Fall Prevention

Article I. The article published by Ivziku, Matarese, Pedone (2011) was a literature review to evaluate the predictive validity and inter-rater reliability of Hendrich fall risk model II (HFRM II).The literature focused on ways to identify older patients at risk of falling in geriatric units with the implementation of the HFRM II and recommend its use in clinical practice. A prospective descriptive design was used. The study was carried out in a geriatric acute care unit of an Italian University hospital. The patoients that were admitted to the geriatric unit were 65 in an Italian University hospital over 8-month period were enrolled. The patients enrolled were screened for the falls risk by nurses with the HFRM II within 24h of admission.

Present the Evidence: Prevention of Patient Falls According to the Centers for Disease Control (CDC), each year, one third of those who are 65 and older fall (2013). These falls contributed to $34 billion in direct medical costs in 2013 (cite). With these statistics, it is apparent that health care professionals and health care settings need to make fall prevention a priority in their facilities. The aim of this paper is to explore a fall prevention policy and practice guidelines to evaluate recent evidence and offer recommendations.

Evidence Based Practice Proposal- Section D: Solution Description The Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) to have higher sensitivity in assessing fall risk in the geri-psychiatric population (Edmonson et. al, 2011). This project of EPFRAT will let the progress of a fall risk prevention protocol to provide the safest environment and best quality of care possible for the geriatric psychiatric inpatient.

The unit had a drastic increase in patient falls during the 1st and 2nd quarter of 2015. The staff nurses and patient care technicians did not get a sufficient education reinforcement regarding fall prevention. Consequently, this has created a knowledge gap among nurses and PCT regarding fall prevention. The knowledge gap in fall prevention has led to an increase of staff non-compliance with the policy and trending increase of fall rates in the unit. The plan to mitigate this problem was developed through the collaboration with the nursing leadership on the provision of staff education on fall prevention. Stakeholders involved were the unit manager, fall prevention resource nurse, and clinical nurse educator who were interested in coordinating

The staff nurses and patient care technicians (PCT) in 6 East were not getting the sufficient education reinforcement regarding fall prevention. Consequently, this has created a knowledge gap among staff members regarding fall prevention strategies. The knowledge gap in fall prevention has led to an increase of staff non-compliance with the policy and the trending increase of fall rates in the unit during the 1st and 2nd quarter of 2015. The plan to mitigate this problem was developed through the collaboration with the nursing leadership on the provision of staff education on fall prevention. The stakeholders involved were the unit manager, fall prevention resource nurse, and clinical nurse educator who were interested in coordinating the quality

Problem Identification Getting out of bed is one of the dangerous things that the elderly patients do when they are admitted in the hospital. Study conducted by Ambrose, Paul & Hausdorff, (2013) on patient falls reveals that a majority of falls in the elderly patients occur between 0700 and 1900, especially when they are getting out of bed to use the rest room. The cause of their falls is mainly due to unsteady gait, memory loss, confusion that comes with age. Memory loss and vision problems which occurs during old age in the elderly patients puts them at risk for falls. Other factors that can lead to falls are; Presence of throw rugs, psychotropic medications, lack of Vitamin D, and weakness of the lower extremities.

This program, called the Nijmegen Falls Prevention Program, included one hundred thirteen elderly clients with a history of falls. Exercise sessions were held twice a week for five weeks with fall monitoring done before and after the experiment. Control assessments were also done continuously thru the study to determine client changes in standing balance, balance confidence, and obstacle avoidance skills. The results of the Nijmegen Falls Prevention Program showed that the number of falls within the exercise group dropped by a significant forty six percent! Not only less falls, but obstacle avoidance skills dramatically improved as did balance

Environmental factors likewise play a role in fall risk. Unfamiliar surroundings can cause confusion with patients and other safety hazards such as cluttered areas and poorly lite

I will also discuss on how this clinical situation could be done differently. Clinical scenario I was posted to a medical ward in National University Hospital for my clinical posting. There is a particular cubicle allocated for patients with very high risk of fall called the “Green eye cubicle “. Patients in that cubicle are usually confused or not compliant to fall precaution.

It also provided the use of critical thinking and clinical judgment on how to prevent falls, support, and be accountable for a client professionally. The practical knowledge I have learned helped me become aware of assessing and assisting a client. As a nurse, our job is to provide “safe, compassionate, competent and ethical care” (p.8) and collaborate as an interprofessional team to deliver safe care and prevent risks from happening while offering quality nursing care (CNA, 2017). I will always provide the professional care under the code of ethics to promote health and wellness for an older adult and prevent risks from happening. As well as following the plan of care, use communication strategies, be aware, acknowledge, and accommodate individuals with different diseases such as with dementia, to promote fall prevention strategies (RNAO, 2017).

The clinical practice guidelines that were selected for this paper are from the National Guideline Clearinghouse and from International journal of nursing studies. The Hendrich Fall Risk Model was primarily developed as a predictive nursing assessment tool based on epidemiological research (NGC, 2011). The Guidelines were developed by the Hartford Institute for Geriatric Nursing the committee was however not stated. Authors were asked to sign confidentiality documents and all the authors agreed this. The research was conducted by hand searches of public literature and searches of electronic database.

Further interventions include home modifications which can also result in positive behaviour outcomes. The intervention had shown to be statistically significantly better in the intervention group (36%) had than the control group (45%) with a decreasing percentage of subjects who had fallen. Together with the prescribed home exercise programme and home modification for safety, these interventions can decrease the rate and risk of future falls (Gillespie et al.,

Falls of critically ill patients admitted to the ICU routine should be avoided developing certain strategies used outside this area, such as prevention of displacement, promote stability, elimination of sliding hazards routinely ensure that the patient is oriented to the environment and the bell is at the fingertips, keeping the beds in the lowest position and braking, providing adequate lighting, and provide anti-slip footwear and technical assistance in lifting patients bed. The response time of the call prolonged ringing patient or family is just one of the potential causes of falls, firstly because if the response time is greater serve their needs later, and partly because no response to the patient may start feeling agitated. Shift schedules nurses can be particularly effective in preventing falls, as they allow the staff to anticipate and address the needs of each patient. The tubing, drains and cables must be securely to prevent tripping when lifting or embody patients. Although falls can happen without warning, subsequent falls can be avoided if the etiology of them is

Statistics indicate that one out of three senors will need an extensive amont of time to recover as a result of a accdnet that occured when they fell, such as a fractured bone. In fact, the Centers for Disease Control and Prevention proclaims that falls ae the number cause on injuries in senriors, and is the number one reason why senior citizens end up in a recovery program. In this posting we'll take a look at several things you can do to minzine the possibility of falling while you're at home. 1) Do Not Wear Loose Clothing Many fall victims sustained an injury as a reusltof the fact that they tripped over loosing cloothing such as an extra long pants.

For example, in the elderly population are at an increased risk of falling from a variety of reasons.