Fall prevention in older adults is considered a serious concern, and special programs are needed to assist such patients. This paper will propose a fall prevention program designed for the University of Miami Health System, South Florida, the inpatient healthcare organization that integrates research and patient care. The program titled Keep Your Balance will target such interventions as increasing awareness of falls, exercising, and other practical solutions.
Program Proposal
The program will be instituted through studying the evidence-based resources and selecting the most appropriate interventions. The paramount goals of the identified program are to help older adult patients to learn to maintain their balance and build a strong understanding of how they may contribute to addressing falls. The first intervention will be derived from a matter of balance (MOB) program that focused on reducing the fear of falls in patients using cognitive-behavioral strategies (Haynes, League, & Neault, 2015).
Since this intervention allows improving fall management in the hospital settings, its use seems to be effective for Keep Your Balance. The second intervention should encourage older adults to appropriately increase their overall activity to strengthen their muscles and tendons (Haynes et al., 2015). This will be achieved by individually set activity goals that are to be discussed by a particular patient and his or her care provider.
Training to nurses should be targeted as the third intervention that should be preliminary to all previously stated issues. It is critical to make sure that personnel realizes the risks and needs of patients and acts accordingly. Singh and Okeke (2016) state that the systematic nurse training allowed reducing the rate of inpatient falls from 18.19±3.46 to 13.36 in one year (p. 7). The educational sessions should be directed towards learning about risk factors and applying risk assessment models that are most pertinent to a specific patient.
For example, the multifactorial falls risk assessment (FRA) may be identified as the key tool, and several supplemental techniques should also be used if required. The next stage of this intervention should be based on educating patients regarding self-care and self-efficiency.
The fourth intervention is expected to implement innovative technology benefits by introducing exergaming training for fragile older adult patients. The goal of this strategy is to engage patients and make their experiences more exciting. Nintendo’s Wii Fit equipment should be used to provide the opportunity to stand on the balance board and strengthen one’s vestibular system. Fu, Gao, Tung, Tsang, and Kwan (2015) report that such an approach allowed significantly improving health outcomes compared to convention exercising.
The last intervention will be associated with group exercising sessions based on yoga or/and tai chi (Nick, Petramfar, Ghodsbin, Keshavarzi, & Jahanbin, 2016). These lessons provided twice a week are likely not only to enhance the physical level of patients but also lead to psychosocial benefits such as deep relaxation and emotional body control. The results received by the mentioned authors show that the intervention that lasted for two years the great potential for yoga in older adults.
The training list will include sessions for nurses to prepare them with relevant knowledge and strategies to recognize fragility signs in older adults and provide all the identified interventions. To initiate and keep the project working, some items will be needed: yoga kits, Nintendo’s Wii Fit equipment, and written and digital materials on falls. In addition, patients should be explained that they will need special clothes for physical exercises. The marketing plan should be developed to reach the target population and attract the attention of national and global funds that may support the program implementation. It should be emphasized that all the interventions are evidence-based, and they will be useful in combination for older adults.
Speaking of the cost of the Keep Your Balance program, it is important to estimate the budget that will be required from the identified care facility. First, the hospital should allocate $50, 000 for nurse training and another $80,000 for purchasing the equipment. Additional costs should be planned for developing the details of the program and marketing plan – approximately $20, 000. Ultimately, the evaluation of the program results will be required to determine its effectiveness based on the change in patient outcomes. Thus, the total estimated costs for the proposed program are $150, 000.
Conclusion
The initial rollout should be performed during the meeting with the facility administration to present the key idea of Keep Your Balance. During this first meeting, the benefits to the institution should be discussed, such as the reduced number of older adult falls and associated costs as well as the work on the prevention of falls in the future. In other words, the key expected outcome will be the enhanced awareness of both nurses and patients on fall prevention through the increased overall activity, technology implementation, yoga, and cognitive-behavioral therapy. It is possible to anticipate that the administration will be interested in this program due to its great potential to prevent health problems rather than treat them at additional costs.
References
Fu, A. S., Gao, K. L., Tung, A. K., Tsang, W. W., & Kwan, M. M. (2015). Effectiveness of exergaming training in reducing risk and incidence of falls in frail older adults with a history of falls. Archives of Physical Medicine and Rehabilitation, 96(12), 2096-2102.
Haynes, M., League, P., & Neault, G. (2015). A matter of balance: Older adults taking control of falls by building confidence. Frontiers in Public Health, 2(274), 1-2.
Nick, N., Petramfar, P., Ghodsbin, F., Keshavarzi, S., & Jahanbin, I. (2016). The effect of yoga on balance and fear of falling in older adults. PM&R, 8(2), 145-151.
Singh, I., & Okeke, J. (2016). Reducing inpatient falls in a 100% single room elderly care environment: Evaluation of the impact of a systematic nurse training programme on falls risk assessment (FRA). BMJ Open Quality, 5(1), 1-9.