NURS2006 Assignment 5 - Clinical Practice Improvement Project Report

NURS2006 ASSIGNMENT 5
Clinical Practice Improvement Project Report
Student Name, FAN and ID:
Type your assignment into the white spaces in the template and the rows will expand as much as
you need them
Project Title:
Fall prevention in geriatric ward
Project Aim:
To achieve 20% reduction in the rate of falls by 12 months
Relevance of Clinical Governance to your project
Clinical governance refers to a framework by which UK National Health Services (NHS) authorities
are accountable for the improvement of the quality of the health care services they are providing. It
is one of the key agenda of the UK central government for ensuring the quality care in health care
sectors (Swift and Iliffe, 2014). In Australia, clinical governance is also a major issue and it depicts a
relationship between the patients and the health care provider. Along with this, state or territory
health department, the governing body are also involved. According to the standards of National
safety and Quality Health Service Standards( NSQHS), the main components of the clinical
governance are (Spigelman and Rendalls., 2015) -
1) Governance, leadership and culture
2) Clinical performance and effectiveness
3) Patient safety and quality improvement system
4) Partnering with consumers

5) Safe environment for delivery of care.
In this project, the patient safety and quality improvement system and safe environment for
delivering care are mostly important, as the project is associated with the prevention of fall in
geriatric ward. The risk of fall and fall related injury is very common in the geriatric ward of
hospitals. To reduce the risk of fall and fall related injury, nurses should take relevant role in
maintaining the safety of patients and safe medical environment and those are key components
of clinical governance. For the nurses, it is very important to have proper knowledge of those
components. Unless, they are unable to give proper care to the patients.
Evidence that the issue / problem is worth solving:
The enhancement of Australian aged population has increased the risk of fall, fall related injury, and
every year the older age population is growing in numbers. Since 2017, about 3.8 million people of
Australians having the age of 65 and over which covers about 15 % of total population of Australia. It
is predicted that, the growing older age population will reach to 8.8 million by 2057 (Australian
Institute of Health and Welfare, 2018). With rising older population, the case of fall related injury in
Australia is also increased. According to a report of Australian Government named ‘Trends in
hospitalization injury due to falls in older people’ stated the trend of fall related injury cases of older
age population in the time of 2002-03 to 2014-15. According to that report, almost 111,222 patients
with the age of 65 or over has been hospitalized due to fall in 2014-15 and it is about 3% of total
hospitalization case of adult population (age 65 or over). In this case scenario, it is seen that women
were more prone to fall injury than the men. The rate of women fall related injury was 3519 per
100,000 and the rate of men fall injury was 2412 per 100,000 population. The age related injury
hospitalization has been increased over the period of time 2002-03 to 2014-15. The rate of increase
hospitalization is 3% for the men and it was 2% for the women. The fall related injury in 2014-15 is
commonly associated with the head injury (24%) and hip and thigh injury (24%). Although the rate

of head injury was higher in older the population of Australia. The hip fracture was the most
common injuries and it is almost 73%. Almost two folds increased the rate of head injury over the
time of 2001-03 to 2014-15. In 2002-03 the head injury cases was about 319 and 336 per 100,000
population for men and women respectively. However, in 2014-15 the numbers increased to 706
and 731 for men and women respectively. The most frequent cause of fall injury in Australia was fall
on a level from stumbling, slipping and tripping (34%). The percentage was about 15% in case of
falling from the household objects as chairs ladder, stairs, beds. Almost, 85% of the fall injury cases
in 2014-15 was occurred in home or in residential care unit. The rate of falling in the home was
about 1814 per 100,000 population and the rate was 10,090 per 100,000 in case of residential aged
care (Australian Institute of Health and Welfare, 2018). Although, there was 17 % case scenario, in
which place of occurrence was not specified (Voula ,Shannon and Janneke, 2015). The fall related
injury also affect the family member and as well as other care giver of the patients. The Australian
Commission on safety and Quality in Health Care had introduced various measures to prevent such
fall related injuries. It can be said that, with proper implementation of various plans, the problem of
fall related injury could be solved in some extent.
Key Stakeholders:
The stakeholders play a crucial role in preventing the fall in the geriatric unit of the hospital. In this
case, the primary stakeholders are the older age patients, the family and other care giver of the
patients, nurses and other health care provider and as well as the health care management team.
The nurses are the primary factor in the implementation of interventions of fall reducing measures
as they are directly involved in providing the care. The main of this of this project is to reduce the
rate of fall related in injury in older age people. To implement the interventions, patient education is
very much required and the nurses can play crucial role in educating the people and promote the
person cantered care to raise the involvement of patients in this awareness programme
(Chamberlain-Salaun , Mills and Usher., 2013).