"The Best Practice of Fall Preventions" is a marvellous example of a paper on care. Nursing action plans are developed based on established evidence from data gathered from NDNQI, which is then used to create the Dashboard. When considering improving nursing practices and strategic outcomes, the Dashboard provides the basis for developing the appropriate nursing actions. The nursing action plan provides well-researched and evidence-based frameworks and guidelines for nurses to apply in their practice. A nursing action plan can be created for a particular performance area such as managing pressure ulcers, dealing with teenage pregnancies, and minimizing patient falls.
One area that continues to receive growing attention from nursing practitioners is patient falls. According to Lach, Krampe and Phongphanngam (2011), falls account for a significant proportion of all cases of morbidity and mortality among the elderly. It is important to establish an action plan specifically for fall preventions. The purpose of this paper is to provide the best practice for fall preventions based on Dashboard from Adams 5, an inpatient rehab unit. Analysis of Data Falls are common especially among the elderly.
Within the community setting, it is estimated that falls affect about 30 to 40 per cent of the elderly (Tideiksaar, 2003). However, this per cent is significantly higher, approximately 50 per cent, in nursing homes (Hill& Fauerbach, 2014). The high risk of falls is a cause for worry within the nursing practise because of its potential negative effects. Falls can have minor to major negative effects including minor injuries, clinical complications, fractures, extended hospital stays, high costs, and even death (Nassar, Helou & Madi, 2013; Hill& Fauerbach, 2014). From the Dashboard data, total falls were recorded for the second, third and fourth quarters of 2009 and the first quarter of 2010.
The data provides evidence of the high prevalence of falls in the inpatient rehab unit. For the four consecutive periods, the average falls recorded were 7.46, 7.68, 7.31, and 7.38. Another amazing statistic is that in all but one of the four periods, the third quarter of 2009, the actual number of falls recorded exceeded the targeted number. The main implication of these figures is that falls are very common in nursing care environments.
Moreover, the falls are so prevalent that they often exceed the anticipated or targeted numbers. Nursing Plan It is impossible to eliminate all the risks for falls in nursing care settings. However, it is possible to minimize these risks significantly. The most common approaches to preventing or reducing falls focus on understanding and eliminating the risk factors. However, it is also important to consider appropriate strategies for dealing with patients who have already experienced falls because they often need treatment and intervention. This nursing plan proposes three best practices for fall preventions. Nursing Plans of Care: Education Education is one of the most effective strategies for preventing falls.
Education creates awareness and builds capacity among the stakeholders in preventing falls. It is unfortunate that a considerable proportion of falls are caused by or related to a lack of awareness or capacity. According to Tideiksaar (2003), one of the main risk factors for falls is a lack of awareness about the risk factors for falls. This may seem weird to a nursing practitioner who is experienced or knowledgeable about the problem of falls.
However, not everyone has this level of awareness. Fall prevention involves multiple stakeholders including the victims, the nursing practitioners, the victim’ s family, and other patients within the nursing care environment. It is possible to have elderly people who are not aware of the risk of falls at all. This is a major risk factor because elderly people are the primary stakeholders in fall prevention. They are the ones who have the greatest responsibility in preventing falls because nurses, relatives, and other people may not be present when they are about to fall or when they actually fall.
Therefore, it is important to educate all stakeholders, especially the elderly people and their close ones about falls. This kind of education should prioritize equipping them with knowledge about the risk factors and how to alleviate or minimize them. Some of the areas to be included in the education program include reporting all falls, identifying risk factors, safety measures, and the need for exercises among others (Tideiksaar, 2003). Nursing Plans of Care: Multidisciplinary Fall Approach There are multiple risk factors for falls in nursing care facilities.
This implies that there are multiple possible approaches to minimizing these risks. Some approaches may be effective for alleviating or minimizing some risks but not all risks. For example, a nursing practitioner may only deal with the risk of bed falls through regular checking with the patients. However, the nursing practitioner may not be well suited to deal with other risks including anxiety and depression. In such cases, the services of other professionals are necessary. Referrals to professionals in various other fields are a common approach to fall prevention (Lach, Krampe & Phongphanngam, 2011; Tinetti, 2003).
For example, nurses should collaborate with occupational therapists, physical therapists, and psychotherapists to ensure an all-rounded approach in preventing falls (Hill& Fauerbach, 2014). The services of these other professionals are vital in most cases. Nursing Plans of Care: Medications Medical management is also an effective approach to preventing falls, especially in nursing care settings. Falls can be caused by certain medications, diseases, or conditions. Some of the common risk factors for falls requiring medications include muscle weakness, cardiovascular diseases, and visual impairments (Tideiksaar, 2003).
In some cases, the use and effects of some medications may be risk factors for patient falls (Hill& Fauerbach, 2003; Tinetti, 2003). In both cases, the use of medical interventions may be necessary to reduce the risk of fall. For example, a nursing practitioner may evaluate a patient’ s recent use of a particular medicine and identify this to be the cause of the frequent falls. In such a case, the nurse may recommend a different drug that does not create the risk of frequent falls. Therefore, the use of medications is also an evidence-based best practice for preventing falls. Summary Falls are common occurrences in nursing and community environments.
Falls increase morbidity and mortality rates especially among the elderly. In preventing falls, priority should be on identifying and minimizing the risks. Considering that there are many risk factors for falls, the best practice for fall preventions should be broad, multifaceted, and multidisciplinary. All stakeholders should be involved in these best practices.
Hill, E., & Fauerbach, L., A. (2003). Falls and fall prevention in older adults. Journal of Legal Nurse Consulting, 25(2), 24-29.
Lach, H. W., Krampe, J., & Phongphanngam, S. (2011). Best practice in fall prevention: roles of informal caregivers, health care providers and the community. International journal of older people nursing, 6(4), 299-306.
Nassar, N., Helou, N., & Madi, C. (2014). Predicting falls using two instruments (the Hendrich Fall Risk Model and the Morse Fall Scale) in an acute care setting in Lebanon. Journal of clinical nursing, 23(11-12), 1620-1629.
Tideiksaar, R. (2003). Best Practice Approach to Fall Prevention in Community‐Living Elders. Topics in Geriatric Rehabilitation, 19(3), 199-205.
Tinetti, M. E. (2003). Preventing falls in elderly persons. New England journal of medicine, 348(1), 42-49.