Fall Prevention by the Nurses and Patients Education - Term Paper Example

Clinical Governance and Practice Improvement Student Name Tutor Course Institution Date NURS2006 ASSIGNMENT 3 Clinical Practice Improvement Project Report Student Name, FAN and ID: Project Title: Fall prevention by the nurses and patient’s education. Project Aim: To prevent the patient fall through educating the patients and nurses Relevance of Clinical Governance to your project Clinical governance has four main pillars which involve consumer risk, consumer value, clinical performance and evaluation and professional development and management. Clinical governance requires the minimization of the risks posed to the patients during care (Weinberg, et al, 2011).The identification of what can go wrong during the provision of care is required as part of clinical governance. The risk of falling is one of the challenges that may be encountered during the provision of care. It therefore forms an important aspect of risk management that is required in clinical governance. During the risk management, all the necessary steps must be put in place to ensure that action is taken to minimize risks to the patient. Clinical performance and evaluation is a component of clinical governance that requires the healthcare professions to measure the quality of care they offer (Neiman, et al, 2011). Prevention of the patient fall is an important aspect that influences the quality of care. The healthcare professional can therefore include the aspects of fall prevention while measuring the quality of care and evaluating the effectiveness of the measures that have been put in place. A high number of falls leading to injuries and fatalities may be an indication of poor quality of health. Clinical governance advocates for professional development and management. This can be achieved through education, training and continuing professional development. The training and development can provide the nurse with more information as well as knowledge to prevent the patient flow (Neiman, et al, 2011). They can also use the information to educate the patients in order to prevent the fall. Clinical governance promotes consumer value which is one of its main pillars. This is aimed at ensuring that the patients are able to receive the highest quality of care. Preventing the patient fall through the provision of education is thus an important aspect related to the consumer value. Preventing the patient fall improves on the consumer value as well as the quality of care. Evidence that the issue / problem is worth solving: Patient fall is defined as unplanned descent to the floor that may or may not result to injuries. Patient fall may result to injuries that further impact negatively on the health of the patient. The injuries may include fractures, lacerations, separations, internal bleeding, and concussions and in some instances the death of the patient. In Australia patient fall is the main causes of separations among the patients. About 20,000 separations are usually reported annually due to the patient fall (Weinberg, et al, 2011). In the United States, about 700,000-1,000,000 patient fall is reported every year. Most of the injuries are however, preventable despite the effects that it has on the patients. The injuries caused lead to increased healthcare utilization. The cost of treating the patient increases due to the injuries and hence imposing a burden to the hospital and the patient. Additional treatment is required by the patient after the fall. This increases their hospital stay which may also negatively impact their recovery plans. Studies indicate that a fall with injury adds about 6.3 days to the hospital stay (Padula, et al, 2011). Depending on the nature of the fall, it may end up increasing the costs by up to $ 14,000. About 63% of serious injuries caused by the fall usually result to the death of the patients (Padula, et al, 2011).This is an indication that the problem is of major concern and it is worth solving. At the hospital, the patient fall may be as a result of various factors which contribute to complexities in its prevention. Prevention programs that contain the fall education components play a vital role in reducing the number of falls. The education of the patients leads to the creation of awareness associated with the fall and hence leading to the prevention (Lee, 2014). Education for the patients may include the use of videos, charts or diagrams. Face to face education of the patients has been found to be more effective in the creation of awareness as compared to the use of videos and other methods. Printed materials and brief advice forms an important component of the patient education. The education of the patients is useful in increasing the perception of risk of falls. It also ensures that the patients are motivated and their self efficacy increased (National Institute for Health and Clinical Excellence, 2013). Behaviour change can be attained though the education of the patients and hence leading to an improved outcome. The nurses are also in need of education as they are mainly involved in the care of the patients. Educating the nurses can also form a vital part of the continuous training and development. The nurses can improve on their skills through the educational programs. The educational programs can impart the nurses with new knowledge and skills leading to improvements regarding the handling of patients (Cameron, Gillespie & Robertson, et al, 2012). The education of the nurses can act as a motivation for better performance. Experts must however be involved in the education of nurses. The nurses can educate the patients once they have received the necessary training and education. Key Stakeholders: Registered and enrolled nurses are among the important stakeholders than have to be involved in the prevention process. This is because they are directly involved in the care of the patients including administering the drugs (Neiman, et al, 2011). They required detailed education about the problem as well as the role they can play to prevent it. The registered nurse can be involved in educating the patients. The doctors must also be involved in the prevention as they are responsible for examining the patients. They can communicate to the nurses about the condition of the patient and how they should be handled. In other instances, the doctors can be involved in the education of nurses and doctors. The hospital management has to be informed of the problem and the prevention strategies. The management has the responsibility of providing resources or making changes in order to support the process. This makes the management the most important stakeholder. The patient is a stakeholder who is directly affected by the problem (Neiman, et al, 2011). The prevention measures are therefore of great benefit to the patient. Educating the patient about the problem is therefore important in enabling them to play their role in the prevention process. CPI Tool: The Clinical Practice Improvement Model PDSA is the most appropriate tool. Plan, Do study and Act (PDSA) have the ability of supporting the intervention strategies. The planning stage will involve highlighting and planning all the changes that have to be trailed. The Do stage involves conducting a trial for the proposed change in order to determine its effectiveness. This can involve trails at the hospital with the involvement of the healthcare personnel (Wong, et al, 2011).The study stage involves an evaluation of the impacts of the trail. This may include changes in the number of patient falls. The Act stage involves the implementation of the changes that have been successful in the prevention process. 1st cycle Planned for the implementation of the designated educational program for the hospital. This is for a period of 2 months in order to educate the nurses and the patients so as to prevent the falls. Do – An education program for nurses requiring 2 hours a day for one week. After the completion of the program, the nurses have to provide the education to the patients. Study: Evidence from previous research about the topic can be utilized during the program. The outcome of implementing the educational program can then be measured against the existing evidence and the set targets. Act: Making decisions on carrying out the intervention in the entire hospital. Summary of proposed interventions: A number of strategies need to be put in place so as to ensure the prevention is effective. Educating the nurses and patients is the strategy of the proposed intervention. The nurses will be required to undertake a one week educational program. This will be conducted before or after the nurses have completed their shifts. Experts have to be hired to educate the nurses. All the necessary materials have to be provided by the management. Change management aspects will also form part of the training. This is for the purposes of ensuring any resistance to change is prevented. Nurses may be resistant to change when new practices are introduced (Wong, et al, 2011).The education program aims at equipping the nurse with new skills and knowledge which may also require the introduction of new practices. The main focus of the education of nurses will involve fall prevention. The nurses will be responsible for educating the patients. The education of the patients will mainly be conducted on a face to face basis at the bed side. It is important for the process to be carried out when the patients are comfortable (Wong, et al, 2011). During the program, the patients have to be provided with educational materials including charts and diagrams. Video based education can also be provided to the patients. The nurses have to carry out the program with a full understanding of the fragile condition of the patient. Booklets comprising of safety information also needs to be provided to the patients. This is due to its relevance even after the patient has been discharged from the hospital (Weinberg, et al, 2011). Barriers to implementation and sustaining change: The complexity of the problem may lead to barriers during the implementation of the strategy. Active engagement with each individual is required in order for the intervention to be successful. This may not be possible due to the high number of patients a few number of healthcare personnel. The human resource challenge is therefore a barrier that may affect the implementation process. The lack of adequate financial resources also presents a barrier to the process. Financial resources are required in order to carry out the training of the personnel and providing education to the patients. The modification of the environment requires financial resources as well as goodwill from the management (Wong, et al, 2011).The process requires several changes to be made within the organization. Resistance to change by the staff may therefore present a barrier to the implementation process. Lack of managerial support is also a barrier that may affect the process leading to poor outcomes. It is difficult to educate the patients who are in critical conditions or under heavy medication. Evaluation of the project: The evaluation of the project is important in ensuring that the successes or failures are established (Wong, et al, 2011). Continuous monitoring is an important evaluation method that can be used to determine the success of the project. All the data regarding fall has to be documented. The data can then be evaluated after every three months to determine the success of the project. A decrease in the number of falls will be an indication of success. However, an increase or lack of improvement will be an indication of failure. In order for the strategy to be considered effective, the patient fall must reduce by up to 75% in the first three months. Bibliography Weinberg J., et al., 2011. An inpatient fall prevention initiative in a tertiary care hospital. Jt Comm J Qual Patient Saf 37(7)3, pp.17-25. Neiman, J., et al., 2011. Development, implementation, and evaluation of a comprehensive fall risk program. J Spec Pediatr Nurs 16(2), pp.130-9. Padula, C. A., et al., 2011. Impact of lower extremity strengthening exercises and mobility on fall rates in hospitalized adults. Journal of Nursing Care Quality 26(3), pp. 279-85. Wong, C., et al., 2011. The Cost of Serious Fall-Related Injuries at Three Midwestern Hospitals. The Joint Commission Journal on Quality and Patient Safety 37(2). DuPree, E., et al., 2014. A new approach to preventing falls with injuries. Journal of Nursing Care Quality 29(2), pp.99-102. Guarascio-Howard, L., 2011. Examination of wireless technology to improve nurse communication, response time to bed alarms, and patient safety. HERD 4(2), pp.109-20. Lee, A. D., 2014. Falls prevention education for older adults during and after hospitalization: A systematic review and meta-analysis. Health Education Journal, 73(5), pp.530–544. National Institute for Health and Clinical Excellence., 2013. Falls: Assessment and prevention of falls in older people: Draft for consultation. NICE Clinical Guideline. UK: National Institute for Health and Clinical Excellence. Cameron, I.D., Gillespie, L.D., Robertson, C.M., et al., 2012. Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews,12. . Read More