Practice Implication
Based on the studies and findings here, tai chi could prove to be beneficial to elderly patients in the hospital setting. The majority of studies that implemented tai chi produced positive outcomes relating to its ability to prevent falls. As a professional nurse, I have witnessed countless years of severe falls occurring in outpatient and inpatient settings. It is my personal belief that implementing a tai chi program will not only prove beneficial for the patients but also reduce the number of falls in the hospital. This would be a positive effect because falls have shown to be very costly for the patients, families, and the hospital. The practicing nurse will utilize his or her expertise and coaching skills to integrate
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According to Dossey and Keegan (2016), “Nursing coaching are grounded in the principles and core values of holistic nursing” (p. 541). Dossey and Keegan go on to note that for nurses to be successful in coaching, they must establish a partnership with their patients, build a safe space, and be thoughtful about issues of trust and susceptibility. The practicing nurse will implement a patient-centered tai chi program that is sure to address the patients’ various needs. Such a program may also enhance the relationship with the patient, families, and health care providers that will permit the nurse to be more connected with his or her patient. As further stated by Dossey and Keegan, the theory of relationship indicates that the purpose of human relationships is to minimize one’s chances of anxiety and advance wellness within the person. The authors also implied that a connection exists when there is active involvement with one another that allows for …show more content…
A certified professional tai chi instructor will provide education and support to the staff. The staff will receive 8 hours of training, and for staff members seeking certification, a 3-day, 8-hour class will be provided. A video recording will also be available on the hospital intranet for those who need additional training. Trained tai chi staff will also be able to provide support. This program will be available to patients and as well as, their family members, and loved ones. Tai chi exercises can be done twice-weekly in the patient’s room for 30 minutes each session, or they may be practiced in our approved exercise room depending on the number of participants. I have reserved an exercise room in the inpatient rehabilitation unit for such use during this pilot program. The participants in this program will be identified based on their assessed falls score. Those with a high number will be asked to participate. All members of the program must be alert, oriented, and able to consent to this study. The limitations of this study such as a willingness to participate, general overall health status, will be addressed with the staff and participants. A further recommendation from their health care provider will be discussed when such limits pose
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: assessment and interventions. Nursing Standard, 25(52), 50-55.
Fatigue, decreased mobility and impaired balance from the rheumatoid and osteoarthritis pain also increases the risk of falls (Stanmore et al., 2013). Age related changes such as sarcopenia causes muscle tone and strength to decrease, especially in the lower limbs and as a result, balance and gait become impaired (Culross, 2008). These factors significantly influence the risk of falls and also affect the ability to carry out daily activities therefore, with a physiotherapists assistance, the nurse could introduce a personalised exercise regime to enhance muscle tone and strength (Culross, 2008). According to Neuberger et al (1997), exercise lessens fatigue and improves muscle tone and balance in older people. Recommending an exercise programme for Mrs Jones that incorporates strength training exercises and aerobics, could potentially improve muscle tone and strength and as a result improve mobility, balance and lessen the risk of falls (Bird, Pittaway, Cuisick, Rattray & Ahuja, 2013). The nurse could also suggest safety precautions such as advising Mrs Jones to use a mobility aid (Gooberman-Hill & Ebrahim,
The National Patient Safety Goal (NPSG) for falls in long term care facilities is to identify which patients are at risk for falling and to take action to prevent falls for these residents. (NPSG.09.02.01). There are five elements of performance for NPSG: 1. Assess the risk for falls, 2. Implement interventions to reduce falls based on the resident’s assessed risk, 3. Educate staff on the fall reduction program in time frames determined by the organization, 4. Educate the resident and, as needed, the family on any individualized fall reduction strategies, and 5. Evaluate the effectiveness of all fall reduction activities, including assessment,
This document’s purpose is to assist nurses to identify elderly patients at risk for falls and to implement interventions to prevent or decrease the number of falls and fall related injuries (RNAO, 2005). The target population are elderly adults in acute or long-term care. The recommendations are to help practitioners and patients make effective healthcare decisions, support nurses by giving educational recommendations, and to guide organizations in providing an environment receptive to quality nursing care and ongoing evaluation of guideline implementation and outcomes. These guidelines stress and interdisciplinary approach with ongoing communication and take patient preferences into consideration.
Wolf, S. L., Barnhart, H. X., Kutner, N. G., McNeely, E., Cooler, C., Xu, T. (1996). Reducing fraility and falls in older persons: an investigation of Tai Chi and computerized balance training. Journal of American Geriatrics Society, 44, 489-497.
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. ...
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization (Swartzell et al. 2013). Because the multi-etiological factors contribute to the incidence and severity of falls in older society, each cause should be addressed or alleviated to prevent patient’s injuries during their hospital stay (Titler et al. 2011). Therefore, nursing interventions play a pivotal role in preventing patient injury related to hospital falls (Johnson et al. 2011). Unfortunately, the danger of falling rises with age and enormously affect one third of older people with ravages varying from minimal injury to incapacities, which may lead to premature death (Johnson et al. 2011). In addition, to the detrimental impacts on patient falls consequently affect the patient’s family members, care providers, and the health organization emotionally as well as financially (Ang et al. 2011). Even though falls in hospital affect young as well as older patients, the aged groups are more likely to get injured than the youth (Boltz et al. 2013). Devastating problems, which resulted from the falls, can c...
People have created a hectic and busy world, that includes careers and daily activities that require physical activity. While attempting to attain the required physical conditioning, people often take chances with their personal health as they try to stretch their physical limits. Sometimes, people can surpass their current limits and form new boundaries; however, other times people are not so fortunate. These unfortunate times often lead to injury, including workplace accidents, sporting incidents, disease afflictions, as well as others; any or all of which could bring about the need of rehabilitation services. Many of these require physical therapy, which includes assisting injured or otherwise impaired patients as they recover to their pre-injury status or to recover as much as is physically possible. The field of physical therapy is a choice career for those who enjoy helping people recover from injury, and the following text will provide reason for choosing this profession.
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,
Therapeutic relationships are an essential part of nursing; they are the foundation of nursing (CNO, 2009). The National Competency Standard for Registered Nurses states that nurses are responsible for “establishing, sustaining and concluding professional relationships with individuals/groups.” Throughout this essay, the importance of forming therapeutic relationships will be explained. The process of building a therapeutic relationship begins prior to time of contact with a patient, the interpersonal skills of the nurse; then the process includes skills required by the nurse to communicate effectively, including respect, trust, non-judgment and empathy. The way to portray these skills can be via verbal or non-verbal cues that are important to understand how they influence a person.
Fall can lead to serious injuries and death which, increase the health care cost. Hence prevention of fall is an important public health issue in the hospital for patient safety. We had many falls incidents reported in our unit every month. Therefore, it is essential to implement prevention strategies through multidimensional approach by interdisciplinary team. Through the proposed fall management program, we can reduce fall rate drastically.
Patient falls in the hospital is a serious issue and challenging problem that could lead to prolonged hospital stay, longer recovery time for patients, increased costs for hospitals, and a source of distress and anxiety for patients, nurses, and families. Patient falls can cause minor or major serious physical injury depending on the situation and the age of the client. In addition to the physical harms, patients can suffer from psychological injuries which make them lose their independence and confidence on themselves and build a lot of anger, distress and fears of falling.
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
My journey to nursing began with my personal healthcare experience, and has continued to evolve since entering the nursing program at State University. My personal philosophy of nursing is related my life experience and my personal philosophy of life. Using reflection-on-action, I have begun to understand the influences that have lead me to nursing. I discovered client and family centered care to be an important quality when I look at the influential nurses in my life. To develop a positive therapeutic nurse-client relationship, nurses must integrate all 5 dimensions of the therapeutic nurse-client relationship into their practice (CNO, 2006). When it comes to providing client-centered care, the dimensions of trust, empathy and respect are particularly important (CNO, 2006). Illness can be a traumatic experience for patients and their families, and it is important to be empathetic to the patient’s needs, while still trusting the patient to be an expert in their illness and care.
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.