Roles of Nurses in Minimizing Hospital Based Falls: A Critical Analysis

Sandhya Neupane Khadka student Id: 2196209 Assignment 4: Investigate clinical
governance issue
Background
The assignment undertakes a critical analysis of the roles played by nurses in minimizing the
incidences of hospital based falls. About 30% of the 700,000 patient falls that occur on a yearly
basis could be prevented (Chaboyer 2015 p.1286). Similarly, the longer stays that result from
such incidences increase the patient care costs by over 60% resulting from unplanned intracranial
harms, fractures and dislocations. The results of the analysis indicate that the application of
complex multifactorial interventions plays a significant role in alienating the adverse outcomes
associated with hospital based falls among patients with an advanced age. Further, the scholars
reveal that the success of these programs is greatly dependent on the multifactorial interventions
put in place in different levels of the institution. However, poor collaboration between nurses and
other healthcare practitioners hinders effective flow of information and therefore, the
effectiveness of the initiatives set to minimize falls.
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Sandhya Neupane Khadka student Id: 2196209 Assignment 4: Investigate clinical
governance issue
Introduction
According to Chu (2017 p.31), clinical governance is defined as the process through
which healthcare institutions are held accountable for enhancing the quality and standard of the
services they offer while fostering high notch values of care through advancement of clinical
environments in which medical excellence flourishes. Consequently, Grealish and Chaboyer
(2015 p.1286) said that clinical governance audits pertinent healthcare issues such as incidence
and management as well as quality assurance and improvement based on the pillars of clinical
performance and evaluation, professional development and management, clinical risk and
consumer value . Risk management is one of the most essential aspects of fostering
the ,minimization of falls through delivery of high quality services in medical settings.
Consequently, prevention of falls in medical settings is a role acquainted to nurses that needs to
be analyzed with optimal degrees of care. Furthermore, (Morgan et al. 2017 p.116), hospital
based falls is a major issue of safety based on its detrimental effects in increasing the patient’s
length of stay and reduction of the affected client’s quality of life. Coppedge, Corner and Se
(2016 p. 64) report that about 30% of the 700,000 patient falls that occur on a yearly basis could
be prevented. The scholars reveal that the longer stays that result from such incidences increase
the patient care costs by over 60% resulting from unplanned intracranial harms, fractures and
dislocations.
Nurses play a significant role in preventing hospital based falls. Grealish and Chaboyer
(2015 p.1286) explain that older patients aged over 65 years are at a greater risk of encountering
falls in comparison to their younger counterparts. Moreover,(Morgan et al. 2017 p.118)
underscore hourly rounding as an aspect of enhancing the availability of nurses; adoption of
effective channels of communication; institutionalization of medication reviews and educating
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Sandhya Neupane Khadka student Id: 2196209 Assignment 4: Investigate clinical
governance issue
stakeholders in order to enhance fall prevention awareness as the most effective ways of
minimizing the effects of this menace. On the other hand, Basic and Hartwell (2015 p.1637)
reveal that nurses dealing with older patients need to adopt a wider variety of process
improvement tools to avail the system with long lasting solutions.
Critique of Literature
The critical analysis identifies pertinent research issues proposed by the three articles
through examination of the quality of the pieces of evidence proposed, identification of the areas
of bias, relevance of the scholarly works in fostering the reduction of falls, as well as the aspects
of validity and reliability. The Critical Appraisal Skill Programme (CASP) tool will be applied to
foster the critical analyses advanced. According to Carter, Creedy and Sidebotham (2015 p.864),
CASP vets the efficacy of a scholarly material by evaluating the appropriateness of the
methodologies applied, the degree of credibility of the findings presented and the relevance of
these results to the questions under scrutiny. Similarly, CASP audits the effectiveness of the
research design adopted by scholars in addressing the underlying aims of the study and the
degrees of efficacy in establishing relationships among variables.
Colón-Emeric et al. (2017 p.1634) present a study aimed at assessing the extents to
which a “complexity science–based staff training intervention” dubbed CONNECT meets its
desired levels of effectiveness minimizing falls through enhancement of high quality interactions
among caregivers in clinical settings. The researchers fulfill the 10 propositions of CASP. The
goal established for this scholarly material play a crucial role in contributing to the wide body of
literature by proposing new frameworks of implementing the interventions of reducing falls in
healthcare settings. Further, the scholars adopt a cluster-randomized trial in an effective way as
evidenced by their inherent capabilities to include a control group and an intervention group.
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Sandhya Neupane Khadka student Id: 2196209 Assignment 4: Investigate clinical
governance issue
Similarly, the recruitment strategies reveal higher degrees of appropriateness to the objective of
the research. For instance, the participants only qualified for inclusion if they worked in
healthcare settings with patients facing the risk of falls. On the other hand, issues of ethics were
put into consideration. For instance, there is evidence that informed consent was acquired for the
participants. Similarly, privacy was ensured by initiating patient record abstractions about 6
months prior to the intervention.
Vlaeyen et al. (2017) present a systematic review aimed at identifying the factors that
hinder as well as those that act as facilitators for programs established to prevent falls in
residential care facilities. A critical analysis of the research reveals that the scholars were highly
effective in adopting their articles from five databases (MEDLINE, EMBASE, CINAHL,
PsycINFO, and Web of Science) which boast of their capacities in wealth of journals. Further,
the quality of the study is enhanced by the fact that the researchers implement quality appraisal
by the use of the Mixed Method Appraisal Tool. Most importantly, the researchers enhance both
the degrees of reliability and validity of the scholarly work by implementing thematic
explorations for the qualitative data obtained and descriptive analysis for quantitative data.
Additionally, the review puts into consideration multiple agencies (Grol and panelists) to foster
the processes of synthesizing the data obtained through identification of the barriers and
facilitators of implementing programs aimed at minimizing falls in hospital settings. The strength
of the scholarly material emanates from its dynamic abilities to include a multi-sector
perspective that reviews the effects of social, political and economic issues in preventing falls
rather than focusing on nurses alone.
Dykes et al. (2017) present a study aimed at advancing the Fall TIPS instrument aimed at
enlightening and engaging patients in the processes of preventing hospital based falls with the
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