Depersonalization refers to treat other as objects rather than people through uncaring attitudes and behaviors. Diminished personal accomplishment is to evaluate oneself negatively because of failure a result it occurs when the individual’s external demands become higher than their coping ability. (Maslach, Schaufeli, leiter., 2001) . Many studies revealed that there is a high prevalence of burnout among nurses worldwide, it can affect approximately 45% of medical and nursing staff . (Abdo, El-Sallamy, El-Sherbiny, & Kabbash., 2015) .
A 95-year-old woman while being transferred from her bed to a chair is dropped on her head with a laceration to her scalp and internal bleeding to the right side of her head due to a mechanical device failing. Consequently due to the mechanical failure, the sling that lifted her from her bed to the chair snapped sending her crashing to the floor. She died three months later because of these injuries. The National Ombudsmen Reporting System (NORS) uses a reporting tool to measure abuse and neglect in nursing home facilities. “The Old Americans Act in section 712 requires state long-term care ombudsmen to identify, investigate, and resolve complaints made by or on behalf of residents, and to ensure that residents have regular and timely access to ombudsman services”(Bloeman, Rosen, Clark, Nash, Mielenz, 2015,p.3).
According to the Agency for Healthcare Research and Quality, between 700,000 and 1,000,000 people in the United States fall in a hospital each year. According to our reports, 20 of these falls occurred in our hospital last year. Research has identified risk factors for falling in a hospital, such as impaired balance, history of falling, vertigo, orthostatic hypotension, altered mobility, visual impairment, the use of certain medications, etc. Patients who fall are more likely to feel hopeless, become less confident, become depressed and more isolated socially, experience a loss of physical functioning, a loss of quality of life, etc. This is an issue that must be resolved as soon as possible because the safety and well-being of the patients in this hospital should be a top priority.
For example, how the registered nurses do the scoring for high risk patient and how do they fill up the fall assessment form. The nurses should conduct fall risk assessment during the admission and post procedure. The patients who are the high risk, a red identification will be place on the patient’s limbs. A red sticker also is placed at the nursing notes and at patient room door. If the patient is not a high risk patient, the fall assessment is done weekly or upon change in patient condition.
However, there are more people that suffer from congestive heart failure. According to Niloufar Binaei , Mahin Moeini , Masoumeh Sadeghi , Mostafa Najafi , Zahra Mohagheghian, who work at School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran “Almost 5 million people in America suffer from chronic heart failure. In Iran, there are over 1 million patients with heart failure” If 1 million people in the United States of America have heart failure then that must mean that 20% of Americans have this
Nurses often face ethical dilemmas and moral distress throughout various levels of direct and indirect patient care. According to Moon and Kim (2015), patients often die in the intensive care unit, and ethical conflicts frequently occur due to a variety of factors, such as verbal abuse, poor communication between health care providers, and increased incidences of end-of-life issues. I think this is a very important subject to think about, especially when these conflicts can significantly impact job satisfaction, burnout, and ultimately threaten the quality of care for patients. Furthermore, a qualitative study conducted by Henrich et al. (2017) shows that healthcare providers often experience negative emotional repercussions from moral distress in the ICU, and patient care is frequently perceived as being negatively affected.
Another example is domestic violence leading to death when Mrs. Steiner quotes “Over 500 women and girls this age are killed every year by abusive parents, boyfriends, and husbands in the Unites States” (Steiner). The atmosphere seems to change in the room after she says this. The thought of young women and especially girls cause of death is because of an abusive parent or
“Fall risk assessment and post fall assessment are two very different and distinct approaches for falls prevention” ( Boltz, 2012). Knowing why the fall has occurred is crucial information to know. If you can do a post fall assessment and learn the underlying cause the nurse can create a care plan individualized and appropriate for each client. “The PFA is a comprehensive, yet fall-focused history and physical examination of the present problem (falling), coupled with a functional assessment, review of past medical problems, and medications. Clinical fall prevention guidelines are very clear about all of the necessary components for inclusion for patients who have fallen, which include fall history; fall circumstance; medical problems; medication review; Mobility assessment; vision assessment; neurological examination, including mental status; and cardiovascular assessment” (Boltz,
Even though some types of nursing home neglect are noticeable, numerous cases of nursing home neglect go unreported and ignored. Reporting nursing home neglect can make a difference between life and death for the patient being mistreated. Malnourishment, thirst, and ulcers are noteworthy worries for a nursing home patient. These physical forms of nursing home neglect may be more definitely identifiable for the patient’s family when they come to visit their loved ones. Wounds from nursing home drops, or choking in a nursing home bed, are likewise both instances of physical nursing home neglect (Gil,
Working on the burn and wound unit which is a step-down from the burn ICU, the patient population varies in age with the youngest aged 17 to a patient that was 106. People get burned through many mechanisms such as fire, hot liquid, or electricity and falls are a small reason why the patients get burned. Falls play a small role as to why our patients get burned. Our focus however, is fall prevention once they reach us. Patients who get burned are considered fall risks for multiple reasons; from the opioids they will receive while staying with us, to mobility issues due to their injuries.
As working as a Certified Nursing Assistant in a long term care rehabilitation facility, I encounter many elderly patients who are admitted for fall related injuries. The majority of patients are recovering from total knee and hip replacements as a result from falling at home or elsewhere. Fuller states, “Falls are the leading cause of injury related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years…More than 90 percent of hip fractures occur as a result of falls, with most of these fractures occurring in persons of over 70 years of age” (Fuller, 2000, para.1). There are many factors that can contribute to the reason why individuals, particularly the elderly,
Every department should be involved in developing strategies for fall prevention and in monitoring residents who are in danger of falling. Front-line staff members are a facility 's best resource in developing practical interventions that are tailored to the unique needs of each individual resident. Interventions for Activity Professionals As a member of the interdisciplinary team, activity professionals play an integral part in the facility 's fall prevention program. During the care planning process, activities should be part of the approaches for residents who are identified as "at risk for falls." It is important to share information about the identified residents with the rest of the activity staff so that each member of the team can do their part for the fall prevention
Fall rates should be assessed prior to implementation, post 1 month and post 6 months of implementation. In addition, a survey provided to nursing staff can assist in the evaluation of increased resources and collaboration with physical therapy increasing their ability to assist with ambulation and exercise. This survey may include questions relating if nurses feel they have increased time to assist patients in education and exercises to decrease fall risk. Conclusion Through evaluation of currently UTMB policy and recent policy guidelines, no new additions to the policy were identified. Rather, recommendations to increase compliance and ease staff load were identified.