Today, much attention is paid to the improvement of care that patients receive in hospitals and nursing homes. Millions of older people under 65 years fall each year, and the Centers for Disease Control and Prevention (2017) predicts seven fall death every hour by 2030 if no effective interventions are offered. Therefore, fall management and prevention turn out to be critical topics for discussions and initiatives. The role of nurses in fall prediction cannot be ignored because of the existing harmful consequences on administrative work (King et al., 2018). The fall prevention quality improvement initiative will be developed in terms of its purposes, target population, benefits, implementation, budget, and evaluation to predict fall prevalence among older adults in nursing homes.
The integral goal of the fall prevention initiative is to improve the quality of services that nurses could offer to older patients. Despite the intention to predict falls in care facilities, many residents report serious fall-related consequences and question safety concerns in nursing homes. Within the chosen context, quality improvement includes the analysis of falls and the implementation of strategies to reduce the number of fall accidents. Cameron et al. (2018) recommend the combination of several interventions as a part of the same program, including physical exercises, vitamin D supplementation, and the creation of a safe environment. The latter on the list is based on assistive technologies like chair alarms and low beds (Cameron et al., 2018). Therefore, the purpose of the quality improvement initiative is to enhance knowledge and equipment for nursing home patients and the staff.
The audience for this initiative includes two groups of people. On the one hand, nurses should be interested in the development of high-quality services for people. According to King (2018), nurses usually experience increased pressure to meet the goal of “zero falls”. However, it is not always possible to protect all patients, and depression or other negative emotional outcomes like blame or shame are observed (King et al., 2018). On the other hand, seniors and their families expect to use safe and highly technological equipment. Fall prevention touches upon every patient, and it is not enough to offer protective means and support but to educate how to use the offered equipment (alarms, rails, and light).
Due to its educational and organizational nature, the chosen initiative is beneficial for nurses and seniors in several ways. First, it is necessary to increase the number of supportive tools for residents. Falls may be caused by the impossibility of seniors to walk or lay safely. As soon as the number of beds and chairs with safety alarms or stairs with two-sided railing is increased, fall risks can be decreased. Second, when patients are able to move and rely on technical support, nurses could pay more attention to patients’ health problems, conditions, and personal needs. The level of responsibility for falls is lowered, as well as the cases of burnout.
The success of the program considerably depends on how well different aspects of fall prevention are identified and discussed. Interprofessional collaboration plays an important role in fall prevention because when several people are involved in a process, it is easy to analyze data, observe the improvements or shortages, and give recommendations. Cameron et al. (2018) indicate the participation of such health professionals as nutrition coordinators, physiotherapists, and nurses. In this initiative, it is expected to enlarge a cooperation team and invite a therapist to evaluate the general condition of patients and a dietician to discuss food and medication intake. In addition, a professional coach should choose physical activities for patients. Several registered nurses educate and assist seniors, as well as gather patients’ histories of falls. Finally, it is possible to invite patients’ families to promote emotional support and communication.
Nursing home modifications should begin with adding rails to all the stairs, the approximate price of which is about $20-40per bar. At this moment, 20 bars are required, which costs $400-800. The price of bed rails for the elderly is between $50-70, and it is possible to equip at least 20 beds in a nursing home, which costs $1000-1400. Finally, partial participation of health professionals (a therapist, a dietician, a trainer, and a nurse) requires an increase in salary up to $100 each per month. In general, during the first year of the implementation of the program, $2000 are necessary for equipment, and $4800 – to stabilize salaries.
The evaluation of the quality improvement program is based on the analysis of fall ratings before and after the implementation. A registered nurse studies the current cases of falls in a facility and compares the results each month. Although the quality of health does not directly depend on fall frequency, fall-related injuries and health complications must be reduced, and this difference should serve as a critical element.
In general, the prediction of falls is one of the integral purposes of many healthcare facilities. It is not enough to create safe environments and make nurses observe their patients all the time. The implementation of the fall prevention intervention is characterized by quality improvement in terms of nursing services that seniors obtain in nursing homes. In case the number of falls is reduced within the next year after the implementation, it is possible to consider the offered idea successful.
Cameron, I. D., Dyer, S. M., Panagoda, C. E., Murray, G. R., Hill, K. D., Cumming, R. G., & Kerse, N. (2018). Interventions for preventing falls in older people in care facilities and hospitals. Cochrane Database of Systematic Reviews, 2018(9). Web.
The Centers for Disease Control and Prevention. (2017). Older adult fall prevention. Web.
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. Web.