Background- The people over the age of 65 are more vulnerable to falls owing to reduced mental abilities and increased chronic illness. Susceptible health conditions will increase the focus of nurses to improve patient safety and quality of care. The report aims to develop an implementation plan for patient safety by imparting clinical practices by nurses. Moreover, the role of theoretical and practical knowledge and its importance in shaping nursing practice to ensure patient safety has been discussed. Education plays an essential role in achieving nursing profession goals by combining organizational and workforce interest. The nurses must be proficient in clinical practice skills to prevent fall in patients who are vulnerable.
The growing age is directly related to fall in critically ill patients who can lead to physical fractures, brain injuries, and even death (William, 2019). In hospital settings, sinking and slipping are two main reasons behind the increased number of patient fall. Moreover, patients with loss of balance reduced mental ability, chronic illness, and under excessive medications, are more vulnerable to fall incidents. In this case, nurses are required to incorporate essential interventions for reducing fall cases and to improve patient safety (Travalgia et al., 2014). Every nursing professional must be aware of the severe impacts of falling incidents among critically ill patients and must know the associated procedures to tackle such critical situations effectively (William, 2019). Many doctors have specified the role of education and training for the adoption of new fall prevention strategies which helps to solve the issues of fall. The aim of this report is to develop an implementation plan which can help the nurses and other healthcare professionals in dealing with the issue of increased fall in healthcare settings.
People over the age of 65 are more vulnerable to falls owing to reduced mental abilities and chronic illness. It is the leading cause of death among elder population if it is not recognized and escalated timely. In Australia, the number of fall patients in 2017 reaches to about 832 per 100,000 people. With the increasing number of older people, fall incidences are likely to increase and most of the falls are linked to reduced psychological abilities and chronic disease which results in loss of self-confidence, and self-efficacy among older people (Corlett et al., 2014). The limited knowledge about risk factors, adequate measures and timely escalations are certain reasons for increased falls in healthcare settings and hence the knowledge of fall prevention among healthcare workers is essential for improved care and safety. The rising number of falls remains under noticed and the nursing practitioner knowledge regarding fall prevention interventions is an essential part of their everyday practice (Bailey et al., 2014). The senior nurses must arrange training and presentations to improve the practical skills of the nurses; however, the practical implementation of fall prevention strategies is a crucial part of the manager's profession and must be done for patient’s safety (Bailey et al., 2014).
The effective handling of any issue in critical clinical environment is directly proportional to patient wellness and improved quality of life and the nurses are required to be well adapted with this environment to prevent subsequent number of falls (Corlett et al., 2014). The theoretical information provided in the institutions may not be sufficient for nurses to improve the patient outcomes in healthcare settings and may require additional training to work in clinical environment for better care of the patients. It can help to improve research skills, critical thinking, effective communication, and critical decision-making skills for quality care and prevention of falls (Lee et al., 2014). Every nursing professional must be aware of the ill effects of falling in patients and must know the procedures to tackle such critical situations. Nurses must be aware of the environmental factors like low light, high beds, slippers and uneven floor surfaces which adds in the number of falls and must adopt various strategies that aim to reduce the number of falls in old age people (Lee et al., 2014). The nurses must have knowledge about effective teamwork and timely recognition and escalation interventions to decrease fall incidents in healthcare.
A lack of practical knowledge related to fall prevention and associated psychological stress creates a barrier for effective care and safety in older people. The interventions involving evidence-based knowledge and practice always demands cognitive and behavioral changes to uphold the effects of the associated interventions (Machado et al., 2014). Moreover, the exchange of evidence-based knowledge between the senior and junior nurses will prove helpful for reducing falls in patients and this approach will effectively link the theoretical knowledge with the clinical practice (Machado et al., 2014). It means the senior registered nurses should initiate training sessions followed by one on one session to upgrade both the theoretical and practical knowledge in nurses for improved patient outcomes.
For successful implementation of any intervention, it is very important that the intervention is implemented according to a well-structured plan for minimum hurdles and effective utilization of existing resources of the organization (Uzarski & Broome, 2019). This also helps in ensuring minimum expenditure and maximization o patient outputs to achieve organizational goals. Education is an essential component in the nursing profession to achieve the target of patient safety and care but there must an adequate plan to provide this education to nursing professionals. For the implementation of above-mentioned knowledge sharing intervention first of all the NUM or senior nursing professionals are required to take approval from the management and must accumulate all the resources required in the process of knowledge transfer. This includes funds, human resources, projectors, infrastructure and others.
After approval from management, the NUM/ senior staff must effectively communicate the goals related to fall prevention. This will include gathering all the nurses and sharing knowledge on risk factors, causes and intervention for fall prevention. The process of sharing knowledge starts from the traditional teaching practice and the quantity of theoretical knowledge determines the student knowledge accumulation. The NUM must arrange a meeting for this purpose and PowerPoint presentation can be used for this purpose where the knowledge on various topics can be shared with the staff nurses which can be followed by one-to-one sessions.
After that, the understanding of the nurses about the concepts of falls and fall prevention can be assessed by the senior nursing professionals through questionnaires and on the basis of the current theoretical knowledge level of the nurses, the process of practical knowledge provision must be started. The practical knowledge pays more attention to skill education which shows the reflection of actual working abilities (Tinetti &Kumar,2014). The practitioners providing practical knowledge should possess the capabilities of rethinking, evaluating, and sensing (Tinetti &Kumar, 2014). The use of simulation techniques regarding falls prevention strategies like use of checklists, patient cognitive assessment, flooring, slippers, bed railings, and others can be used to improve the technical skills among nurses for handling critical fall incidents in real-world clinical environments (Lee et al.,2014). Simulation techniques help the nurses to learn in safe environment similar to critical clinical situations under supervision of senior staff members without the fear of making medical errors and patient deterioration (Wolfgram & Leary, 2014). This will help to learn the ways to manage the falls incidents and reduction of fall induced injuries among older patients.
The nurses must possess good communication and behavioral skills to create a strong therapeutic relationship and comfortable environment so the patient can share their needs and priorities, helping to prevent falls (Handley & Dodge, 2015). For this purpose, the roleplays can be used by the nurses where a group of nurses can act the role of health professional and patients to learn how to communicate with fragile and critically ill patients and how to address their issues for better prevention of fall incidents. The teamwork and collaboration practice in role-plays will improve the communication skills and confidence among nurses which will encourage for implementing interventions for fall management in healthcare settings (Handley & Dodge, 2015). This will be followed by implementation of strategies in hospital and assessment of outcomes by NUM, senior staff members of patients.
Increased falls increases the burden on the patient and healthcare systems nurses are required to be well acquainted for handling such critical situations. Patient falls need to be identified and escalated using simple interventions to achieve patient safety and care. The training and education can be implemented in healthcare settings for developing theoretical and practical knowledge among nurses for better prevention of fall incident. This will improve the proficiency of nurses to reduce falls and benefiting the patients and their family members through safe and quality care.
Corlett, J., Palfreyman, J., Staines, H., Marr, H. (2014). Factors influencing theoretical knowledge and practical skill acquisition in student nurses: An empirical experiment. Nurse Education Today, 23(9), 1-14.
Handley, R., & Dodge, N. (2015). Can simulated practice learning improve clinical competence? The British Journal of Nursing, 22(9), 529-535
Lee, A., Wei, L., &Khang, P. (2014). Preventing falls in the geriatric population. The Permanente Journal. 17(4), 37–39.
Machado, J.P., Veiga, E.V., Ferreira, P.A., Martins, J.C., Daniel, A.C., Oliveira, S., &Silva, P.C. (2014). Theoretical and practical knowledge of nursing professionals on indirect blood pressure measurement at a coronary care unit. Einstein (Sao Paulo), 12(3),330-335.
Tinetti, M.E., &Kumar, C. (2014). The patient who falls: “It’s always a trade-off. JAMA.303(3), 258–66.
Travalgia, J.F., Debono, D., Spigelman, A.D., &Braitwait, J.(2014).Clinical governance: A review of key concepts in the literature. Clinical Governance, an International Journal, 16(1).62-77.
Uzarski, D., & Broome, M. E. (2019). A leadership framework for implementation of an organization's strategic plan. Journal of Professional Nursing, 35(1), 12-17.
Williams, H.(2019). Preventing falls in older Australians. Retrieved from https://healthtimes.com.au/hub/aged-care/2/practice/hw/preventing-falls-in-older-australians/4462/
Wolfgram, L. J. B., & Leary, Q. A. (2014). Integrating simulation innovatively: Evidence in teaching in nursing education. Clinical Simulation in Nursing, 8(5), 169-175.
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