Quality Improvement Problem
The problem of falls among elderly patients remains a difficult issue to confront in the modern healthcare setting because of the problems regarding the introduction of control tools and the provision of the relevant instructions for nurses and patients (Van der Marck et al., 2014). Seeing that falls affect the recovery rates among the target population to a considerable extent, reducing the opportunities for a successful management of their health issues, it is crucial to introduce the tools for managing the problem of falls among elderly inpatients.
Data to support QI Problem
According to the recent statistics, the number of falls among elderly patients has been dangerously high (Stam et al., 2016). Furthermore, reports show that a significant percentage of falls has led to the further development of complications and, thus, affected the quality of care to a considerable degree (DuPree, Fritz-Campiz, & Musheno, 2014). According to the World Health Organization (2017), the injuries received as a result of falls remain the second leading death cause globally. Every year, approximately 646,000 people die because of falls (World Health Organization, 2017). Although the environment of a healthcare facility provides tools for controlling the well-being of patients, the strategies designed so far do not seem to work, which means that new and improved models must be suggested.
Literature to support QI Problem
Studies show that the problem of falls among elderly patients remains on the agenda of the contemporary healthcare despite the efforts taken to introduce precaution measures and enhance the supervision process (Avin et al., 2015). Partially, the failure to manage the problem successfully can be explained by the staff-related issues that can be witnessed in the modern healthcare environment, such as the low retention rates among nurses, increasingly large numbers of workplace burnouts among the staff, etc., hence the inability to provide the supervision of the required quality. However, a closer look at the subject matter will also indicate that the low levels of patient independence and awareness also contribute massively to the rise in the instances of falls among the elderly. With the distinct lack of patient education, the further promotion of agency among the target population becomes barely possible, which leads to a drastic drop in the degree to which the issue is controlled.
Workplace burnouts among nurses can also be viewed as one of the contributors to the rise in the number of falls among elderly patients. With the increase in workload and tight schedules, nurses cannot deliver the services of the required quality. As a result, the opportunities for controlling patients are reduced significantly (Hirsbrunner, Denhaerynck, Fierz, Milisen, & Schwendimann, 2015).
There is also evidence showing the need to reconsider some of the current strategies for administering medications to patients; particularly, Milos et al. (2014) claim that some forms of medication create premises for falls because of the effects that they have on the patients’ ability to coordinate their movements. Specifically, one must mention the mixture of certain types of cardiovascular and psychotropic drugs as a significant threat to elderly patients’ ability to manage the movements of their body, including the basic functions such as walking. Thus, the choice of the medication strategy can be seen as one of the key factors that may possibly lead to a vast increase in the possibility of a fall in the elderly (Milos et al., 2014).
Action Plan
To manage the problem successfully, on will have to consider taking the following steps:
- Redesigning the approach toward maintaining the physical fitness of patients by introducing new exercises that will help reduce muscle weakness among the elderly;
- Raising awareness about the subject matter among the target population with the help of patient education programs implemented by nurses;
- Reconsidering some of the present-day medication prescriptions by replacing the substances that are likely to lead to the rise in the threat of a fall with less dangerous ones;
- Enhancing control over the vulnerable population by assigning the supervision process to nurses;
Changing the current schedule and workload among nurses, as well as creating a more favorable environment for hiring more nurses to give the patients the care of the required quality and prevent the instances of workplace burnouts among nurses.
It is expected that the specified changes are bound to improve the current situation and reduce the number of falls among the elderly in the environment of nursing and healthcare facilities. As a result, a rapid drop in the number of falls and, consequently, the complications and injuries caused by them, will be reduced significantly. The specified measures are expected to lead to a massive increase in positive patient outcomes.
Resources to Support the Action Plan
The action plan will be implemented based on the program that will be designed in a local healthcare facility. The resources that are available at the identified facility will be utilized to build a system according to which medications and nursing care will be administered to elderly patients. Furthermore, the available technological advances will be used to encourage communication among nurses, as well as between nurses and patients. Thus, patient education and efficient management of the target population’s needs will become possible.
References
Avin, K. G., Hanke, T. A., Kirk-Sanchez, N., McDonough, C. M., Shubert, T. E., Hardage, J., & Hartley, G. (2015). Management of falls in community-dwelling older adults: Clinical guidance statement from the Academy of Geriatric Physical Therapy of the American Physical Therapy Association. Physical Therapy, 95(6), 815-834. doi:10.2522/ptj.20140415
DuPree, E., Fritz-Campiz, A., & Musheno, D. (2014). A new approach to preventing falls with injuries. Journal of Nursing Care Quality, 29(2), 99-102. doi:10.1097/NCQ.0000000000000050
Hirsbrunner, T., Denhaerynck, K., Fierz, K., Milisen, K., & Schwendimann, R. (2015). Nurse staffing, patient turnover and safety climate and their association with in-patient falls and injurious falls on medical acute care units: A cross-sectional study. Journal of Hospital Administration, 4(3), 54-60. doi:10.5430/jha.v4n3p54
Milos, V., Bondesson, Å., Magnusson, M., Jakobsson, U., Westerlund, T., & Midlöv, P. (2014). Fall risk-increasing drugs and falls: A cross-sectional study among elderly patients in primary care. BMC Geriatrics, 14(1), 40. doi:10.1186/1471-2318-14-40
Stam, H., Harting, T., Sluijs, M. V. D., Marum, R. V., Horst, H. V. D., Wouden, J. C. V. D., & Maarsingh, O. R. (2016). Usual care and management of fall risk increasing drugs in older dizzy patients in Dutch general practice. Scandinavian Journal of Primary Health Care, 34(2), 165-171. doi:10.3109/02813432.2016.1160634
Van der Marck, M. A., Klok, M. P. C., Okun, M. S., Giladi, N., Munneke, M., Bloem, B. R., & Force, N. F. T. (2014). Consensus-based clinical practice recommendations for the examination and management of falls in patients with Parkinson’s disease. Parkinsonism & Related Disorders, 20(4), 360-369. doi:10.1016/j.parkreldis.2013.10.030
World Health Organization. (2017). Falls.