Fall Prevention - Research Paper Example

Fall Prevention Alexander Igwilo Chamberlain School of Nursing Trace Stogner Capstone Introduction Orientation tour along with fall prevention education is vital in the process of long term care of patients. In the new environment of healthcare, it is difficult for medical practitioners and providers to depend completely on physiologic rationale, opinion based processes and clinical experiences. Experts are required to implement evidence-based methods and critical thinking in order to increase the cost-effectiveness and quality of healthcare. The research works and studies in the modern medical science reflect a paradigm shift from intuition-driven practices to new evidence based practices. The importance of orientation tour along with fall prevention education for family members and patients on admission day is very essential to overcome the risks related to falls. Approximately 15 percent of total number of hospitals participated in ANA-NDNQI of United States. The risk of fall and related injury is high. Therefore, further research is required in order to validate examinations and screening to mitigate those risks. This research paper provides the necessity of change practice with the help of Rosswurm & Larabee’s six-step Model for Change. Contribution to Future of Healthcare Patients and family members often feel that they have been neglected from quality care during hospital stays. Falls and related injuries are risky in many ways and proper initiative should be taken by nurses to overcome the problems associated with healthcare management. Orientation tours along with fall prevention education can help to improve the quality of patient services. Implementation of new remedies including involvement of external and internal stakeholders can help to reduce the risks that are involved in falls and related injuries. The involvement of stakeholders can be helpful in various ways. Vast research on in-patient services and detailed survey reports based on the stay of patients will help to reduce the risk factor (Gregory, 2013). The application of new remedies can enhance the services provided to patients, which can reduce the risks associated with falls. Change Model Overview Model for Change in evidence-based practice is very important because it explains the possible ways to enhance the protocols that have presence in picture. Larrabee and Rosswurm proposed the change management model theory for evidence-based practices in modern world. The model helps practitioners to go through the entire process of evidence-based change management. It starts with the assessment of the requirement for change and terminating with the addition of evidence-based protocols. The steps of the model are assess the need for change, link the problems, interventions and outcomes, synthesize the best evidence, design practice change, implement and evaluate the change in practice, and integrate and maintain the change in practice. The Rosswurm and Larrabee model mainly proposes six steps with explanations for nurses on proper management of patients during hospitalization with acute confusion. Step 1: Assess the Need for Change “Does an Orientation Tour Along With Fall Prevention Education for Family Members and Patients on Admission Day Lower the Rate of Falls of Patients in Long Term Care?” Acute confusion of patients and family members is very important for high rate of falls in different healthcare organizations. Falls generally affect elderly people, who are admitted in hospital for long term care. Orientation tour and fall prevention education can help family members and patients to understand the use of complex instruments. High fall rate has increased the expense of hospitals (Healey & Darowski, 2012). For example, several insurances, such as Medicare and Medicaid in U.S. have already started denying payment for injuries related to fall that could have been prevented. Lack of payment increases the cost of treatment in hospitals. Step 2: Link the problems, interventions and outcomes It is necessary to define a problem using standardized classification and find a method to link with the outcome and intervention. Growing fall rate is the major issue in this facility. Major goal of this implementation of change model is fall prevention in order to reduce the percentage of fall rate. It has been identified that inadequate care of patients by the nurses is causing growing percentage of fall rate. The fall rate has been increased by 10 percent in last two years. Major goal of the orientation tour is to reduce the fall rate by 5 percent within next six months through the help of this orientation tour. Providing initial orientation tour and fall prevention education on the first day of admission can be very helpful. Educating patients and family members about the proper utilization of rooms, bathrooms, nursing stations, dinner area and use of call light can definitely reduce the chances of accident. Patient outcomes are linked with periodic physician intervention (Poloni, Ghisla, Loda, Baroni, Firetto, Agostini & Facchi, 2012). Longitudinal goals are required to be incorporated in order to provide high quality service. Potential interventions and outcomes are mainly based on system priorities and resources and clinical judgment. Step 3: synthesize the Best Evidence Falls are risky for healthcare organizations as well as family members and patients. More than 10% patients are elderly people who suffer from falls in healthcare organizations. Adoption of educational process and orientation tour will help to promote positivity in the self-identity of patients. This change process will also help the nurses to improve their caring activities. Constant discussion with patients about the issues and problems will help to reduce fall rate. Moreover, it is the responsibility of both the patients and family members to get orientated with the facility before get admitted in specific rooms. Last but not the least; it is the responsibility of the administrators to review the facility of the hospital frequently in order to mitigate the chances of critical falls. These orientation processes will help nurses, patients and family members to get orientated with the fall prevention process (Jeske, et al 2006). Synthesizing data only accumulates the data bases; it does not create new knowledge. Hence proper verification is required to design an error free model. Moreover, constant review of outcome after the implementation of process and assessment will help to synthesize the best evidence. Step 4: Design Practice Change After synthesizing the evidences, detailed sequences are developed for implementation of change process in practice. Use of pilot protocol can help in developing desired change practice. Hospital staffs, such as nurses and nurse managers should be trained significantly in order to implement new change practice successfully. Looking after patients in proper duration and train the patients about the use of walkers and canes can create a healthy atmosphere in an organization (Swann, 2013). The implemented protocol should be designed in such a way that it can become easier and feasible for stakeholders to follow. Orientation training in this phase can help patients to gain knowledge. Therefore, the patients do-not have to get readmitted in hospitals. This can increase the satisfaction rate and reduce the fall rate. Step 5: Implement and Evaluate the Change in Practice Application of pilot study is very important in an evidence-based change practice model in healthcare. Setting up a panel involving staffs in different departments will help to initialize the process. Monitoring unit should be capable of collecting as well as reviewing data transparently during the process. Nurses and nurse managers should keep track of every action being performed in routine intervals. The staff opinion survey is essential for successful completion of the change in practice. It can help to reduce the rate of fall in long term care and increase the satisfaction level of family members and patients at the same time (Wu, Li, Hu & Liao, 2012). Step 6: Integrate and maintain the change in Practice Practitioners involved in the implementation of change practice should consider cultural atmosphere of the organization. Adherence to an organization’s operational details is mandatory because it ensures speedy and smooth integration of the change in the organization’s standards of healthcare. Nurses should be interviewed regularly regarding the new change practice so that the process can run efficiently. Surveys opted by patients and nurses should be reviewed by management seriously in order to reduce the rate of fall. Providing orientation tour with fall prevention education with the Rosswurm and Larabee’s change model can help patients to overcome the consequences of fall and lead risk-free life in future. Implement and Evaluate plan First of all, it is important for the administrators to create awareness among patients, family members and nurses about the implementation of change project. Major goal of this project is to reduce the fall rate. On the day of admission, the administration department of the organization would aware the patients and their family members about the orientation tour in order to reduce the possibility of further falls. On the other hand, an online notice circulation process will be implemented in order to aware nurses and medical support staffs about the newly adopted change model. Practitioners will provide effective training to the nurses in order to ensure effective patient care for long-term. Medical staffs and administration executives will train patients and their family members to reduce the possibility of critical falls. Professional monitors should be appointed in order to review and monitor the accuracy of ongoing training and education program. This education process for patients and family members will be done during the first week of patient admission as it will enhance effective orientation process. Surveying nurse, patients and their family members will help to evaluate the effectiveness of this program. Patient follow-up and evaluation of facility fall rate will help to determine this significance of this education program. Ratio of development of a standard benchmark and current fall rate will determine whether the change management process is working appropriately or not. Administration department of hospital; will look after these numbers. Steps to Maintain Change Participation of more people, proper detailing of the evidence-based model and enhancing ongoing communications are the important steps in change management practice. These can increase the quality of service received by patients and family members. These steps can enhance the organizations’ working standards and provide optimum quality service that can reduce the chances of patient fall. Orientation tour along with fall prevention education helps to lower the chances of the risks involved in acute confusions. The evidence-based model should be successfully applied by nurses because it can help in a variety of settings. The management should have long-term and short-term orientation plan. Continuity in the process of staff training on fall prevention and implementation of proper modules for orientation tour can definitely overcome the challenges of falls in the next 2-3 years on short-term basis. On long-term basis, the management of hospital should try to expand the facility of care. They should engage government officials and important agencies to ensure effective quality of the existing facility. Administrators must provide proper infrastructure to provide proper training to the stakeholders. Conclusion Based on the above research and evidences, it can be concluded that orientation tour with fall prevention education is essential for healthcare organizations. The increase of fall rate has also increased the expense of hospitals. The idea of educating patients and family members provides perfect outcome in reduction of fall rate through the implementation of Rosswurm & Larabee’s change model. Surveys opted by nurse and managers have tremendous effect on smooth running of the new evidence-based change model. Hence it can be said that orientation tour along with fall prevention education for family members and patients can lower the rate of falls of patients in long term care. References Gregory, K. L. (2013). Preventing Falls of the Elderly Patient. AARC Times 37(10), 16-21. Healey, F., & Darowski, A. (2012). Older patients and falls in hospital. Clinical Risk, 18(5), 170-176. Jeske, L., Kolmer, V., Muth, M., Cerns, S., Moldenhaur, S., & Hook, M. (2006). Partnering with patients and families in designing visual cues to prevent falls in hospitalized elders. Journal Of Nursing Care Quality 21(3), 236-241. Poloni, L., Ghisla, M., Loda, C., Baroni, F., Firetto, S., Agostini, C., & Facchi, E. (2012). How to intervene to prevent and reduce the risk of falls in geriatric patients admitted to a rehabilitation unit. Giornale Di Gerontologia 60(2), 82-87 Swann, J. I. (2013). How to prevent and manage falls in the care home. Nursing & Residential Care, 15(7), 488. Wu, L., Li, Y., Hu, X., & Liao, Z. (2012). Prevention of falls of hospitalized elderly patients using clinical pathway. Medical Science Edition 43(2), 222-225. Read More