The Prevention of Accidental Falls in The Elderly Discussion

Part 1: Problem Identification and Description

1. Identifying and Describing the Problem   

In the instance of this project, a need for quality improvement was discovered (Melnyk & Fineout-Overholt, 2019). The high rate of patient falls among the elderly patient group was noted as a need that needed to be addressed. This was discovered to be particularly prevalent in skilled nursing institutions set up for the rehabilitation of elderly people away from their homes. The number of elderly adults seeking skilled nursing care at aged care facilities has been increasing due to a rapidly aging population and longer lifespans ascribed to improved healthcare (Guirguis-Blake et al., 2018). However, due to age-related declines in physical functionality, this group of older adults is more susceptible to unintentional falls. The Prevention of Accidental Falls in The Elderly Discussion

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The danger of client falls in this patient population is also worsened by the reality that it is also this very patient population demographic that primarily experiences multiple already existing long-term health-related and psychological illnesses such as heart disease, diabetes, hypertension, and Alzheimer’s disease amongst others. For example, if an elderly patient rises abruptly from their bed without assistance, heart disease raises the risk of hypotension (AHRQ, 2018). In the elderly diabetic, the possibility of hypoglycemia is a continuous risk for unintentional falls because elderly individuals are not constantly watched and are forced by circumstances to leave their beds only when essential and with help.

The aforementioned patient group is susceptible to gait abnormalities due to chronic musculoskeletal conditions like osteoarthritis, which also limits their range of motion and puts them at risk for falling. Obviously, elderly patients in these residential nursing homes will not be aware of the peril that they are placing themselves in when they abruptly leave their beds with no assistance because of the existence of neurocognitive conditions like Alzheimer’s disease.  The Prevention of Accidental Falls in The Elderly Discussion

The PICOT Question

The PICOT question in this case is as follows:

Among the elderly patients in residential care facilities for rehabilitation (P), does performing hourly nursing rounds, using bed alarms, and training staff on fall risk assessment (I) compared to current practice (C) significantly reduce accidental patient falls (O) within a period of 12 months (T)?

Table

The PICOT elements for the prevention of accidental falls in the elderly

1. Problem Statement, Background, and Target Population

According to Kenny et al. (2017), the majority of reported incidents of physical injuries among elderly patients are caused by unintentional falls, which can be avoided if the appropriate preventive measures are put in place. However, the costs of falls in the elderly population go beyond just bodily harm. These unintentional accidents also cause fatalities. In reality, it has been noted that accidents involving falls account for the majority of injury-related deaths in older adults over the age of 65 in the US (Heng et al., 2020). All of these details demonstrate the pressing need of tackling this problem because it endangers the wellbeing of elderly patients and degrades the standard of care provided to this patient group.    Falls inevitably result in readmission in the future, which is a crucial quality indicator for healthcare organizations. The Centers for Disease Control Prevention (CDC) estimates that the annual expense of treating the effects of unintentional patients is roughly USD 68 billion. Therefore, when a patient falls, both the patient and the care facility suffer losses in terms of bodily harm or death as well as expense or costs. The community of skilled care nurses working in skilled nursing rehabilitation centers for elderly people is the focus of this clinical inquiry and the interventions that will be determined through clinical inquiry. Nurses who work in assisted living facilities and skilled nursing facilities to rehab elderly patients are expected to be quick, competent, perceptive, proactive, and aware of their environments.  The Prevention of Accidental Falls in The Elderly Discussion

The skilled care nursing facility for the rehabilitation of older people serves as the setting for the measures taken. In essence, these are residential aged care centers that look after elderly patients recovering from surgery, injuries, or other types of therapy. The reality that the patients being cared for are not only frail from old age but also sickly from chronic conditions makes it clear that this is a challenging environment.

• Significance of the Project
• It will reduce morbidity and mortality in nursing homes and rehabilitation facilities.
• It will reduce hospitalization costs and mortality.
• It will improve patient satisfaction scores.
• It will also improve job satisfaction and morale among the nurses working at rehabilitation centers for the elderly. The Prevention of Accidental Falls in The Elderly Discussion

References

Agency for Healthcare Research and Quality [AHRQ] (2018). Preventing falls in hospitals. https://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/index.html

Guirguis-Blake, J., Michael, Y., Perdue, L., Coppola, E., & Beil, T. (2018). Interventions to prevent falls in older adults. JAMA, 319(16), 1705. https://doi.org/10.1001/jama.2017.21962

Heng, H., Jazayeri, D., Shaw, L., Kiegaldie, D., Hill, A-M., & Morris, M.E. (2020). Hospital falls prevention with patient education: A scoping review. BMC geriatrics, 20(140), 1-12. https://doi.org/10.1186/s12877-020-01515-w

Kenny, R., Romero-Ortuno, R., & Kumar, P. (2017). Falls in older adults. Medicine, 45(1), 28-33. https://doi.org/10.1016/j.mpmed.2016.10.007

Melnyk, B.M., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare: A guide to best practice, 4^th ed. Wolters Kluwer. The Prevention of Accidental Falls in The Elderly Discussion