Patient Rounding

The elderly in nursing home are at an increased risk for falls, more than any other area. An average of 5% of all persons over the age of 65 reside in nursing homes. On average, over 1,800 people over the age 65 fall while in nursing homes every year and 20% of all fall related deaths occur from falls while living in nursing homes (Centers of Disease Control & Prevention, 2012).

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. The guidelines were developed by reviewing published meta- analysis and systematic reviews making it the strongest evidence however, the method used to formulate the recommendations was that of a level I to an expert consensus which is a level IV. The guidelines were validated by an external peer review. All recommendations for this guideline was tagged by the level of evidence and linked with scientific evidence. The limitation that were evident in this study was that its intended users were immediate healthcare providers in the hospital settings and not those in the out- patient healthcare

Teamwork builds up the ability of nurses and other healthcare providers to implement higher quality and a more holistic care. In this essay, firstly, I am going to discuss about teamwork in nursing. Secondly, I am going to talk about the importance of teamwork within nurses and other healthcare providers. Thirdly, I am going to discuss about the benefits of having teamwork and proper delegation needed among nurses. And lastly, using Singapore nursing board, code of ethics and professional conduct that direct to this clinical situation. I will also discuss on how this clinical situation could be done differently.

Additionally while in the patients room all paths should be clear of clutter and objects to increase safety as well. On each hourly round the nurse or nurses assistant will inform the patient of when the next hourly rounding will occur. Hourly rounding also gives patients the peace of mind that someone (nurse or nurses’ assistant) is coming back at a designated time to check on them. Hourly rounding also provides patients and opportunity to ask the nurse questions. Hourly rounding needs to be done on a schedule, every hour between 6 am and 10 pm then every 2 hours from 11pm to 5 am by either the nurse or the nurses assistant. Nurses will be assigned the even hours and nurses aids will be assigned the odd hours. The pilot trial for hourly rounding will continue for six months. On the first Monday of each month the interprofessional team will meet to discuss the results of hourly rounding as well as staff and patient feedback. With the collection of data over the next 6 months the team will evaluate if there is a decrease in patient injury and falls as well as in increase in patient

There were several factors which may have contributed to this scenario. The patient’s comorbidities which include the ischaemic stroke which happened 2 years ago might have caused his fall. A Grade A recommendation and Level 1+ evidence were given by the National Stroke Foundation (2010) that patients are advised to undergo intensive rehabilitation for the first six months post-stroke. Given the fact that he had only received four months of inpatient rehabilitation, his functional status might not have been maximised. In addition, a Grade A recommendation and Level 1+ evidence were given for multi-disciplinary intervention in inpatient rehabilitation (MOH, 2008). However, the inpatient rehabilitation approach in the patient’s holistic management is

The name of the responsibility is negligence due to falls of patients in intensive care unit. The liability may occur due to the medical staff that forget to put the brakes on the beds, put in a low position, the call light within reach and personnel items easily reach to every patient. These falls can bring a lot of injuries to patients and fractures (loss of continuity of bone tissue. It ranges from a small crack to total bone fracture displacement of the two ends of the bone fracture), trauma to the skull and face (injuries to the skull and face are especially important, since the intensity of the shock can affect the central nervous system (CNS), located within the cranial cavity), trauma to the extremities (as a result

This is reviewed with any change in patient status, a fall, and/or quarterly. Patients, depending on screening, might receive services from physical therapy (PT), occupational therapy (OT), nutritional services, bed/chair alarms, floor mats, medication adjustment, and change in room to closer to the nurses’ station, or other services. All at risk patients are easily identifiable by notation on wrist band, footwear, room and equipment signage, in the electronic medical record, and on any paper records. The fall rate of patients at SAVAHCS continues to be at or slightly below the benchmark, but our goal is to have zero falls. The intervention not fully utilized at this hospital, that does show promise in the literature, is the post-fall huddle. For this reason, it was proposed that this intervention be implemented, along with a fall algorithm to reduce the rate of recurrent falls,

During the extended hospital stay, the cost of treatment also increases, sometimes by about 61 percent of the normal charges for treatment (Guse et al., 2015). Evidence based practice has shown evidence that hourly rounding can decrease the general hospital stay significant while at the same time cutting down the cost of treatment through reduction of falls. Nurses against this change complain of increased commitment on other duties, making it difficult for them to attend to their patients within the hour (Marquis & Huston, 2015). It should, however, be understood that hourly rounding may never be successful without teamwork. The absence of one nurse during the hourly rounding should be substituted by another nurse without regular complaints about personal patients. The effectiveness of hourly rounding has been clearly outlined by various evidence based materials and nursing literature, guaranteeing its adoptability (Fagan, 2012). All the same, it is most for the healthcare organization to found out ways of making hourly rounding a policy, in order to help nurses internalize the strategy as part of normal caring

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.

Significance of the Problem for Nursing: Prevention of falls in the elderly is an extremely important facet of nursing. Elderly falls often result in fractures, pain, decreased mobility, traumatic hemorrhages, as well as increased healthcare costs. Due to the increased prevalence of injuries acquired from elderly falls, increased risk of morbidity in the elderly experiencing falls, and the growing number of elderly patients, it is of vast importance that nurses research and incorporate evidence-based fall prevention practices to prevent falls in the elderly

Patient fall rates – The number of falls per 1,000 patient days (Tucker, Bieber, Attlesey-Pries, Olson, & Dierkhising, 2012).

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.

Time is of the essence in the ED. Nurses must work together in an ethical way to collaborate with their patients and make it quick. Mc Carthy et al. reported that to determine the effect of crowding on emergency waiting room, they did a cohort study including emergency visit and inpatient medicine occupancy for a 1 year period at 4 EDs. The result shows that during the day shift, when the number boarding increased from the 50th to the 90th percentile, the adjusted median waiting room time increased by 6% to 78%, and the adjusted median boarding time increased by 15% to 47% depending on the site. Using discrete time analysis and evaluation at Kennedy medical Center will dynamically demonstrate its deleterious effect on the waiting time and the number of staff needed.

An effective ward round should enable all individuals involved in the health care delivery process to express a shared aspiration to make the patient the centre of attention empowered in his or her own care. This will help the patient to co operate and develop confidence in health care delivery system. Ward round should ensure the delivery of good quality, safe, efficient, compassionate patient care. A successful ward round should enhance the patient’s confidence with health care delivery system. Ward round is the key for proper inpatient management, to facilitate speedy discharge, avoid any harm to the patient during health care delivery and to improve team communication among the health care delivery staff4.

Ageism is discrimination or prejudice based solely on a person’s age, an extreme issue in many elderly clients that reside in sheltered housing communities, as well as quality of life. Bodner, Cohen- Friedel, and Yaretzky conducted a study involving awareness and beliefs about ageism and quality of life in sheltered housing versus those feelings in seniors who live outside such an environment. It was anticipated that that seniors within sheltered housing would have elevated agist attitudes. To test this hypothesis, they took a sample of one hundred twenty six volunteers between the ages of sixty four and ninety four. The contributors completed a survey called the Fraboni scale of ageism, and a Quality of Life (QoL) Inventory. Bodner, Cohen-