Wait a second!
More handpicked essays just for you.
More handpicked essays just for you.
Importance of quality improvement in nursing
Importance of quality improvement in nursing
Essay on fall protection
Don’t take our word for it - see why 10 million students trust us with their essay needs.
Recommended: Importance of quality improvement in nursing
Each year, between 700,000 and 1,000,000 people in the United States will fall in the hospital according to the Agency for Healthcare Research and Quality (AHRQ, 2013). Out of these falls, 30-35% of these patients will sustain an injury. Each of these injuries, on average, adds 6.3 days to the hospital stay and cost about $14,056 per fall. (Joint Commission, 2016). Injuries may include lacerations, fractures, internal bleeding, or even cause death. Research has shown that close to one-third of falls can be prevented (Ganz et al., 2013). A fall is defined as an unplanned descent to the floor or other lower surface with or without injury to the patient. In 2002, AHRQ listed falls as a “never event,” meaning that the event is a preventable, rare occurrence that could cause serious injury or death. In 2008, the Centers for Medicare and Medicaid Services (CMS) eliminated all reimbursement for any “never event,” sending a clear message to hospitals the importance of implementing fall prevention tools and programs in the acute care setting (McNair, Luft, & Blindman, 2009). The responsibility of ensuring that prevention tools are implemented and patients are kept free from falls, weighs heavily on nursing and the bedside care team.
Purpose
Despite the efforts of implementing fall prevention tools over the years, patients continue to fall. Joint Commission 2017 Summary Data of Sentinel Events
…show more content…
The theory provides a structure for nurses to determine a patients pre-existing self-care baseline, identify the patient’s deficit from their baseline, develop nursing goals to bridge the gap of the deficit, and identify types of nursing interventions to assist the patient back to their self-care baseline. The theory is broken down into three separate theories, self-care, self-care deficit, and theory of nursing systems, that together form the
Falls in nursing homes residents are associated with morbidity, mortality, and healthcare costs. The centers for Medicare and Medicaid indicate falls as the quality indicator. (Leland, Gozalo, Teno, Mor, 2012). Factors such as new environment, medication, cognition, and non-compliance contribute to falls. A significant number of falls occur from wheelchairs. (Willy, 2013). Newly admitted residents to long-term care facilities are confused with the change. The new environment and the new unfamiliar faces increase the level of anxiety. Pain may also contribute to falls. In order to take tailor made preventative measures, fall risk factors for each resident should be evaluated periodically. Tools scoring risk factors can be utilized.
The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.
Registered Nurses’ Association of Ontario (RNAO). (2005). Prevention of falls and fall injuries in the older adult. Retrieved from http://rnao.ca/sites/rnao-ca/files/Prevention_of_Falls_and_Fall_Injuries_in_the_Older_Adult.pdf
A fall is an “untoward event which results in the patient coming to rest unintentionally on the ground” (Morris & Isaacs, 1980). When it comes to patient safety in health care, there isn’t any subject that takes precedence. Patient falls are a major cause for concern in the health industry, particularly in an acute-care setting such as a hospital where a patient’s mental and physical well being may already be compromised. Not only do patient falls increase the length of hospital stays, but it has a major impact on the economics of health care with adjusted medical costs related to falls averaging in the range of 30 billion dollars per year (Center for Disease Control [CDC], 2013). Patient falls are a common phenomenon seen most often in the elderly population. One out of three adults, aged 65 or older, fall each year (CDC, 2013). Complications of falls are quite critical in nature and are the leading cause of both fatal and nonfatal injuries including traumatic brain injuries and fractures. A huge solution to this problem focuses on prevention and education to those at risk. ...
Yates K. M., & Creech Tart. (2012). Acute care patient falls: evaluation of a revised fall
... M.A. (2006). Applications of Dorthea Orem's self care deficit nursing theory. In M.E. Parker (Ed.) (2006). Nursing theory and nursing practice (2nd ed., pp. 149-155). Philadelphia: EA. Davis Company.
Nurses play an important role to facilitate these programs successful. Fall can have happened to any patient’s at any age or due to physiological changes such as medications, medical conditions. It is very important that nurses to follow evidence- based fall prevention management initiative- purposeful rounding to reduce fall in hospital
The nursing theories that are currently in place in the emergency room to promote professional growth and development are vital; however, there are other nursing theories that could be implemented to help improve professional growth and development. A theory that should be implemented to more effectively promote professional growth and development is Orem’s theory of self-care deficit. Orem’s theory is considered a “realistic reflection on nursing practice” (McEwen & Wills, 2014, p. 146). If the nurse is not taking care of him or herself, “stress [can] accumulate [and the] nurse can … become angry, exhausted, depressed, and sleepless” (Ruff & Hoffman, 2016, p. 8). By the nurse having these feelings he or she is not able to take care of him
Fall prevention needs to be the target of many hospitals. Falls occur each year in hospitals and can be detrimental to the patient, especially the elderly patient (Peel, Travers, Bell, & Smith, 2010). Falls can lead to broken bones, longer stays in the hospital and potentially can lead to death. Falls are expensive to both the patient and the hospital (Trepanier & Hilsenbeck, 2014). This paper would like to take a look at a strategic action plan that would help to prevent falls. This plan of action will includes organizational changes that are geared towards fall prevention. The second part of this paper will include an evaluation plan that is designed to measure and monitor the plan.
Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator monitored by the American Nurses Association, National Database of Nursing Quality Indicators and by the National Quality Forum. (NCBI)
Every person’s needs must be recognized, respected, and filled if he or she must attain wholeness. The environment must attuned to that wholeness for healing to occur. Healing must be total or holistic if health must be restored or maintained. And a nurse-patient relationship is the very foundation of nursing (Conway et al 2011; Johnson, 2011). The Theory recognizes a person’s needs above all. It sets up the conducive environment to healing. It addresses and works on the restoration and maintenance of total health rather than only specific parts or aspect of the patient’s body or personality. And these are possible only through a positive healing relationship between the patient and the nurse (Conway et al, Johnson).
However, even non-injurious falls can be disabling. A fall can cause psychological difficulties such as, anxiety (e.g. fear of falling again), lowered confidence, depression, and increased dependency. This in turn can limit a person’s activities, reducing their level of physical activity, making them more susceptible to another fall (bc citation). It can also lead to social withdrawal, which can lead to depression. Overall, it is evident that a fall can have an eminent impact on a person’s quality of life and
I chose to do a concept analysis on ‘Self-Care.’ The nursing theory that uses this concept is Orem’s theory of nursing. This theory is a grand theory and consists of three minor interrelated theories; self-care, self-care deficit, and nursing systems. (Parker & Smith 2010). Orem defines self-care as when an individual initiates activities and performs to maintain life, health and well-being on their own and self-care deficit as not meeting adequate self-care requisites which include “limitations for knowing, deciding and producing care to self or dependent. (Parker & Smith, 2010)
The grand theory to be analyzed in this paper is Orem’s Self-Care Deficit Nursing Theory (SCDNT). The method used to analyze Dorothea Orem’s theory is Walker and Avant Theory Analysis (WAT). Theory analysis is a process of evaluating a nursing theory. The WAT is comprised of seven steps. The steps are defining the origins, meaning, logic, usefulness, details, structure and testability of the theory (McEwen & Wills, 2011). “Critical reflection of a theory determines how well the theory serves its purpose” (McEwen & Wills, 2011, p.95). Therefore, a critical reflection will be applied to the SCDNT. The purpose of this paper is to analyze and critique the SCDNT using the WAT method of theory analysis.
One of the theories of nursing is Dorothea Orem’s self-care theory, also called the self-care deficit theory. Nursing theories are important for several reasons. The profession is strengthened when knowledge is built on sound theory (Black, 2014). Theory is important for reasoning, thinking, decision-making, and supporting excellence in practice (Black, 2014). Dorothea Orem’s theory is a conceptual model that provides a structure for critical thinking in the nursing process (Black, 2014). A conceptual model provides a comprehensive and holistic perspective of nursing (Black, 2014). Orem published her theory in 1959 and continued to develop her model, eventually formalizing three interrelated theories: theory of self-care, theory of self-care deficit, and theory of nursing system (Black, 2014). The focus of Orem’s model is the patient’s self-care capacity. The process helps to design a nursing process specific to each patient that will provide for the self-care deficit of the patient (Black, 2014). Self-care deficits exist when the patient has limitations and the self-care requirement is greater than he patient’s capacity (Manzini & Simonetti, 2009).