Inpatient Rehabilitation Case Study

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.

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.

has intermittent pain and weakness in her right knee, she is at risk of falling. To address this concern, an appropriate nursing diagnosis is the risk of falls related to altered mobility from pain and weakness. Subjective data related to the risk of falling are the self-report of seasonal dizziness and intermittent increases in pain and weakness. The objective data that support this diagnosis are her age, unsteady gait and difficulty rising from the chair and low toilet.

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

Risk factors associated with fall related minor injury are young age, male gender and cognitive impairment whereas with fall related major injury the risk factors include functional autonomy, and length of stay in hospitals. In further statistical analysis, controlling for functional autonomy, disruptive behaviours and neuroleptic use were found associated with fall related major injury. To add on falls also have significant psychosocial consequences as those who have been victims of falls often develop a post fall syndrome which is fear of falling. The elderly than further reduce their activities as to prevent further falls thus precipitating a cycle of increased dependency, loss of function, loss of confidence, social isolation and depression which leads to decreased quality of

This act created a major revision of standards of care for nursing homes. This legislation also changed the expectations and the quality of care that patients should receive in long term care facilities. This Nursing Home Reform Act passed by congress specifically stated “that each residents have the right to be free from any physical or chemical restraints imposed for purposes of discipline or convenience and not required to treat the resident’s medical symptoms”. While there may be some benefits to using restraints in nursing homes, however, studies have shown that using restraints in nursing homes negatively impacts patients and for the most part does not prevent them from falling or from other incidents that may occur. There are very high levels of risks associated with the use of restraints (Lapane,150).

Optimum care and patient safety is a nurse’s main goal, and therefore, affects each and every nurse. With falls being such a critical part of a patient’s hospital stay as well as the nursing profession, nurses must perform adequate assessment and implementation

Prevent falls at facilities • Identify residents at high risk for falling, including those having poor vision, gait disturbances, weakness, cardiovascular disease, incontinence, and a history of falls. • Include specific measures in the care plan of high-risk residents to prevent falls. • Increase the sensitivity of the entire staff to the potential for accidents within and around the facility through ongoing education programs. Each employee must play a part in noticing, reporting, and reducing potential hazards. • Assess newly admitted residents for the presence of factors that increase their risk of falls, orient them to their environment, and observe them carefully during their first two weeks at the facility.

A fall is defined as moving downward, in a rapid and freely without control from a higher position to a lower position. There are many contributing factors that increase the risk of falls including age, medications, disease and changes in environmental needs. This paper contains an overall assessment of fall prevention including current protocols in place to decrease the incident of falls and barriers to overcome. Included will be evidence based research that on the current standards in place for fall prevention and where there are improvements to be made. The incident of falls has an overall impact on the cost of healthcare and with fall prevention measures the decrease can be

Evidence-based practice refers to problem-solving and making the best decision to solve problems with evidence produce in healthcare settings. Numerous researched study on evidence-based practice shows that, it is very useful for healthcare providers to identify the needs in patients and providing the relevant interventions which helps to improve the care process towards patients during hospitalization. My team members and myself decided to focus in the topic in the most effective exercise programs which can reduce falls among the older adults in hospitals.

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

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.

Outpatient rehabilitation refers to services a person receives when they are not admitted to the hospital and have the ability and functionality to return home with or without assistance. These inpatient and outpatient clinic can range from nursing homes, pediatric clinics and Rehabilitation tackles the privations of people with injuries, illnesses, or insufficiencies in their occupational functioning as a result of existential causes and is also a primary staple in occupational therapy. The overall goal of rehabilitation is to restore the health and functional abilities of people after an injury or acute illness (AOTA n.d.). Moreover, it is not enough to just know what rehabilitation and disability means in occupational therapy, it also helps to include those who receive services, other services that are provided, and the roles of those who facilitate and help assist the Occupational Therapist and

The thought and actions of taking care of a stroke victim may seem easy, but contrary to belief, most caretakers are not aware of the enormous and strenuous road that lies ahead of them. One of the main issues amongst stroke victim caretakers is that they aren’t aware of the important risk factors or preventable measures of a stroke. In most cases involving strokes, caretakers are left with an onerous responsibility of providing care for a stroke victim. Particularly, stroke rehabilitation is a critical step immediately following survival of a stroke. It is important that caretakers and stroke victims understand and receive education regarding his or her condition and know the continuing limitations that occur after stroke rehabilitation.

In the case of Mr. J. the low level of care is evident, why the facility policies were not followed?. Evidently the nursing staff require more education about the facility policies and procedures. Nurses should have applied the nursing-quality of care indicators for falls risk, Branden pressure risk assessment, restraints protocols and procedures, turn and reposition of patients, and cultural competencies. There is a clear evidence of neglect in patient's care, and believes by the nursing staff and the supervisor. The facility policies and standards of care must be re-valuated,