Clinical Issue Australia | Nursing Assignment
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Added on 2019-11-25
Clinical Issue Australia | Nursing Assignment
Added on 2019-11-25
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Running Head: NURSINGNursing Name of the StudentName of the University Author Note
1NURSINGIntroductionDeveloping the person centered care culture requires practice development. Practicedevelopment is the creative methodology. It is the person-centered design that bridges the gapbetween the rhetoric and the practice of values and culture. Practice development is thecontinuous process of developing the evidenced based cultures (Laird et al. 2015). It ischallenging to implement the evidenced based practice, as it is uncomfortable to adapt tochanges on a daily basis. However, the dynamics of the health industry is changing continuouslyand demands a change in the practice development. One of the effective tools in practicedevelopment is the wadula puzzling cube, which will be used in this assignment (Walsh et al.2008). The assignment deals with the clinical issue that is identified form personal practiceexperience in native country, Australia. Identifying the issue and PurposeWhen I was placed as clinical nurse in the reputed hospital of Melbourne, the fall ofolder adults was a prominent issue. Patients fall in the aged care is the burning issue among thehealth care workers. It is challenging to obtain the “zero falls goals”. To obtain this goal the staffnurses are directly responsible as they are frontline carers for older adult patients. The increasingrate of falls and the fall prevention message add stress to nurses. They develop a fear of falls andmust be careful for protecting the self along with unit. They also must restrict the fall riskpatients (Burns et al. 2016). To meet the hospital goals and to stop the fall prevention messages or alerts, there is needof identifying the barriers to prevention. To implement the fall prevention strategies, there is a
2NURSINGneed of strong evidence on the factors causing fall and consensus on the set of questions that willdetermine the readiness for change. There is rich evidence on the fall prevention strategies.However, there is limited evidence on the factors that is preventing the staff to be ready forchange. I the hospital it was observed that fall prevention protocol was already in place, but invain. There is limited evidence on the implementation and evaluation of the protocol.Therefore, the purpose of the assignment is to identify what fall prevention a strategy, thestaff prefers to use. Therefore, I have developed a puzzle question, which is as follows-“Which fall prevention practices do you want to use, that will ensure patient safety?”The purpose of the puzzle question is to reduce the number of falls in the hospital andunintended consequences associated with it. Being successful in addressing this question will bebeneficial to both the patient and the nurses. Solving this puzzle will help relieve the stress of thenursing staff in my organization. The puzzle uses the CIP (collaborative, inclusive, participatory)principles as the main purpose of developing puzzle question is to improve the quality of care byreducing falls of the older adults. It will help achieve the person centeredness and the servicesprovided will be of high quality, while ensuring the optimal outcomes. No hospital can reduce all the types of falls. Every hospital have a fall pattern, whichmeans presence of factors that cause commonly occurring falls. It may happen that a particularfall prevention strategy, is working in hospital X and failed to reduce falls in hospital Y. Thiscan be attributed to various factors such as lack of awareness among the nursing staff, lack ofregular audits, programs lacking patient evaluation, lack of appropriate training for staff. Costcan be additional barrier behind implementing the innovative technology for fall prevention such
3NURSINGas virtual sitter (Coppedge et al. 2016). Thus, my aim is to know front the staff itself as to whatfall prevention practice they want to use.EvidenceWhen I was working in the geriatric care ward, I have observed that the staff did not takethe fall prevention protocol seriously. On the other hand, some staff members were aware of theproblem and strategies to implement. The study by Hill et al. (2015), highlighted that the falls formajority of cases are preventable. There are adverse consequences of falls including fractures,significant internal bleeding, lacerations and many others. These consequences increase theburden of cost and overutilization of health care resources. These factors adversely affect thepatient outcomes. Karlsson et al. (2013) reported that the average length of stay after the fall increases by12.3 days and increases the cost by 61%. Each year the total number of falls in Australia Thisproblem is only expected to increase in future given the rapid growth of older adult population. According to Ambrose et al. (2013), many hospitals have failed in trying to adopt theevidence based practices. The local challenges faced are risk assessment tools do not covercertain factors such as morbidity, mortality, medications etc. Sometimes the risk assessmentcategorise majority of the patients as “high fall risk” patient.Karlsson et al. (2013) involved the hospital staff in the survey to identify the root causesof fall and it worked as eye opener for them to be ready for changes. Since the staff are bestpeople to know the causes of the fall, they are the best one to suggest preventive measures.
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