Change management in reducing the percentage of inpatient fall in hospital.
Fall is defined as being “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” (World Health Organization, 2012). The author is a registered nurse working in a private hospital. In the author practicing hospital, inpatient fall was identified has a major problem. The targeted aim for inpatient fall is less than 5%. However, the inpatient fall has been increasing drastically from the month of January to May 2014. The statistic shows the inpatient fall’s rate of 10% for the month of January and it has increased to 25% in the month of May.
The quality department has investigated the impact of high rate falls on
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Ad hoc and weekly audit were conducted to measure compliance and the effectiveness of health education of fall prevention by registered nurses to patients. During the audit, one or two patients were interviewed to check whether the registered nurses has orientate them regarding fall prevention. Registered nurses also were interviewed and observed on how they perform orientation for patient. The final audit is on the documentation. For example, how the registered nurses do the scoring for high risk patient and how do they fill up the fall assessment form. The nurses should conduct fall risk assessment during the admission and post procedure. The patients who are the high risk, a red identification will be place on the patient’s limbs. A red sticker also is placed at the nursing notes and at patient room door. If the patient is not a high risk patient, the fall assessment is done weekly or upon change in patient condition. Not forgetting pediatric patients, it is a must to nurse patient who are below then three years old in a baby cot. Patel (2010) explained that to ensure and maintain a good quality service for patient, regular audits must be conducted to ensure services which are needed meets the purpose and registered nurses adheres to professional …show more content…
A positive outcome is achieved. The result from the month of June 2014 to September 2014 has reduced to 8%. Even though, the percentage is still higher than the targeted aim, the trending for inpatient fall shows a downward trending. These results were shared to all staff and doctors. It shows that the strategy plan which has been implemented is success. To maintain the good quality of nursing care and to achieve the target the top management encourage he nurse educators to continue with the continuing nursing education session two time per month. Besides that, quality department works together with nurse manager to continue with the audit to make sure the patient’s education is maintained (Quigley and White,
The conclusion of the article was that hourly rounding that has leadership involvement and staff that buy into the program is an effective fall prevention program. This conclusion was based off the results from the study. This review was of good quality. Hourly rounding and patient falls was a study that was conducted to see if hourly rounding was an effective fall prevention strategy. The study involved 2 units.
The clinical practice guidelines that were selected for this paper are from the National Guideline Clearinghouse and from International journal of nursing studies. The Hendrich Fall Risk Model was primarily developed as a predictive nursing assessment tool based on epidemiological research (NGC, 2011). The Guidelines were developed by the Hartford Institute for Geriatric Nursing the committee was however not stated. Authors were asked to sign confidentiality documents and all the authors agreed this. The research was conducted by hand searches of public literature and searches of electronic database.
Falls of critically ill patients admitted to the ICU routine should be avoided developing certain strategies used outside this area, such as prevention of displacement, promote stability, elimination of sliding hazards routinely ensure that the patient is oriented to the environment and the bell is at the fingertips, keeping the beds in the lowest position and braking, providing adequate lighting, and provide anti-slip footwear and technical assistance in lifting patients bed. The response time of the call prolonged ringing patient or family is just one of the potential causes of falls, firstly because if the response time is greater serve their needs later, and partly because no response to the patient may start feeling agitated. Shift schedules nurses can be particularly effective in preventing falls, as they allow the staff to anticipate and address the needs of each patient. The tubing, drains and cables must be securely to prevent tripping when lifting or embody patients. Although falls can happen without warning, subsequent falls can be avoided if the etiology of them is
Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.
This research proposes a nurse-led rounding program in an acute care context, with an implementation based on the Iowa Model, to decrease patient falls. The Iowa Model's first stage is to determine the problem for the change in practice. The necessity to reduce patient falls is the trigger in this circumstance.
The policy and procedure to be examined presents guidelines for both preventing and documenting falls in an acute care setting. This policy is to be used daily and with every patient in a hospital setting.
Problem Identification Getting out of bed is one of the dangerous things that the elderly patients do when they are admitted in the hospital. Study conducted by Ambrose, Paul & Hausdorff, (2013) on patient falls reveals that a majority of falls in the elderly patients occur between 0700 and 1900, especially when they are getting out of bed to use the rest room. The cause of their falls is mainly due to unsteady gait, memory loss, confusion that comes with age. Memory loss and vision problems which occurs during old age in the elderly patients puts them at risk for falls. Other factors that can lead to falls are; Presence of throw rugs, psychotropic medications, lack of Vitamin D, and weakness of the lower extremities.
It also provided the use of critical thinking and clinical judgment on how to prevent falls, support, and be accountable for a client professionally. The practical knowledge I have learned helped me become aware of assessing and assisting a client. As a nurse, our job is to provide “safe, compassionate, competent and ethical care” (p.8) and collaborate as an interprofessional team to deliver safe care and prevent risks from happening while offering quality nursing care (CNA, 2017). I will always provide the professional care under the code of ethics to promote health and wellness for an older adult and prevent risks from happening. As well as following the plan of care, use communication strategies, be aware, acknowledge, and accommodate individuals with different diseases such as with dementia, to promote fall prevention strategies (RNAO, 2017).
Introduction: This assignment will explore the Roper, Logan and Tierney model used in first clinical placement and will explain how it helped to guide nurses to focus on the fundamentals of patient care. Patient dignity is upheld by using this model following the principles outlined in the Code of Professional Conduct and Ethics for Registered Nurses and Midwives as will be discussed. An outline of the philosophical claims of the nursing model that guides practice on the unit for first clinical placement.
This program, called the Nijmegen Falls Prevention Program, included one hundred thirteen elderly clients with a history of falls. Exercise sessions were held twice a week for five weeks with fall monitoring done before and after the experiment. Control assessments were also done continuously thru the study to determine client changes in standing balance, balance confidence, and obstacle avoidance skills. The results of the Nijmegen Falls Prevention Program showed that the number of falls within the exercise group dropped by a significant forty six percent! Not only less falls, but obstacle avoidance skills dramatically improved as did balance
Many influences even though the historical or contemporary that is important to shape the profession of nursing. The Health Practitioners Competence Assurance Act 2003 [HPCA] and Nursing Council of New Zealand Code of Conduct for Nurses 2012 [COC] underpin the nursing practice, in order to promote the nursing profession. Professional boundaries play an important role in nursing. This essay will identify and discuss how the historical influence which is Florence Nightingale and the contemporary influence that is education has shaped the profession of nursing, the purpose and impact of the HPCA and COC on nursing, how they are implemented in the workplace and also define and explain the importance of the professional boundaries in nursing. One
According to Clement (2012), a nursing audit can be defined as a detailed review and evaluation of selected clinical records by qualified professional personnel for evaluating quality of nursing care. There are different types of nursing audits to choose from. A nursing management audit, which is a structured audit that concentrates on the administrative aspect of nurses responsibilities. A retrospective audit which
Self-Regulation and the New Registered Nurse Introduction self-regulation is Understanding self-regulation is an important In this paper, self-regulation in relation to nursing practice and quality assurance will be explored. Self-regulation of RN Practice As with many other professions, registered nursing is a self-regulated profession. The purpose of regulation is to ensure that professionals practice in a safe, competent and ethical manner (CNO, 2014, pp. 3).
• Assessment: Nurses often feel uninformed when changes are made. Not being made aware of important changes can affect patient care. • Nursing Diagnosis: Communication breakdown due to ineffective delivery of new changes related to patient care. • Goal setting: Implement an education book that is placed near the nurse 's station and nurses are responsible to read the changes and sign off when they have read it. • Evaluation: Nurses are better informed and are up to date with new
I will also discuss on how this clinical situation could be done differently. Clinical scenario I was posted to a medical ward in National University Hospital for my clinical posting. There is a particular cubicle allocated for patients with very high risk of fall called the “Green eye cubicle “. Patients in that cubicle are usually confused or not compliant to fall precaution.