Patient Falls 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.

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

SAVAHCS “Fall Prevention Program” utilizes the interventions discussed in the literature review and includes a post fall assessment (PFA). Post fall huddles (PFHs) are discussed within the Fall Prevention Program, however, they are not consistently used. The PFA currently captures information discussed in the literature including intrinsic and extrinsic factors and includes the physical attributes of the patient, and extrinsic environmental factors. In a cyclic process, patients are assessed for fall risk. If a patient is found at risk, he/she is placed on the hospital’s

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.

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.

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).

Capstone Project: Falls Prevention and Risk Assessment of the Elderly Population while in Long Term Care facility Evidence Based Practice – NUR 4775L Dr. Susan Poole, DNP, CNE November 22, 2015 Capstone Part I: Falls Prevention and Risk Assessment of the Elderly Population while in Long Term Care facility Introduction to Problem According to Centre for disease Control (CDC) more than 1.4 million people 65 and older live in nursing homes. If current rates continue, by 2030 this number will rise to about 3 million (CDC, 2014). Nursing home residents are at an increases risk for falls depending on the acuity of their illness and their mental state.

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

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

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

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.

Consider physiological and environmental risk factors for falls. Patients at greatest risk for OH are the elder population 65 and older. “Orthostatic hypotension (OH) is associated with significant morbidity and mortality among older people. (Lampela, Lavikainen, Huupponen, Leskinen & Hartikainen, 2013)” Several risk factors must be taken into consideration when assessing fall risk.

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).

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.