Fall Prevention Self-management Among Older Adults Essay

n this assignment, students will pull together the capstone project change proposal components they have been working on throughout the course to create a proposal inclusive of sections for each content focus area in the course. For this project, the student will apply evidence-based research steps and processes required as the foundation to address a clinically oriented problem or issue in future practice. Develop a 1,250-1,500 written project that includes the following information as it applies to the problem, issue, suggestion, initiative, or educational need profiled in the capstone change proposal: Background Clinical problem statement. Purpose of the change proposal in relation to providing patient care in the changing health care system. PICOT question. Literature search strategy employed. Evaluation of the literature. Applicable change or nursing theory utilized. Proposed implementation plan with outcome measures. Fall Prevention Self-management Among Older Adults Essay.Discussion of how evidence-based practice was used in creating the intervention plan. Plan for evaluating the proposed nursing intervention. Identification of potential barriers to plan implementation, and a discussion of how these could be overcome. Appendix section, if tables, graphs, surveys, educational materials, etc. are created. Review the feedback from your instructor on the Topic 3 assignment, PICOT Question Paper, and Topic 6 assignment, Literature Review. Use this feedback to make appropriate revisions to these before submitting. Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required. This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support articles for assistance. Benchmark Information This benchmark assignment assesses the following programmatic competencies: RN to BSN 1.1: Exemplify professionalism in diverse health care settings. 2.2: Comprehend nursing concepts and health theories. 3.2: Implement patient care decisions based on evidence-based practice.

Background

Among the elderly population above 65 years, falls have continuously become the key mortality and morbidity causes.  Approximately 30-40% of elderly inpatients above this age have at least one reported case (Vandenberg et al., 2017). More often than not, falls result to moderate to severe injuries, death, lost independence, fear of falling, disabilities, mental problems among other consequences. One third of elderly patients die from falls with an estimated global annual death of about 646,000 people. Falls are associated with the events leading to coming to rest on the ground inadvertently and they disproportionately alter the quality of lives of the elderly. Falls risks usually increase with age probably because of vision problems, immune system weaknesses and lifestyle changes associated with advanced age (Burns, Haddad & Parker, 2018). Moreover, men are considered to be at higher risks of falling compared to women even though the difference is not scientifically clear. However, the activities of gender engagement could be a relevant factor in this occurrence. Fall Prevention Self-management Among Older Adults Essay.

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Clinical problem statement

The clinical problem addressed in this paper is falls and the complication of falls in older adult in an acute healthcare facility. As identified above, falls are a devastating burden in the healthcare system. They present physical, social and economic burden to individuals, healthcare facilities and the community as a whole. For instance, they cause injuries which increase the healthcare needs of an individual. Still on this, they increase the cost of care and result in long hospital stays which present a toll on the healthcare resources and their distribution. On the other hand, physical effects occur with regard to injuries and disabilities which in turn lead to dependency (Schnock, Howard, Dykes, 2018). The quality of life is also affected causing feelings of worthlessness and decreased self-esteem as well as image problems. This can also be mentally draining leading to psychological problems.

Purpose of the change proposal in relation to providing patient care in the changing health care system

This change proposal seeks to provide fall prevention strategy to promote the prevention of falls and reduce the falls risks and their complications. The purpose is to provide self-management interdisciplinary interventions effective in decreasing falls in older adult patient in acute medical care unit. The recommended fall interventions include teaching on call light and getting return demonstration on call light use, placement of call bells within the patient’s reach, ensuring that the personal belongings of the patient are within their reach. Other strategies include ensuring the lights are on at night, making sure that the beds brakes are locked together with the wheels of the wheelchair, ensuring patients have well-fitting and nonslip footwear on, the floor and surfaces as well as care areas are free of clutter and dry as well as placement of bed at lowest position (Guirguis-Blake et al., 2018). In addition, interdisciplinary involvement and smooth adjustment of the patient to the new environment facilitates fall prevention. Of the above adjustments, a multidisciplinary approach that is self- managed is recommended as the most effective intervention for fall prevention in the acute patient care facility.

PICOT question

Among inpatient older adults in acute medical care unit (P), does the use of an interdisciplinary intervention, self- management intervention (I) compared to no intervention (C) decrease the rate of falls (O) over one month (T)?

Literature search strategy employed

Literature review involved the search of multiple databases for data relevant to the topic of interest. The search strategy involved the use of key words, phrases and terms that facilitated the return of the most required findings. The review started with the development of a search question which identified the clinical problem and the effective interventions to mitigate and resolve the problem in an evidence-based manner. For more understanding of the topic, the main points were brainstormed to create an overview of what sources and data type was required. Fall Prevention Self-management Among Older Adults Essay. The Boolean operators were also employed to limit the search to the most relevant sources essential in answering the PICOT question. These operator tools were “OR”, “NOT”, “AND” and “AND NOT” and they acted as conjunctions of the words, phrases and terms in the search. Synonyms were also used to facilitate the search and also reduce the time spent in obtaining the results. The databases used to obtain the sources include PubMed, PubMed and CINAHL whereby a wide range of articles were returned. The search was then narrowed down to 8 articles using the range of 5 years to ensure that they related to the current healthcare environment.

Evaluation of the literature

Most of the research articles used for this proposal are primary sources which makes it more reliable. Moreover, the sources are within a range of 5 years dating back from 2016 to 2020. This ensures that the obtained data is current, reliable and relevant to the contemporary nursing setting as well as firsthand obtained directly from the field. The literature is also limited to the research question and hence is relevant to answering the PICOT. In addition, the literature sources used in this research are based on critical theoretical frameworks essential in the development of a relevant project that supports the presence of a clinical problem and informs the process of resolution.

Applicable change or nursing theory utilized.

The Rogers’ Change Theory is used in this project as a theoretical framework to inform the literature and support the development of the proposed change. The theory was selected because of its effectiveness in the application of fall interventions and risk prevention. The Rogers Change Theory is based on four elements which include time, communication channels, social systems and culture. These elements assist in the adoption of new practices, ideas and objects and hence makes organizational change processes more efficient and successful. As such, this theory will be important in communicating the proposed project to the organization, stakeholders while still informing the planning process through timeline development (Fleig et al., 2016). Consequently, it will be useful in convincing the organization and the staff that the proposed change is worthwhile and will help in significantly reducing fall rates and preventing the occurrence of falls in acute care units.

Proposed implementation plan with outcome measures

The proposed project seeks introduce an interdisciplinary self-management intervention with the aim of reducing the rate of falls in the acute older inpatient care setting. This intervention will entail the provision and improvement of self-management skills among patients in order to manage their safety, security and balance to prevent falling. The plan will start by identifying the key causes of falls in the acute care unit among the elderly patients and design an effective strategy to address the problem in the interdisciplinary self-management program. The intervention will then be communicated to the administration for consideration and approval followed by education and training for the nursing staff and the patients on self-management skills that prevent falls (Titler et al., 2016). Evaluation of the proposed intervention will be done by measuring the rate of falls that occurred before the implementation of the project and after one month of adoption. The difference between the two rates will demonstrate the relevance of the project to the healthcare facility and among the elderly population in the acute care units. Fall Prevention Self-management Among Older Adults Essay.

Discussion of how evidence-based practice was used in creating the intervention plan

The creation of the intervention plan was informed by evidence-based practice. Multiple literature material was explored from various nursing databases to ensure that the plan was in line with the past primary research studies conducted in the acute care settings. More so, the research was current and often provided first hand information which is essential in obtaining relevant and reliable evidence from recent practices. Interprofessional and interdisciplinary collaboration was incorporated during the creation of the implementation teams to ensure that all essential aspects of the nursing practice were considered (Schnock, Howard & Dykes, 2019). This promoted informed decision-making and supported the use of evidence-based practice.

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Plan for evaluating the proposed nursing intervention

The plan for the proposed nursing intervention will be evaluated to determine its success. This will be totally dependent on the objectives of the project as well as the outcomes. In this case, the goal of the proposal is to reduce the rate of falls in the elderly inpatient acute care unit within one month of implementation of an interdisciplinary self-management fall prevention intervention. On the other hand, the outcomes of the proposal are expected reduced rates of falls. As such, evaluation will entail determine the outcomes and measuring them against the results obtained after one month.

Identification of potential barriers to plan implementation, and a discussion of how these could be overcome

The potential barriers to the implementation of the plan include lack of financial resources. This will pose a challenge in obtaining the necessary resources critical in adopting the intervention. The lack of funds to compensate the teams involved in the implementation and also to train the nurses and the patients will challenge the implementation of the plan. Another potential barrier is resistance from the staff members as well as the patients. This can be frustrating particularly in the event that they have not been clearly enlightened about the proposed change and the kind of effects its projected to have on them and the facility. Lastly, the health literacy of the patients is a notable potential barrier to implementation (Rimland et al. 2017). This describes the capacity by which the patients will obtain, synthesize and understand the basic services and information on health.

These barriers can be overcome through the development of particular measures. For instance, the financial burden can be resolved through seeking for funds from sponsors and donors. The organization can also support the project from the surplus budget. Notably, resistance can be prevented by informing the staff of the proposed change and its impacts as well as convincing them of its value in the healthcare sector. Health literacy can be reduced by creating awareness to the patients and ensuring that they clearly understand the importance of the implementation and how it is destined to improving their security, safety and well-being in the hospital.  Fall Prevention Self-management Among Older Adults Essay.On resistance and health literacy, creation of awareness and engagement in decision-making will also resolve the problem.

References

Burns, E. R., Haddad, Y. K., & Parker, E. M. (2018). Primary care providers’ discussion of fall prevention approaches with their older adult patients—DocStyles, 2014. Preventive medicine reports, 9, 149-152. Retrieved from https://www.sciencedirect.com/science/article/pii/S2211335518300160

Fleig, L., McAllister, M. M., Chen, P., Iverson, J., Milne, K., McKay, H. A., … & Ashe, M. C. (2016). Health behaviour change theory meets falls prevention: feasibility of a habit-based balance and strength exercise intervention for older adults. Psychology of Sport and Exercise, 22, 114-122. Retrieved from https://doi.org/10.1016/j.psychsport.2015.07.002

Guirguis-Blake, J. M., Michael, Y. L., Perdue, L. A., Coppola, E. L., & Beil, T. L. (2018). Interventions to prevent falls in older adults: updated evidence report and systematic review for the US Preventive Services Task Force. Jama, 319(16), 1705-1716. Fall Prevention Self-management Among Older Adults Essay.

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. Retrieved from  https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0197457217300393

Rimland, J. M., Abraha, I., Dell’Aquila, G., Cruz-Jentoft, A., Soiza, R. L., Gudmundsson, A., … & Cherubini, A. (2017). Non-pharmacological interventions to prevent falls in older patients: Clinical practice recommendations–the SENATOR ONTOP Series. European Geriatric Medicine, 8(5-6), 413-418. Retrieved from https://www.sciencedirect.com/science/article/pii/S1878764917301328?casa_token=T4rk3-gc7IUAAAAA:_2sXOm_7Yo9E5UCh4hQKQZjCPN1gx35HQW6DNJYlw1r7m-kQv5TzyEJ1ovkd_JAdP7ZJELTyRKkw

Schnock, K. O., Howard, E. P., & Dykes, P. C. (2019). Fall prevention self-management among older adults: a systematic review. American journal of preventive medicine, 56(5), 747-755. Retrieved from https://www-sciencedirect-com.lopes.idm.oclc.org/science/article/pii/S0749379718324310

Titler, M. G., Conlon, P., Reynolds, M. A., Ripley, R., Tsodikov, A., Wilson, D. S., & Montie, M. (2016). The effect of a translating research into practice intervention to promote use of evidence-based fall prevention interventions in hospitalized adults: A prospective pre–post implementation study in the US. Applied nursing research, 31, 52-59. Retrieved from https://pubmed.ncbi.nlm.nih.gov/27397819/

Vandenberg, A. E., van Beijnum, B. J., Overdevest, V. G., Capezuti, E., & Johnson II, T. M. (2017). US and Dutch nurse experiences with fall prevention technology within nursing home environment and workflow: A qualitative study. Geriatric nursing, 38(4), 276-282. Retrieved from https://www-sciencedirect com.lopes.idm.oclc.org/science/article/pii/S0197457216302397 . Fall Prevention Self-management Among Older Adults Essay.