Improvement Tool Kit Discussion Paper

This paper will discuss the implementation of an improvement tool kit for the prevention of patient falls to enhance patient safety in the emergency department and other healthcare settings. Four different categories of the tool kit have been organized to present detailed safety information. They include quality best practices and general organization safety, self-led preventive measures, environmental safety and quality risk, and best practices for environmental safety improvement and reporting issues concerning safety. Three articles will be used for each section hereafter Improvement Tool Kit Discussion Paper.

Don't use plagiarized sources. Get Your Custom Essay on

Just from $12/Page

Order Essay

PLACE YOUR ORDER HERE NOW

Best Quality and General organization Safety

Tricco, A. C., Thomas, S. M., Veroniki, A. A., Hamid, J. S., Cogo, E., Strifler, L., Khan, P. A., Sibley, K. M., Robson, R., MacDonald, H., Riva, J. J., Thavorn, K., Wilson, C., Holroyd-Leduc, J., Kerr, G. D., Feldman, F., Majumdar, S. R., Jaglal, S. B., Hui, W., & Straus, S. E. (2019). Quality improvement strategies to prevent falls in older adults: a systematic review and network meta-analysis. Age and Ageing, 48(3), 337–346. https://doi.org/10.1093/ageing/afy219

This article is a systemic review and network meta-analysis (NMA). The article aimed to assess the effectiveness of various quality improvement (QI) strategies used in healthcare to reduce patient falls and related risks. Papers were searched from different sources, including MEDLINE, EMBASE, Angeline, Cochrane, and Central Region of control trial were used to identify papers that met the inclusion criteria. A total of 126 randomized control trial articles representing 84,307 patients were used for review and NMA.

This article elucidated the importance of the multifaceted use of various QI strategies to reduce patient falls. The QI strategies examined were classified into either; patient strategies, healthcare providers` strategies, and strategies target health system. Patient-oriented strategies included patient education, patient reminders, promotion of self-management, and motivational interviews (Tricco et al., 2019). On the other hand, strategies targeting healthcare works included staff education, clinician reminders, team change, case management, continuous QI, and auditing and feedback. Lastly, financial incentives were classified as health system strategies. The effectiveness of these QI initiatives was compared to usual care.

Upon comparing patient outcomes and patient falls, the study concluded that using the aforementioned QI strategies was superior to usual care in preventing falls. For instance, the risk of injurious falls was reduced by implementing team changes, while the risk of falls was reduced by combining patient reminders, case management, and staff education. Therefore, the use of multiple QI strategies can be implemented in various stages of patient care to prevent falls.

Nurses and other healthcare providers should assess the various QI strategies described in this review. Depending on preference and resource availability, the most feasible QI strategies can be combined and used to improve patient safety. In addition, nurses should emulate teamwork with other healthcare providers and patients during care to prevent falls (Tricco et al., 2019)Improvement Tool Kit Discussion Paper. Fortunately, reduction of patient falls will improve patient outcomes. Such include reducing hospital stays, reducing emergency visits, preventing fractures, and improving patients’ quality of life.

Wang, L., Zhang, L., Roe, E., Decker, S., Howard, G., Luth, A., Marks, K., & Whitman, B. (2022). The perceived knowledge of fall prevention in nurses working in acute care hospitals in China and the United States. Journal of Patient Safety, 18(2), e580–e584. https://doi.org/10.1097/PTS.0000000000000873

This article presents a cross-sectional study that investigated the perceived knowledge of fall prevention among nurses working in the United States and China. The study assessed the knowledge of 1442 nurses from China and 260 from the US, about 17 items included in the risk assessment tool for evaluating patients. Four hospitals, two from each country, were involved with medico-surgical units, and pediatric units were given priority. Hypothetically, informed nurses about patient falls are likely to employ their expertise to provide the holistic care required for patient care Improvement Tool Kit Discussion Paper.

As evident from the study, nurses from countries had a high perception of knowledge about patient prevention. Therefore, they undertook preventive measures, including patient education, case management, clinician reminders, and staff education to prevent falls. However, most of them were less familiar with some critical issues which were not commonly included in fall risk tools. They included assessment of vision, balance, and activity, medications, cognitive changes, vestibular dysfunction, vertigo, and foot problems. Consequently, failure to grasp knowledge about the aforementioned components could potentially predispose most patients to falls with poor clinical outcomes. Therefore, nurses must perform a complete assessment on every patient.

Fall risk tools, like other fall preventive measures, are vital for every nurse and other health care providers. Having adequate knowledge as well as the importance of various parameters in this tool is essential in classifying patients and prioritizing management. For instance, identifying high-risk populations will prompt the application of a myriad of expertise to provide care and prevent patients from falling (Wang et al., 2022)Improvement Tool Kit Discussion Paper. As a result, nurses should take the initiative of familiarizing themselves with various parameters of the fall risk tool and educating other healthcare providers about its usefulness. Healthcare providers can share knowledge through conferences, practical sessions, and small group discussions. This will help in improving knowledge and improve patient safety. As a result, patient outcomes are increased while there is a reduced cost of care.

Turner, K., Staggs, V., Potter, C., Cramer, E., Shorr, R., & Mion, L. C. (2020). Fall prevention implementation strategies in use at 60 United States hospitals: a descriptive study. BMJ Quality & Safety, 29(12), 1000–1007. https://doi.org/10.1136/bmjqs-2019-010642

This is a descriptive study conducted in 60 hospitals in the United States. The study aimed at identifying and describing the prevalence of implementation of specific fall prevention strategies in US hospitals. These strategies were proposed by the United States Organizations, including the Agency of Healthcare Research and Quality and the Joint Commission to prevent patient falls. The recommended strategies include the formation of interdisciplinary falls committees, leadership support, staff and patient education, and the use of electronic health record tools.

Every strategy addressed special concerns aimed at preventing patient falls. For instance, leadership support is required in formulating policies, updating policies, and rewarding staff for their outstanding performance in preventing falls. In addition, interdisciplinary falls committees are tasked with the duty of identifying fall risks, reporting falls, identifying common causes of falls, and conducting post-fall analysis. This helps address modifiable risks, assess the prevalence of falls, and helping in coming up with improvement strategies aimed at reducing future incidences of falls. Staff and patient education comprise the aspects of identifying risks and addressing them (Turner et al., 2020). For instance, education improves knowledge among patients and nurses. As a result, staff members will likely implement preventive strategies such as close monitoring and improving communication with patients. Likewise, patients will heed the instructions provided, thus helping prevent falls and their related consequences. Finally, electronic health record (EHR) tools are paramount in providing reminders and warnings. For instance, EHR tools can provide medication warnings for high-risk patients as well as remind clinicians about interventions they ought to carry out in specific patients. This helps in reducing risks while improving patient safety.

Conversely, applying these strategies varies depending on the feasibility and availability of resources. From the study, all centers used patient education and orientation to prevent falls (Turner et al., 2020)Improvement Tool Kit Discussion Paper. This was followed closely by updating fall policies and interdisciplinary falls committees. Staff education, rewarding staffs, and use of EHR were the least used strategies. Lack of resources and feasibility limited the use of EHR tools and rewards, while negligence limited staff education. Regrettably, failure to incorporate all strategies could increase incidences of preventable falls.

Nurses can advocate for the implementation of the aforementioned fall prevention strategies. For instance, they can participate in updating policies, be part of interdisciplinary committees, educate patients, educate other staff members, and advocate for the use of EHR tools in preventing falls. Furthermore, they should incorporate interdisciplinary teamwork and effective communication to enhance holistic care and improve outcomes. By doing so, all aspects of patient care, including primary, secondary, and tertiary care, will be incorporated at an affordable cost to ensure the best possible outcomes.

Self-led Preventive Measures.

Twibell, K. R., Siela, D., Delaney, L., Avila, P., Spradlin, A. M., & Coers, G. (2020). Perspectives of inpatients with cancer on engagement in fall prevention. Oncology Nursing Forum, 47(4), 457–468. https://doi.org/10.1188/20.ONF.457-468

In this article, a descriptive exploratory approach with qualitative data collection using interviews was used to conduct a study among 30 patients in cancer units in the Midwestern academic health system, United States. The primary aim was to assess the perspective of cancer patient involvement in fall prevention strategies and improve knowledge on designs to reduce falls. In addition, the secondary aim compared the fall-related perspective among patients who had sustained falls verse those who hadn’t. Improvement Tool Kit Discussion Paper

Evaluating patients’ perspectives on fall prevention plans is a vital aspect of the intervention. For instance, patients with a positive perspective on fall prevention will likely take positive steps to prevent falls. Such include communicating appropriately with nurses and relatives to offer support when going to the bathroom. Comparatively, patients with a negative perspective are likely not to wait for help. Besides, despite perspective being a critical factor in undertaking preventive measures, nursing activity and quality of care offered predominate patient decisions. For instance, patients will likely engage or wait for assistance from compassionate, trustworthy, time-conscious nurses who have developed a positive relationship. Engaging nurses reduce incidences of falls. On the contrary, poor communication, the need for privacy, and negligence in nursing practice hinder engagement between patients and nurses. As a result, some patients may choose against calling for help, disengage from fall prevention plans, and end up walking without support. This increases the risk of falls while limiting patient safety.

The need to improve patient safety requires the intervention of nurses and other healthcare providers. However, nurses are pivot as they spend the most time with patients while providing care and monitoring their progress. Therefore, nurses can foster the engagement of patients in fall prevention plans through improved communication, listening to patient concerns, responding appropriately, involving patients in assessing their fall risk and identifying high-risk populations. This will enhance trust and interpersonal relationships, reduce the need for bedside bells and improve goodwill among nurses and patients, making patients adhere to fall prevention plans. Furthermore, organizations should ensure that more nurses are employed to ensure an appropriate patient-to-nurse ratio. This will reduce burnout among nurses while improving care and patient outcomes.

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., Ergai, A., Lindros, M. E., Lipsitz, S. R., Scanlan, M., Shaykevich, S., & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: A nonrandomized controlled trial: A nonrandomized controlled trial. JAMA Network Open, 3(11), e2025889. https://doi.org/10.1001/jamanetworkopen.2020.25889

This article is about a non-randomized control trial conducted in 14 medical units in Boston and New York City. The study assessed the effectiveness of engaging patients and families when using a fall-prevention tool kit could result in a reduction of falls and injuries related to falls (Dykes et al., 2020)Improvement Tool Kit Discussion Paper. Nurses used a 3-step fall-prevention process to reduce falls. To begin with, nurses displayed a laminated fall TIPS poster at the patient’s bedside. Then a color-coded clinical support system was used to link Morse Fall Scale (MFS) risk factors to determine the specific interventions to be provided. The poster was updated and erased daily from the day of admission to suit factors. Thereafter, the MFS was used to identify specific risk factors for every patient. A chart showing the risk factors and fall- prevention plan was generated and displayed at the bedside. Patients and family members were engaged in the process through education and effective communication. Finally, patients and families were reviewed using the displayed charts from admission throughout their stay and in every shift.

The act of identifying patient factors, displaying charts, and involving patients and family members led to reduced incidence of falls and injuries from falls. For instance, nurses use patient risk factors to plan for care. Furthermore, nurses continuously communicated with patients, family members, and other healthcare workers, leading to an adjustment of care. As a result, the relationship between patient nurses improved, thus improving care.

Likewise, nurses in other healthcare set-ups can implement the improvement tool kit while engaging patients. Engagement of patients in safety practices enhances their satisfaction and experience, and makes them feel valued in care (Dykes et al., 2020)Improvement Tool Kit Discussion Paper. Furthermore, the patient-nurse relationship is improved remarkably, which strengthens the falls prevention tool kit. As a result, they are likely to carry out interventional actions prescribed by nurses. Nonetheless, the patient understands their roles and are likely to perfect in meeting expectations. In addition, nurses should engage patients in continuous education about risk factors and EBP interventions that aid in improving patient outcomes. Finally, incorporating a fall-prevention tool kit helps bridge the gap in knowledge concerning the assessment of fall risk, improving knowledge on interventions, and enhancing the active engagement of patients in care to prevent falls.

Barker, A., Cameron, P., Flicker, L., Arendts, G., Brand, C., Etherton-Beer, C., Forbes, A., Haines, T., Hill, A.-M., Hunter, P., Lowthian, J., Nyman, S. R., Redfern, J., Smit, D. V., Waldron, N., Boyle, E., MacDonald, E., Ayton, D., Morello, R., & Hill, K. (2019). Evaluation of RESPOND, a patient-centered program to prevent falls in older people presenting to the emergency department with a fall: A randomized controlled trial. PLoS Medicine, 16(5), e1002807. https://doi.org/10.1371/journal.pmed.1002807

This is a randomized control trial study carried out in Australia. The study investigated the effects of a 6-month telephone-based patient-centered program-RESPOND-on reducing patient falls as a primary outcome. The secondary outcome assessed the rate of hospital admissions, fractures, emergency visit presentation, falls efficacy, quality of life, and death. A total of 430 patients aged between 60-90 years were recruited into the study; 213 were in the control group, and 217 were in the intervention group.

The intervention group benefited from the RESPOND program, while the control group received the usual care. Activities in the RESPOND group included 6 months of education on the telephone, coaching, goal setting, assessment of home-based risks, offering support for management of risk factors, and linkage of patients to available services (Barker et al., 2019)Improvement Tool Kit Discussion Paper. These activities required the active engagement of both patients and healthcare providers. Unlike healthcare providers required for education, coaching, and offering timely interventions, patients, on the other hand, were required to follow the instructions, communicate routinely, and address their concerns. As a result, a positive relationship was established, making patients feel motivated to participate in the interventions. Consequently, there was a reported reduction in patient falls among the intervention group compared to the control group. Furthermore, fractures were reduced among the intervention group. Conversely, there was no significant difference in hospitalization, quality of life, and fall efficacy. Therefore, optimization of patient outcomes implementation of more strategies.

ORDER HERE NOW

The aspect of offering patient-centered care is a cornerstone in improving safety. Nonetheless, nurses acquire specialized training that enables them to interact with patients, build positive relationships with patients, and offer holistic care (Barker et al., 2019). Making constant calls to patients, educating, coaching, and goal setting are some of the few methods used in building a relationship while improving patient safety. Therefore, whenever possible, nurses should actively engage patients in their care while responding to concerns raised by patients. In addition, nurses can also use a patient-centered when following up on patients with chronic conditions in remote settings. This helps in improving compliance and improving patient outcomes.

Environmental Safety and Quality Risk

Pop, H., Lamb, K., Livesay, S., Altman, P., Sanchez, A., & Nora, M. E. (2020)Improvement Tool Kit Discussion Paper. Tailoring a comprehensive bundled intervention for ED fall prevention. Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association, 46(2), 225-232.e3. https://doi.org/10.1016/j.jen.2019.11.010

This article provides information about the comprehensive prevention bundle applied in the emergency department. The prevention bundles contain multifactorial issues aimed at improving patient safety. They include safe ambulation, fall risk assessment, staff communication, safe toileting, patient education, and early warning (Pop et al., 2020). Implementing these practices with the integration of screening tools can help in improving patient safety.

To begin with, fall risk assessment is a primary role of every healthcare provider who comes into contact with a patient. Specific risks of falls, including environmental, medication, and patient factors, should be assessed. The important environmental risk includes slippery floor, inadequate spacing, poor lighting, and inadequate nurses to provide. On the other hand, patient risk factors include advanced age, orthostatic hypotension, incontinence, cognitive impairment, previous history of falls, weakness, gait disturbances, and instability (Pop et al., 2020)Improvement Tool Kit Discussion Paper. Nevertheless, while assessing patients, nurses should identify patient-related risk factors and classify patients. The high-risk patients should receive patient-centered care while prioritized during care. Furthermore, patients’ medications should be reviewed to determine medications that are likely to increase the risk of falls. Such medications should either be removed from the treatment sheet or dosages adjusted while patients remain informed about the decisions made. The role of patient education and staff education cannot be overemphasized. They are routine activities that have proved effective in preventing falls.

In addition, implementing safe ambulation and safe toileting are integral parts of reducing patient falls. This is because most falls occur either from sitting or standing position, moving into or out of toilets and latrines or when waking up or getting out of bed. Therefore, nurses should identify these postures and take responsibility for improving patient safety. Routine communication and close monitoring can help nurses identify patients who need help. Such patients are either assisted when ambulating or trained on how to use walking aids. Besides, nurses should also train patients about safe toileting. This will help reduce anxiety, which can increase the likelihood of falls, especially when incontinence is an issue.

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case-control study. International Journal of Health Policy and Management, 8(5), 300–306. https://doi.org/10.15171/ijhpm.2019.11

This article addresses the risk factors for falls. A prospective nested case-control study was done in an educational university hospital in Tehran for nine months. A comparison of risk factors for falls was made between the intervention group and the control group. Specific data was collected from the patients. This included demographics, clinical conditions, type of medications, admission details, comorbidities, and a detailed narrative of events before and after falls. The data was collected from various sources, including the hospital information system, clinical records, observations, error reporting system, and from conducting interviews with patients, family members, and care providers. The data was used to compare the common risk factors for falls.

Multi-level analysis was used to analyze the data and derive some findings. Various factors ranging from the patient to medication through environmental factors were associated with an increased risk of falls. According to this study, risk factors for falls included long hospitalization, use of medications such as chemotherapy, anticonvulsants, sedatives, benzodiazepines, and angiotensin-converting enzyme inhibitors, manual transfer aid, gait disturbances, urinary incontinence, reduced vision, and cancer (Najafpour et al., 2019)Improvement Tool Kit Discussion Paper. In addition, other factors such as polypharmacy, previous history of falls, stroke, and nurse-to-patient ratio were contributory to falls. Therefore, it is evident that the risks for patient falls are multifactorial, combining both patient-related and medication-related.

From this study, it is evident that nurses can play a role in preventing patient falls. First, nurses should perform a complete patient assessment through a detailed history and physical examination. Nurses can identify various risk factors by reviewing their past medical history, medication history, and other underlying conditions such as cancer, hypertension, and visual impairment (Najafpour et al., 2019). In addition, polypharmacy should be ruled out in every patient primarily because having multiple drugs could potentially lead to adverse events such as orthostatic hypotension, dizziness, disturbances in balance, and reduction of visual acuity, which increase the risk of falls. In the case of chronic conditions, nurses should work with other caregivers to ensure patient optimization through control of diabetes, vision improvement, regular toilet programs, and modification of treatments. This will help in increasing safety while reducing incidences of falls. Improvement Tool Kit Discussion Paper

Stoeckle, A., Iseler, J. I., Havey, R., & Aebersold, C. (2019). Catching quality before it falls: Preventing falls and injuries in the adult emergency department. Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association, 45(3), 257–264. https://doi.org/10.1016/j.jen.2018.08.001

This article presents a systematic review of a quality improvement project designed to reduce patient falls in the emergency unit. The project contains evidence-based interventions aimed at reducing falls and injuries in patients admitted for acute care. Various resources included PubMed, Journal Storage, Cochrane Database of Systematic Reviews, and Cumulative Index for Nursing. In addition, a 19-month fall risk report from a specific emergency department was collected.

The resources proposed EBP interventions that could be used to prevent falls. They include patient education hand out, nursing education sessions, and identification of signs of high-risk patients. Surprisingly, the implementation of the interventions above proved to be effective in preventing falls. There were zero falls in the post-intervention period. However, adequate knowledge and skills for the application of the improvement project are essential in its progress.

Likewise, nurses working in the emergency department can emulate the use of patient education, handouts, and screening for risk factors when assessing patients. Routine education and handouts improve patient knowledge about risk factors and interventions (Stoeckle et al., 2019)Improvement Tool Kit Discussion Paper. As a result, patients are likely to follow the guidelines, which help in preventing patient falls. On the other hand, using a fall risk assessment tool is essential in identifying potential risk factors that could increase the risk of falls. It also allows nurses and other caregivers to make adjustments tailored toward optimizing patient outcomes. As a result, every caregiver should have basic knowledge and skills to perform a complete assessment of patients. Finally, patient engagement in care improves relationship that fosters a positive environment for patient care. Therefore, patients should be involved in every step of care aimed at improving patient satisfaction, motivation, and interest in their well-being.

Best Practices for Environmental Safety Improvement and Reporting Issues Concerning Safety

Xia, L., Zheng, Y., Lin, Z., Chen, P., Mei, K., Zhao, J., Liu, Y., Song, B., Gao, H., Sun, C., Yang, H., Wang, Y., Song, K., Yang, Y., Luan, X., Wen, X., Yin, X., Fu, A., Cai, Y., … Gu, Z. (2022). The gap between risk factors and prevention strategies? A nationwide survey of fall prevention among medical and surgical patients. Journal of Advanced Nursing. https://doi.org/10.1111/jan.15177

This paper addresses the finding of an online survey carried out in 662 hospitals in China. The aim was to determine the gap in reporting falls risk factors among nurses and implementing preventive measures for surgical and medical patients. One among many evidenced practices to prevent falls is identifying risk factors. Thereafter, strategies are implemented to address risk factors and prevent falls.

Various risk factors can be classified as either patient-related or environmental factors. Quality of lighting, floors, space, and nursing initiatives are considered environmental. On the other hand, patient factors include medication, balance, orthostatic hypotension, continence, cognitive impairment, and footwear (Xia et al., 2022)Improvement Tool Kit Discussion Paper. All these factors must be addressed in n effort to prevent patient falls.

From this study, the participating nurses showed variables in their reporting. Most nurses provided a report on assessing mobility and strength, balance, and orthostatic hypotension as significant risk factors for falls. Up to half of the nurses reported issues with continence and footwear as potential causes of falls. Furthermore, the combination of interventions deemed assessment of vertigo, dizziness, and management of postural hypotension as effective means of preventing falls. Nonetheless, assessment of cognitive impairment was the least reported risk factor. Therefore, there were evident inconsistencies when reporting risk factors for patient falls. These inconsistencies may predispose some patients to falls leading to poor outcomes.

Based on the findings from the study, it is prudent that nurses and other healthcare providers follow the best practice guidelines developed by various hospitals on patient fall prevention. Improvement of knowledge about these guidelines can be enhanced through reading evidence-based articles, active participation in patient care, learning from others, continuing medical education, and interprofessional collaboration (Xia et al., 2022)Improvement Tool Kit Discussion Paper. This can help in bridging the gap in risk assessment while improving patient care through care coordinated themes. Furthermore, nurses should be at the forefront of protecting patients by educating other staff on fall risk factors. Special patient concerns should be reported and help in prioritizing care. Thereafter, nurses should use EBP knowledge while integrating interprofessional teamwork to provide holistic care that addresses the identified risk factors. As a result, patient safety will be enhanced with improved patient outcomes.

Tucker, S., Sheikholeslami, D., Farrington, M., Picone, D., Johnson, J., Matthews, G., Evans, R., Gould, R., Bohlken, D., Comried, L., Petrulevich, K., Perkhounkova, E., & Cullen, L. (2019). Patient, nurse, and organizational factors that influence evidence-based fall prevention for hospitalized oncology patients: An exploratory study. Worldviews on Evidence-Based Nursing, 16(2), 111–120. https://doi.org/10.1111/wvn.12353

This article addresses the findings of a descriptive study design carried out in four oncology units. The study aimed at identifying factors that influence sustainable and effective fall prevention strategies at different levels. Furthermore, variables to amenable targeted interventions were identified. Both patient, nursing staff, and organizational factors were considered in the study. Thirty-nine patients answered the questionnaires, while 70 nursing staff completed a demographic form standardized instruments to complete the study. Notably, the applicability of various factors was guided by the guidelines of the Comprehensive Framework for Implementation Research (CFIR)Improvement Tool Kit Discussion Paper.

CFIR guidelines address both nursing, patient, and organizational factors for fall prevention. According to this guideline, the patient should be informed about their fall risk factors and take initiatives to reduce falls. Such risks include advanced age, poor eyesight, disturbances in balance, and orthostatic hypotension, among others. On the other hand, nurses are tasked with identifying risks and formulating interventions to mitigate the risks. Adequate knowledge and skills are paramount to enhance the understanding of risks and help in coming up with appropriate EBP interventions to improve patient safety. Furthermore, nurses can emulate teamwork and communicate effectively with other disciplines as well as patients and family members about risks and possible interventions. On the other hand, organizational factors integrate both patient and nursing factors to improve the environment that enhances patient safety.

The findings from the study concurred with other studies performed in other centers. For instance, despite two-thirds of patients sustaining falls in the past, they did not consider themselves at risk of falling again. This depicted a lack of knowledge among this group of patients. In addition, there were knowledge gaps among nursing staff concerning risk factors and the appropriate interventions. Finally, there was weakness in interdisciplinary communication regarding patient risks between colleagues, patients, and their families.

Nurses, therefore, can improve patient safety by using the CRIF guidelines. They can take part by engaging patients and other healthcare care workers in fall risk assessment and management. This can be achieved through developing clear and routine communication among patients, team members, and the organization’s leadership. As a result, there will be an improvement in engagement between interested parties leading to the channeling of resources required to sustain programs on patient falls prevention. Furthermore, CRIF guidelines can be integrated with other newer initiatives to help in reducing falls.

Choi, Y., Staley, B., Henriksen, C., Xu, D., Lipori, G., Brumback, B., & Winterstein, A. G. (2018). A dynamic risk model for inpatient falls. American Journal of Health-System Pharmacy: AJHP: Official Journal of the American Society of Health-System Pharmacists, 75(17), 1293–1303. https://doi.org/10.2146/ajhp180013 Improvement Tool Kit Discussion Paper

This is a retrospective cohort study done in two hospitals. The aim was to assess the effectiveness of using a fall risk prediction model specific to patients receiving fall risk-increasing drugs (FRID) compared to the use of the Morse Fall Scale (MFS). Patients were followed through obtaining data from the EHR of the hospital over 22 months.

Various medications were considered in the study as potential FRID. However, the most common causes of falls were oxycodone, hydromorphone, and morphine, as captured by the risk prediction model. Despite being strong analgesics required for moderate to severe pain, these medications are associated with several side effects. They can cause depression of the central nervous system and respiration hence increasing the risk of hypoxia, dizziness, and confusion. This phenomenon increases the risk of falls. Therefore, nurses should be wary of patients taking such medications as they require close monitoring. In addition, their doses should be titrated, and dose adjustment should be prioritized. Because high doses not only lead to life-threatening side effects but can also lead to addiction which can be difficult to control.

Nurses can use the FRID risk prediction model in addition to their clinical expertise when managing patients. This model will supplement their work and enable them to identify high-risk patients. This will enable them to do close monitoring, adjust medications, educate patients, and develop appropriate care plans. In addition, nurses should work closely with pharmacists and physicians when caring for patients. This will ensure the exchange of ideas and skills to increase patient care and improve patient safety Improvement Tool Kit Discussion Paper.

References

Pop, H., Lamb, K., Livesay, S., Altman, P., Sanchez, A., & Nora, M. E. (2020). Tailoring a comprehensive bundled intervention for ED fall prevention. Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association, 46(2), 225-232.e3. https://doi.org/10.1016/j.jen.2019.11.010

PLACE YOUR ORDER HERE NOW

ORDER HERE NOW

ORDER NOW