What are specific geriatric risk factors that create an increase in fall risks? What can be done from a health promotion standpoint to decrease falls in the elderly? Define fall risk and what types of assessments are available in the outpatient and inpatient settings.
Tag: fall prevention
Fall Prevention
Mrs. L is an 89-year-old widow who lives independently in her home. She drives, and she is an avid quilter. Her daughter lives within 2 miles and checks in daily with Mrs, L. by phone or in person. Mrs. L has been admitted to your hospital with the diagnosis of WO pneumonia. Her past medical problems include the following: • Bilateral hip replacements • Detached retina x 2 (right eye) • Osteoarthritis • Depression • ❑rthostatic hypotension • Falls at home x 1 • Urinary frequency • Insomnia (sleeps about 3 hours per night) Mrs. L takes no medication, “not even an aspirin.” Mrs. L uses her call button frequently to request assistance to the bathroom. Upon rounding, her nurse found Mrs. L on the floor, having crawled out of her bed with the side rails up. She was assessed and was found to have no injuries. Her gown was wet with urine. When asked to describe what happened, Mrs. L stated the following: “I called for help to the bathroom and no one came. So rather than wetting the bed, I managed to crawl over the side rails. I slipped on the floor trying to get to the bathroom.”
I. What are Mrs. L’s known risk factors (in the hospital) for falling?
• Environmental • Medical conditions • Unsafe behaviors
2. Using the Hendrich II Fall Risk Model flutos.fihien orwsitecAlefaulidilec0022- I I illenthiro 0401111%.20Fall%?0Risl.%211Motki ndf). (htips.uconsult • Cli ore3rytgenera)-assessment issut43.pdt). determine Mrs. L’s fall risk
3. Mts. L states she is “plagued by insomnia.” Using the Pittsburgh Sleep Quality Index (httoswwww (maw cony u oloadvdricuments/PV/1 mg). measure Mrs. L’s quality and patients of sleep. Could Mrs. l.’s sleeping patient contribute to her risk for falls? What actions will you take based on your analysis?
4. Mrs. L is asked to complete the “Clock Drawing” portion of the Mini-Cog (buoy/mini-
1011 , •I ‘ I 1 I 1’r b..• • taut • • e,i I
She draws the clock showing 3 PM. Iler drawing is missing the numbers 3.4. and S. One clock hand is pointing at 9 and the other is pointing at 12. For the “Three Word Recall” portion. Mrs. L remembers two words. What is her Mini-Cog score?
Fall Prevention
Mrs. L is an 89-year-old widow who lives independently in her home. She drives, and she is an avid quilter. Her daughter lives within 2 miles and checks in daily with Mrs, L. by phone or in person. Mrs. L has been admitted to your hospital with the diagnosis of WO pneumonia. Her past medical problems include the following: • Bilateral hip replacements • Detached retina x 2 (right eye) • Osteoarthritis • Depression • ❑rthostatic hypotension • Falls at home x 1 • Urinary frequency • Insomnia (sleeps about 3 hours per night) Mrs. L takes no medication, “not even an aspirin.” Mrs. L uses her call button frequently to request assistance to the bathroom. Upon rounding, her nurse found Mrs. L on the floor, having crawled out of her bed with the side rails up. She was assessed and was found to have no injuries. Her gown was wet with urine. When asked to describe what happened, Mrs. L stated the following: “I called for help to the bathroom and no one came. So rather than wetting the bed, I managed to crawl over the side rails. I slipped on the floor trying to get to the bathroom.”
I. What are Mrs. L’s known risk factors (in the hospital) for falling?
• Environmental • Medical conditions • Unsafe behaviors
2. Using the Hendrich II Fall Risk Model flutos.fihien orwsitecAlefaulidilec0022- I I illenthiro 0401111%.20Fall%?0Risl.%211Motki ndf). (htips.uconsult • Cli ore3rytgenera)-assessment issut43.pdt). determine Mrs. L’s fall risk
3. Mts. L states she is “plagued by insomnia.” Using the Pittsburgh Sleep Quality Index (httoswwww (maw cony u oloadvdricuments/PV/1 mg). measure Mrs. L’s quality and patients of sleep. Could Mrs. l.’s sleeping patient contribute to her risk for falls? What actions will you take based on your analysis?
4. Mrs. L is asked to complete the “Clock Drawing” portion of the Mini-Cog (buoy/mini-
1011 , •I ‘ I 1 I 1’r b..• • taut • • e,i I
She draws the clock showing 3 PM. Iler drawing is missing the numbers 3.4. and S. One clock hand is pointing at 9 and the other is pointing at 12. For the “Three Word Recall” portion. Mrs. L remembers two words. What is her Mini-Cog score?
FALL PREVENTION
Students will be provided the opportunity to apply the knowledge and skills acquired during their semester to a specific problem or issue.
They will be encouraged to think critically and creatively about professional issues and to develop further leadership skills necessary to address and help solve these issues while developing the skills necessary to implement “small tests of change” in a clinical setting.
Students will also be allowed the opportunity to refine research skills and demonstrate their proficiency in oral communication skills; evaluate best evidence in
support of nursing practice and the generation of new knowledge; integrate an evidence-based practice model in designing a plan of care to ensure optimal client outcomes; demonstrate their achievement of the at West Coast University their ability to extend and refine this knowledge and skill in the realization of their personal and professional goals.
Analyze Evidence-Based Practice Presentation
1. Identify a practice issue which resulted in negative patient outcomes
a. Concept exploration: What is the nature of the clinical problem? How is it defined?
b. Is the issue clinically significant and why? The literature review should support this.
c. Is the issue a priority and why?
a. Identify processes that helped to identify this clinical problem. Examples:
• Shift-to-shift report
• Nurse/student partnership
• Unit-based clinical practice committee discussion
2. Create a case-study to illustrate the problem
3. Develop a PICO question
a. Population of interest
b. Intervention of interest
c. Comparison of interest
d. Outcome of interest
4.Complete a literature review including a critical appraisal and evaluation of the evidence as it related to the chosen topic (This should include no less than three (3), evidence-based practice articles from a peer-reviewed journal). Utilize the following format to discuss the findings:
Title/Year/Author(s) Study Question/Problem Sample Population Study Design Study Findings Conclusions/Implications for Nursing Practice
5 Locate and discuss an evidence-based guideline or practice protocol related to the topic and the identified population (Suggested databases include the Agency for Healthcare Research and Quality or Best Practice Guidelines)
6 In support of the guideline, select one scholarly article that corroborates the evidence-based guideline/protocol chosen. This article must be from a peer-reviewed, scholarly journal, not more than 5 years old. One article from the literature review may be utilized. Textbooks may not be utilized.
7 Critique the selected article utilizing the table below. Discuss the findings associated with the article by reviewing the discussion and implications/recommendations for practice and summary assessment as they relate to the case study. Describe how these findings will support the small test of change (Do NOT summarize the content of the article).
Discussion • Are all major findings interpreted and discussed?
• Are the interpretations consistent with the results and with the study’s limitations?
• Does the report address the issue of the generalizability of the findings?
Implications/Recommendations • Do the researchers discuss the implications of the study for clinical practice or further research-and are those implications reasonable and complete?
Summary Assessment • Despite any identified limitations, do the study findings appear to be valid-is there confidence in the truth-value of the results?
• Does the study contribute any meaningful evidence that can be used in the nursing practice or that is useful to the nursing discipline?
8. Analyze two of the most pertinent QSEN competencies as they relate to the case study and describe how they relate to the practice issue
9.Select evidence based practice model
a. Discuss why the selection of this EBP model is most appropriate to the practice issue identified. Examples of selected models:
• Johns Hopkins Model (2005)
• Rosswurm and Larrabee Model (1999)
• Stetler Model (2001)
• Iowa Model (Titler, 2001)
10. Utilizing the Institute for Healthcare Improvement (IHI) steps for Quality Improvement, create and present a plan for a small test of change addressing the following items:
FALL PREVENTION
Students will be provided the opportunity to apply the knowledge and skills acquired during their semester to a specific problem or issue.
They will be encouraged to think critically and creatively about professional issues and to develop further leadership skills necessary to address and help solve these issues while developing the skills necessary to implement “small tests of change” in a clinical setting.
Students will also be allowed the opportunity to refine research skills and demonstrate their proficiency in oral communication skills; evaluate best evidence in
support of nursing practice and the generation of new knowledge; integrate an evidence-based practice model in designing a plan of care to ensure optimal client outcomes; demonstrate their achievement of the at West Coast University their ability to extend and refine this knowledge and skill in the realization of their personal and professional goals.
Analyze Evidence-Based Practice Presentation
1. Identify a practice issue which resulted in negative patient outcomes
a. Concept exploration: What is the nature of the clinical problem? How is it defined?
b. Is the issue clinically significant and why? The literature review should support this.
c. Is the issue a priority and why?
a. Identify processes that helped to identify this clinical problem. Examples:
• Shift-to-shift report
• Nurse/student partnership
• Unit-based clinical practice committee discussion
2. Create a case-study to illustrate the problem
3. Develop a PICO question
a. Population of interest
b. Intervention of interest
c. Comparison of interest
d. Outcome of interest
4.Complete a literature review including a critical appraisal and evaluation of the evidence as it related to the chosen topic (This should include no less than three (3), evidence-based practice articles from a peer-reviewed journal). Utilize the following format to discuss the findings:
Title/Year/Author(s) Study Question/Problem Sample Population Study Design Study Findings Conclusions/Implications for Nursing Practice
5 Locate and discuss an evidence-based guideline or practice protocol related to the topic and the identified population (Suggested databases include the Agency for Healthcare Research and Quality or Best Practice Guidelines)
6 In support of the guideline, select one scholarly article that corroborates the evidence-based guideline/protocol chosen. This article must be from a peer-reviewed, scholarly journal, not more than 5 years old. One article from the literature review may be utilized. Textbooks may not be utilized.
7 Critique the selected article utilizing the table below. Discuss the findings associated with the article by reviewing the discussion and implications/recommendations for practice and summary assessment as they relate to the case study. Describe how these findings will support the small test of change (Do NOT summarize the content of the article).
Discussion • Are all major findings interpreted and discussed?
• Are the interpretations consistent with the results and with the study’s limitations?
• Does the report address the issue of the generalizability of the findings?
Implications/Recommendations • Do the researchers discuss the implications of the study for clinical practice or further research-and are those implications reasonable and complete?
Summary Assessment • Despite any identified limitations, do the study findings appear to be valid-is there confidence in the truth-value of the results?
• Does the study contribute any meaningful evidence that can be used in the nursing practice or that is useful to the nursing discipline?
8. Analyze two of the most pertinent QSEN competencies as they relate to the case study and describe how they relate to the practice issue
9.Select evidence based practice model
a. Discuss why the selection of this EBP model is most appropriate to the practice issue identified. Examples of selected models:
• Johns Hopkins Model (2005)
• Rosswurm and Larrabee Model (1999)
• Stetler Model (2001)
• Iowa Model (Titler, 2001)
10. Utilizing the Institute for Healthcare Improvement (IHI) steps for Quality Improvement, create and present a plan for a small test of change addressing the following items:
FALL PREVENTION
Students will be provided the opportunity to apply the knowledge and skills acquired during their semester to a specific problem or issue.
They will be encouraged to think critically and creatively about professional issues and to develop further leadership skills necessary to address and help solve these issues while developing the skills necessary to implement “small tests of change” in a clinical setting.
Students will also be allowed the opportunity to refine research skills and demonstrate their proficiency in oral communication skills; evaluate best evidence in
support of nursing practice and the generation of new knowledge; integrate an evidence-based practice model in designing a plan of care to ensure optimal client outcomes; demonstrate their achievement of the at West Coast University their ability to extend and refine this knowledge and skill in the realization of their personal and professional goals.
Analyze Evidence-Based Practice Presentation
1. Identify a practice issue which resulted in negative patient outcomes
a. Concept exploration: What is the nature of the clinical problem? How is it defined?
b. Is the issue clinically significant and why? The literature review should support this.
c. Is the issue a priority and why?
a. Identify processes that helped to identify this clinical problem. Examples:
• Shift-to-shift report
• Nurse/student partnership
• Unit-based clinical practice committee discussion
2. Create a case-study to illustrate the problem
3. Develop a PICO question
a. Population of interest
b. Intervention of interest
c. Comparison of interest
d. Outcome of interest
4.Complete a literature review including a critical appraisal and evaluation of the evidence as it related to the chosen topic (This should include no less than three (3), evidence-based practice articles from a peer-reviewed journal). Utilize the following format to discuss the findings:
Title/Year/Author(s) Study Question/Problem Sample Population Study Design Study Findings Conclusions/Implications for Nursing Practice
5 Locate and discuss an evidence-based guideline or practice protocol related to the topic and the identified population (Suggested databases include the Agency for Healthcare Research and Quality or Best Practice Guidelines)
6 In support of the guideline, select one scholarly article that corroborates the evidence-based guideline/protocol chosen. This article must be from a peer-reviewed, scholarly journal, not more than 5 years old. One article from the literature review may be utilized. Textbooks may not be utilized.
7 Critique the selected article utilizing the table below. Discuss the findings associated with the article by reviewing the discussion and implications/recommendations for practice and summary assessment as they relate to the case study. Describe how these findings will support the small test of change (Do NOT summarize the content of the article).
Discussion • Are all major findings interpreted and discussed?
• Are the interpretations consistent with the results and with the study’s limitations?
• Does the report address the issue of the generalizability of the findings?
Implications/Recommendations • Do the researchers discuss the implications of the study for clinical practice or further research-and are those implications reasonable and complete?
Summary Assessment • Despite any identified limitations, do the study findings appear to be valid-is there confidence in the truth-value of the results?
• Does the study contribute any meaningful evidence that can be used in the nursing practice or that is useful to the nursing discipline?
8. Analyze two of the most pertinent QSEN competencies as they relate to the case study and describe how they relate to the practice issue
9.Select evidence based practice model
a. Discuss why the selection of this EBP model is most appropriate to the practice issue identified. Examples of selected models:
• Johns Hopkins Model (2005)
• Rosswurm and Larrabee Model (1999)
• Stetler Model (2001)
• Iowa Model (Titler, 2001)
10. Utilizing the Institute for Healthcare Improvement (IHI) steps for Quality Improvement, create and present a plan for a small test of change addressing the following items:
Falls prevention in acute care hospital
write down the following
1. introduction
2. fall data in US Hospitals
3.Fall prevention practices in US hospitals
4. New methods in fall prevention in 2015, 2016 in USA
5. Barriers in fall prevention In USA
6.Recommend measures for fall prevention in USA hospitals
Conclusion
Reference- 5 Articles. one from Book, one website, and 3 journals