Identifying Resources Paper
Patient falls are among the most common cause of adverse events in healthcare settings. Falls result in increased mortality, morbidity, cost of care, and reduction of patients` quality of life and clinical outcomes (Cho & Jang, 2020). Despite being common in healthcare settings, evidence indicates that almost half of the falls are preventable.
This can be achieved by implementing safety measures coordinated by nurses and various stakeholders. Such measures prevent falls while improving patient outcomes. This paper will address evidence from four articles that address various tools, skills, and resources used in preventing patient falls, as well as the recommendations for such measures in clinical settings.
To begin with, Montejano-Lozoya et al. (2020) did a quasi-experimental study on 581 patients to assess the effects of educating nurses to perform a systematic fall risk assessment on reducing patient falls. Among the group, 303 patients were used in the intervention group, while 278 were in the control group. The average age was 68.3 years. A total of 33 nurses from various departments were included in the workshop for training.
The attending professionals were allowed to perform self-assessment before the training while comparing their knowledge after training. The formative activity involved training nurses on performing a complete systematized assessment of patients at admission and continued during patient care. This is aimed at identifying patient problems while addressing them. Therefore, the intervention group benefited from systematic assessment while the control group used intuitive, improvised, and non-systematic assessment.
The results of the study showed a difference between the two groups. For instance, the average incidence of falls was 1.2%: 2.2% among the control group and 0.3% among the intervention group. Besides, most falls were experienced by individuals aged > 65. As a result, most patients had a better outcome with a reduction in the hospital stay.
Therefore, based on these results, it is recommended that every healthcare provider should perform a systematic patient assessment on all patients during admission and throughout their hospital stay. This helps identify high-risk populations while allowing the development and implementation of appropriate care that increases patient safety.
In another study, King et al. (2018) performed a qualitative study using Grounded Dimensional Analysis (GDA). The study aimed at exploring nurses` experience with fall prevention and how those experiences impacted their care of patients.
The need to reduce patient falls was an initiative pressured by the Center for Medicare and Medicaid (CMS) to ensure zero falls in the healthcare setting. Intense messaging from hospital administrators was used to prevent falls while allowing nurses to develop strategies to prevent falls.
A total of 27 nurses from both high-risk and low-risk departments were used. Notably, any reported case of patient fall was deemed shameful to the unit it occurred. Therefore, to reduce falls, nurses in high-risk units performed complete patient assessments, identified high-risk patients, educated patients, and offered much-advanced care, including hourly rounding, restricting patient movement, developing care plans, and establishing good communication with patients and their relatives.
On the other hand, nurses in a low-risk unit identified both environmental and patient factors that could increase the risk of falls. Generally, these interventions led to a reduction in falls while meeting hospital goals. Therefore, the integration of an intense messaging system is an effective method of improving patient care by encouraging nurses to come up with preventive methods. As a result, nurse leaders and administrators can implement this method to reduce patient falls.
In addition, Park. (2021) did an experimental study to ascertain the effects of a fall prevention program based on King`s goal attainment theory on reducing falls in long-term care. The study involved 57 elderly patients and 58 nurses who trained individually. Thereafter, group training was conducted in a conference room. The training involved identifying risks of falls as well interventions to mitigate falls.
The results showed an increase in knowledge and fall prevention behavior and decreased fear among the intervention group. Similarly, nurses had increased knowledge about fall prevention strategies. Furthermore, there was increased satisfaction with improved interactions among intervention nurses and patients.
Therefore, improving education among nurses and patients about fall prevention should be considered in every healthcare setting. For instance, informed patients will likely communicate appropriately with nurses before undertaking any actions. Similarly, informed nurses are likely to use their clinical expertise to provide holistic care to all patients (Fridman, 2019). This will reduce the fear of falls and increase satisfaction among patients, leading to a reduction in patient falls and their consequences.
Finally, Jahanpeyma et al. (2021) conducted a randomized control trial study to evaluate the effectiveness of Otago exercise in preventing falls and improving balance and physical performance among elderly patients in a nursing home. Seventy-two individuals aged above 6 years were recruited into the program.
Participants were grouped into the Otago exercise group and control group. Otago exercise is a special form of exercise that involves mobility, balance, strength, proper posture, and a walking program aimed at improving balance.
During the study, the Otago exercise group performed the Otago for 45 minutes every 3 days/week for 12 weeks and inclusion of walking program for 3 days/week. On the other hand, the control group was only involved in the walking program 3 days/a week. The number of falls was the primary outcome.
Fortunately, the results demonstrated the superiority of Otago exercise over the walking program. Compared to the walking group, the Otago exercise group reported a significant reduction in falls. This was attributed to increased balanced and physical performance among the Otago group. Therefore, it is evident that the Otago exercise is a simple intervention yet effective in reducing patient falls by improving stability.
As a result, nurses and other healthcare workers can integrate the aspects of Otago exercise while caring for elderly patients in the healthcare setting to help in the reduction of falls. Furthermore, nurses should educate patients about the importance of exercise in preventing falls.
As noted from the reviewed sources, falls in the healthcare setting are a significant healthcare setting problem. Despite a myriad of evidence concerning its prevention, many patients face the consequences of falls, including injury, increased hospital stay, morbidity, and mortality.
As a result, this article shed light on some recommended evidence-based practices to reduce patient falls. Such include patient education, educating nurses, implementing a complete systematic assessment of patients for fall risk, integrating Otago exercise, and using intense messaging. These practices have been used and were useful in reducing patient falls.
However, special considerations must be addressed before implementing either practice in the healthcare setting. Such factors include patient factors, feasibility, affordability, and applicability of either intervention in specialized groups. Finally, adhering to set protocols is necessary for success when either intervention is applied in healthcare.
Cho, M.-Y., & Jang, S. J. (2020). Nurses’ knowledge, attitude, and fall prevention practices at south Korean hospitals: a cross-sectional survey. BMC Nursing, 19(1), 108. https://doi.org/10.1186/s12912-020-00507-w
Fridman, V. (2019). Redesigning a fall prevention program in acute care: Building on evidence. Clinics in Geriatric Medicine, 35(2), 265–271. https://doi.org/10.1016/j.cger.2019.01.006
Jahanpeyma, P., Kayhan Koçak, F. Ö., Yıldırım, Y., Şahin, S., & Şenuzun Aykar, F. (2021). Effects of the Otago exercise program on falls, balance, and physical performance in older nursing home residents with high fall risk: a randomized controlled trial. European Geriatric Medicine, 12(1), 107–115. https://doi.org/10.1007/s41999-020-00403-1
King, B., Pecanac, K., Krupp, A., Liebzeit, D., & Mahoney, J. (2018). Impact of fall prevention on nurses and care of fall risk patients. The Gerontologist, 58(2), 331–340. https://doi.org/10.1093/geront/gnw156
Montejano-Lozoya, R., Miguel-Montoya, I., Gea-Caballero, V., Mármol-López, M. I., Ruíz-Hontangas, A., & Ortí-Lucas, R. (2020). Impact of nurses’ intervention in the prevention of falls in hospitalized patients. International Journal of Environmental Research and Public Health, 17(17), 6048. https://doi.org/10.3390/ijerph17176048
Park, B.-M. (2021). Development and effect of a fall prevention program based on King’s theory of goal attainment in long-term care hospitals: An experimental study. Healthcare (Basel, Switzerland), 9(6), 715. https://doi.org/10.3390/healthcare9060715
Identifying Resources Paper Instructions
For this discussion, find 4 scholarly or professional sources relevant to your improvement plan, its implementation, or its sustainability. For each resource, provide the following in a written post: The APA citation for the resource. A description of the information, skills, or tools the resource provides. An explanation of the resource\'s usefulness in helping nurses understand or implement the safety improvement initiative. Recommendations for how and when nurses should use the resource.