The challenge of addressing the issue of falls among older patients is attributed to multiple reasons for their occurrence, ranging from the limited education of patients to the absence of materials for preventing them. In the proposed intervention plan, five different solutions will be implemented to reduce the number of falls in a nursing home. The first intervention is educational to ensure the provision of knowledge among individuals at risk as well as determine the outcome measures of the number of individuals that are aware of existing prevention programs (Ott, 2018). The intervention will include handing out educational leaflets to the patients of the nursing home, followed by three educational sessions of fifteen to thirty minutes on risk factors of falls and the ways to prevent them. A short knowledge test will be conducted after the final educational session.
The second intervention will be concerned with the provision of exercise training to the population of the nursing home. According to the findings of Sherrington et al. (2017), exercise as a single interventional method can prevent falls in community-dwelling settings for older patients. Exercises targeted at improving balance, gait, and muscle strengthening. Programs that challenge balance and that of a higher dose have more significant effects compared to other exercise-based interventions. The strategy is proposed because of its significance to not only fall reduction but also for the improvement of the general strength and well-being of older individuals.
The third proposed intervention is the provision of non-slip surfaces and products that can prevent the occurrence of falls within the facility. Non-slip socks can represent one of the key tools to help prevent falls on slippery surfaces. However, there is limited evidence in the research literature to support their use in hospitals. This calls for the implementation of the strategy in practice in order to determine its effectiveness while also addressing the challenges such as the potential to spread infection (Hartung & Lalonde, 2017). In addition, an evaluation of the footwear that patients at the nursing home wear is necessary to determine the need for their change.
The fourth intervention proposed to reduce the occurrence of falls at the nursing home concerns the review of patients’ medications with their doctors and pharmacists. It is important to ensure that the prescribed medications do not cause drowsiness and dizziness, which can lead to falls among the elderly. Supplements may also be prescribed in separate instances to improve the bone strength of the patients. While the intervention cannot be applied to all patients, it can be of benefit to those with particular vitamin deficiencies or those taking medications with side effects that increase the risks of falls.
The final intervention proposed to implement at the facility is expected to include nursing home improvements in terms of the environment and amenities. For example, if the staircase is slippery, it is essential to install non-slip mats and ensure that the banisters have enough grip for patients to support themselves when using the staircase. Light improvement is also necessary to ensure that the facility is well-lit so that patients do not trip and fall. This is also associated with the assessment of patients’ eyesight to ensure that poor vision does not contribute to the occurrence of falls at the nursing home.
To implement the list of interventions mentioned above, it is necessary to integrate training for the personnel. Nurses at the nursing home should improve their awareness of the challenges associated with the prevention of falls. The practitioners should be educated on the individual peculiarities of each patient and their risks of falling, processes involved in the prevention of their occurrence, as well as teamwork targeted at the enhancement of the process of care at the facility. It is also vital to educate nurses on the psychological implications of falls among older patients for them to foster the environment of advocacy and understanding how patients can struggle with the outcomes of falls.
Since an educational intervention will be implemented to make patients more confident in improving their own health, nurses should also be trained to administered education to their patients. Patient-centered care represents the critical strategy for training personnel because of the need to target the specific needs of each individual in terms of fall prevention. Nurses will be taught how to implement a fall risk assessment and engage their patients in the process of self-care. Those patients at the highest risk of falling will gain the most attention from the personnel to ensure their security and well-being at the facility.
Several items are necessary to initiate the program and maintain its implementation at the facility. First, it is essential to provide the patients with educational materials that include informational pamphlets, visual materials such as videos, signs to warn patients of the potentially dangerous areas where falls are more likely to take place. Second, remote patient monitoring should be implemented to help the staff monitor the patients at risk of falling without having to be in patients’ rooms around the clock (Cournan, Fusco-Gessick, & Wright, 2018). The use of modern technologies in fall prevention is vital because it will boost patient engagement as well as make it more convenient for nurses to ‘keep an eye on their patients. Virtual patient observation (VPO) represents a technology that enables comprehensive real-time communication and notifications with staff and patients, reliable video monitoring for the implementation of quick and precise health decisions, seamless data integration across different clinical systems, as well as centralized solutions for video monitoring. Although costly, VPO will provide the facility with actionable data on quality control, remote monitoring solutions, as well as endless capabilities for care.
The facility is expected to spend up to $5000 on the implementation of the program because VPO is a costly solution. However, it is possible to implement the proposed interventions without the VPO initially to reduce the high cost. Without the solution, the program can cost up to $2000, which is a significant cost reduction. The expenses will be targeted at the improvement of the environment at the facility, the dissemination of educational materials, as well as the administration of training of personnel.
The developed intervention is targeted at reducing the occurrence of falls among the elderly population at a nursing home by addressing the problem from multiple perspectives. Since the problem is multi-dimensional and involves several risk factors, it is essential to ensure that it is viewed from several points. The key benefit of the proposed system of interventions is ensuring that the patients possess enough knowledge of fall prevention and can be more proactive in administering self-care procedures. In addition, the project is expected to improve the confidence of nurses in preventing the occurrence of falls. The following is the breakdown of the most notable goals of the program:
- Educate patients on the risks of fall occurrence;
- Improve the environment at a healthcare facility to reduce the number of potentially risky situations that lead to falls;
- Facilitate self-care practices among patients;
- Strengthen the physical health of patients through exercising and vitamin supplementation where appropriate;
- Invest in technologies (when necessary) to enhance the capabilities of nurses to monitor patients at risk and prevent the occurrence of falls.
Senior fall prevention should be a serious topic for consideration within health care facilities as well as seniors who receive care at them (Kwan & Straus, 2014). Because of the adverse implications of falls and the need to address its consequences, such as fractures, long-term pain and bruising, intracranial bleedings, hematomas, and many others are requiring immediate hospitalization. It is imperative to consider the developed set of interventions in the context of a nursing home and evaluate its effectiveness after implementation. Critical success factors of the program will include the reduction of falls at the facility after the implementation of the intervention at the nursing home, the increased knowledge of both nurses and their patients in terms of fall prevention, as well as improved environments at the facility that prevent the occurrence of falls. The outcomes of the interventions will be evaluated three months after their implementation, with appropriate adjustments made as a result of the evaluation.
References
Cournan, M., Fusco-Gessick, B., & Wright, L. (2018). Improving patient safety through video monitoring. Rehabilitation Nursing, 43(2), 111-115.
Hartung, B., & Lalonde, M. (2017). The use of non-slip socks to prevent falls among hospitalized older adults: A literature review. Geriatric Nursing, 38(5), 412-416.
Kwan, E., & Straus, S. E. (2014). Assessment and management of falls in older people. CMAJ: Canadian Medical Association Journal, 186(16), E610-E621.
Ott L. D. (2018). The impact of implementing a fall prevention educational session for community-dwelling physical therapy patients. Nursing Open, 5(4), 567-574.
Sherrington, C., Michaleff, Z., Fairhall, N., Paul, S., Tiedemann, A., Whitney, J., … Lord, S. (2017). Exercise to prevent falls in older adults: An updated systematic review and meta-analysis. Journal of Sports Medicine, 51, 1750-1758.