Introduction
The purpose of this project is to prevent falls among elderly patients which is an issue of concern for the nurses in the Unit. A proposed solution is the implementation of bed alarm. As nurses seek to keep patients safer, a critical analysis of the literature on bed alarms is developed to introduce the proposal in the unit. Pre and posttest questionnaires were conducted to evaluate the nursing learning needs. Strong evidence to support the use of bed alarms as an early warning system was discussed such as quantitative studies done at Methodist University in Memphis Tennessee sponsored by the National Institute of Aging in 2009. This resulted with the hypothesis that patient falls will be 25 percent lower with the use of bed alarms. Implementation of bed alarms requires time and money. Additional funds are needed to make the intervention possible. Funds are available through nonprofit organizations such as a capital grants and government’s grants to purchase bed alarms. This will educate the staff and cover technology costs. Various possibilities can be discussed with the nurses to maintain the success of the implementation of bed alarms in the unit to expand it to other wards. Open dialogue and continuous education are essential for the nurses. In the event that the project isn’t successful or has to be terminated, the process has to be done gradually and the facilitator needs to have an open dialogue with the staff to understand that the proper solution has its advantages.
The Purpose of the Program or Project
The proposed solution is to reduce falls in the hospitals. The program recommendation will be presented as guidelines for fall prevention and can be presented as follows.
• Educate staff about safety care....
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...crease adverse outcomes for the patients. Education goals for nurses needed not only to promote their professional knowledge and skills to implement the proposal but also to cultivate their caring attitudes.
Works Cited
References
Burgess, L; Herdman, T; Berg, B; Feaster, W; & Hebsur, S. (2009). Alarm Limit setting for early warning systems to identify at risk patients. Journal of Advanced Nursing, 65(9), 1844-1852. Doi:10.1111/j.1365-2648.2009.05048.x
Day, L; Finch, C; Hill, K; Haines, T; Clemson, L; Thomas, M; & Thompson, C. (2011). A protocol for evidence-based targeting and evaluation of statewide strategies for prevention falls among community-dwelling older people in Victoria, Australia. Injury Prevention: Journal of The International Society for Child and Adolescent Injury Prevention, 17(2), e3.
The Joint Commission is a nonprofit organization that focuses on improving the Healthcare system. They do this by regulating and evaluating health care organizations, helping them improve and give a more effective and safe care (The Joint Commission, 2012). The National Patient safety goals are ways in which the joint commission strives to improve the way health care is provided (The Joint Commission, 2012). Effective on January 1, 2012, the Joint commission came up with new ways to improve the Care of Medicare Based Long term Care facilities and provided Safety regulations to be followed. In order to better understand the impact that this regulations have in the healthcare, it is necessary to identify and describe the purpose of each regulation, and emphasize on the impact that falls in particular, can have among the geriatric patients.
Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. Archives of gerontology & geriatrics, 56(3), 407-415. doi:10.1016/j.archger.2012.12.006
From the literature researched, the writer thinks that environmental modifications along with multifactorial interventions can make a difference for falls that an elderly can receive. Still, he thinks that there should be more research done on environmental assessment tools, flooring, and effective behavioral interventions. On his last thoughts, he believes that strategies should be patient focused and environmental modifications should be developed for that individual.
In addition, the charge nurse needs to reinforce the safety check among nurses in regular basis. On the other hand, nurses are spending a great amount of time on charting their assessments outside the patients’ rooms. Knowing that every patient room is equipped with a computer, nurses can complete all their nursing risk assessment at the patient’s bedside in order to provide some supervision to the patients especially clients at high risk for falls and injuries. Furthermore, nurses are great educators. Teaching patients how to use their call bell during admission and have the patient demonstrate back is a big intervention to encourage patients to press the call button when help is needed instead of getting out of bed on their
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
The Quality and Education for Nurses (QSEN) project has set several goals for future nurses to meet in terms of knowledge, skills, and attitude (KSAs), one of which is safety (2014). The definition of safety according to QSEN is minimizing risk of harm to patients through system effectiveness and individual performance (QSEN, 2014). Since falls are such a huge occurrence in health care, preventing falls is critical for patient safety. The Joint Commission (2011) has also noted fall prevention as a National Safety Patient Goal (NPSG) 09.02.01 requiring hospitals to reduce the risk of harm resulting from falls.
Patients are falling in hospitals and nursing homes on a regular basis. The number of falls per hospital has caused injury and death to some, and has cost hospitals a lot of money. Patients feel like nurses have a lot of work to do, and tend not to bother them when they want to go to the bathroom, which is the reasoning behind why many patients are falling out of bed. Many believe that falls should not happen in hospitals, and many insurance companies are no longer willing to cover the costs associated with patients falling. Therefore, many hospitals have looked for ways to implement interventions that will reduce the number of falls, because it is something that can be prevented to begin with. The articles that I have chosen for this paper reflect how hourly rounding has reduced falls in hospitalized patients.
Huey-Ming Tzeng, PhD, RN, Chang-Yi Yin, Nurses' Solutions to Prevent Inpatient Falls in Hospital Patient Rooms. Nurs Econ. 2008;26(3):179-187. View at:
Falls are the leading cause of injuries, disabilities, and deaths among community-dwelling older adults (Moyer, 2012). According to the Center for Disease Control and Prevention (CDC, 2016), each year one out of three community-dwelling older adults aged 65 years or above falls at least once. There is a need to identify effective interventions pertinent to the primary-care setting to prevent falls among older adults living in the community. The guideline titled “Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement” is focused on determining the effectiveness and harms of different fall-prevention interventions relevant to primary care for adults aged 65 years or above (Moyer,
While about 5 percent of adults over the age of 65 live in nursing facilities, they account for nearly 20 percent of fall-related deaths in this age group. Up to 20 percent of residents who fall sustain serious injuries that can lead to a decline in functional ability and mobility impairment. The Best Practice Guidelines consist of broad principles upon which standard procedures for individual health services can be based. The guidelines aim intended to assist service providers in developing and implementing standard policies and procedures in the area of falls prevention. Best practice guidelines can be successfully implemented only where there is adequate planning, resources, organizational and administrative support, as well as appropriate
7). In an article by Rosalina Butao, RN, MSN, “Hitting Two Birds With One Bullet: Bedside Shift Reporting; “bedside reporting solidifies compliance to the Joint Commission’s 2009 National Patient Safety Goals: improve the accuracy of patient identification, improve communication among caregivers and encourage patient’s active involvement in their own care” all of which improves patient safety (Butao, 2010 p. S50). In a synthesis of literature by Sherman, et al., (2013), patient benefits include the patient being more knowledgeable and involved in their health care, improved the relationship between the nurse and patient, also improving patient satisfaction, as well as patient safety thus decreasing the number of falls, and increasing discharge times (p. 310). Bedside reporting allows the patient and family the opportunity to intervene during
Tzeng H. & Yin C. (2010) Nurses' response time to call lights and fall occurrences. MEDSURG
...ches indicate how nurses can ensure prevention and mitigation of the problems experienced due to falls. There are various strategies that can be used to enhance the safety of individuals from falls. In order to be able to deal with these issues within the healthcare facilities, nurses must be involved in the effective policy making so that the risks of patient falling can be amicably dealt with. On the other hand, the nurses must be placed at the forefront of the implementation process of the designed interventions. Leaders must engage the nurses in applying the evidence-based therapies so that they can ensure good safety for the patients. Nurses are important in ensuring advocacy, education and the management of the facility environment. The nurses will therefore apply various necessary interventions that guarantee safe environments for the patients and the nurses.
Fall is sudden, unpredicted, unintentional occurrence resulting in-patient landing on ground or at lower level. Falls and fall related injuries incur cost for the patient as well as the health cares system. The fall has a significant impact in patient quality of life and usually fall has many reasons to happen. Thus, preventing falls among patients in healthcare settings requires a complex approach, and recognition, evaluation and prevention of patient falls are significant challenges. Falls are a common cause of injury and the leading cause of nonfatal injuries and trauma-related hospitalizations in the United States (Barton, 2009). Falls occur in all types of healthcare institutions and to all patient populations. Up to 12% of hospitalized patients fall at least once during their hospital stay (Kalisch, Tschannen, & Lee, 2012). It has been using different strategies in many hospitals to prevent or at least to decrease the incidence of fall. However, the number of falls in the hospitals increases at alarming rate in the nation. The hospitals try to implement more efficient intervention strategies, but the number fall increase instead of decrease. In fact, many interventions to prevent falls and fall-related injuries require organized support and effective implementation for specific at risk and vulnerable subpopulations, such as the frail elderly and those at risk for injury.