night positions. I believed the plan was thorough because it addressed equipment, slings and staffing at once.

The First Challenge: Staffing

A classmate who works as a staffing coordinator at a hospital asked how many nursing assistants Brookmere has on nights. The answer is seven for the whole building. A two-person lift team would take two of the seven off the halls, leaving five to answer call lights for 118 residents, or the facility would need to hire two more night staff, which my capstone has no authority or budget to propose. She pointed out that night shifts in small facilities are exactly where lift teams struggle, because there is no spare capacity to form a team. My own synthesis had noted the same thing: the studies of lift teams were set almost entirely in hospitals with deeper staffing, not in homes where two assistants cover a hall.

The objection held. My own needs assessment had recorded night staffing as a constraint the capstone could not change, and then my recommendation ignored it.

The Second Challenge: Equipment

The instructor asked a simpler question: what did the needs assessment find was the largest gap? The answer was access. Brookmere already owns three full-body lifts, but they are locked in an equipment room after 9 p.m. and take six minutes to fetch. Buying two more lifts and locking them in the same room would change nothing. The evidence I had synthesized says equipment helps only when it is used (Lee et al., 2013), and my plan spent most of its money on equipment that would face the same barrier.

I had answered the needs assessment's second-largest gap with my largest expense and left its largest gap, a locked door, almost untouched.

Why I Had Proposed Too Much

Looking back, I think I proposed too much because the evidence I had read was about programs, and programs sound large. Pooled studies show that safe handling programs reduce worker injuries (Teeple et al., 2017), and I took that as permission to build a full program at once. What I missed is that the programs that worked were fitted to their settings, and Brookmere's setting is seven people on nights with lifts they cannot reach. A program fitted to that setting starts with the locked door.

The Revised Recommendation

The recommendation now has two parts. First, a staging rule: from 3:00 p.m., one full-body lift is parked on each long-stay hall rather than in the locked room, with the equipment room locked only for spare equipment. With three lifts and four halls, the fourth hall shares with its neighbor, and the timed walk shows that sharing adds under a minute. Second, a correctly sized sling for each of the 41 residents, stored in the resident's room, at about 3,900 dollars. Laundry would wash slings on a set schedule with a spare for each size on each hall. A written rule that lift residents are transferred mechanically, and one trained lift resource person on each evening and night shift drawn from existing staff, complete the plan.

First-year cost falls from over 16,000 dollars plus two positions to roughly 4,300 dollars, mostly slings and a small laundry charge.

What the Smaller Version Does Better

It addresses the largest gap directly by putting lifts and slings where night staff are. It works within the staffing constraint instead of against it. And it follows the pattern in the program studies, which combined equipment within reach, a policy and trained staff (Collins et al., 2004), rather than relying on purchases.

What I Am Less Sure About

I do not know whether parked lifts will be damaged or block hallways, which is why the equipment room was locked in the first place. A pilot on one hall would answer that before the rule spreads. I also wonder whether the trained resource person on nights can realistically help other halls when she has her own residents. The pilot should measure that as well, and the plan should name what happens if it does not work.

References

Collins, J. W., Wolf, L., Bell, J., & Evanoff, B. (2004). An evaluation of a "best practices" musculoskeletal injury prevention program in nursing homes. Injury Prevention, 10(4), 206-211. https://doi.org/10.1136/ip.2004.005595

Lee, S.-J., Faucett, J., Gillen, M., & Krause, N. (2013). Musculoskeletal pain among critical-care nurses by availability and use of patient lifting equipment: An analysis of cross-sectional survey data. International Journal of Nursing Studies, 50(12), 1648-1657. https://doi.org/10.1016/j.ijnurstu.2013.03.010

Teeple, E., Collins, J. E., Shrestha, S., Dennerlein, J. T., Losina, E., & Katz, J. N. (2017). Outcomes of safe patient handling and mobilization programs: A meta-analysis. Work, 58(2), 173-184. https://doi.org/10.3233/WOR-172608