Patient Falls in Inpatient Rehabilitation Healthcare Homes

This blog discusses the issue of patient falls in inpatient rehabilitation healthcare homes, particularly in patients with mental illness or stroke. It also covers the nursing and clinical guidelines for fall prevention and the need for individualized treatment and rehabilitation programs. Additionally, the blog explores the concept of Knowledge Translation (KT) in bridging the knowledge-to-practice gap in rehabilitation services.

Running head: ASSESSMENT 1 - BLOG
ASSESSMENT 1 - BLOG
Name of the student:
Name of the university:
Author note:

Impatient rehabilitation healthcare home are referred to the hospitals that are devote to
healthcare service users with various kinds of neurological, musculoskeletal, orthopedic as well
other medical conditions following stabilization of their acute medical problems. One of the
major issues that have been evidenced at the rehab center is the frequent fall of the health care
users. The incident of patient fall is majorly evidenced in healthcare users suffering from stroke.
Patient fall is currently a burning issue in today’s rehab since according the survey conducted in
the year 2017, almost 13 percent of the death of patients has taken place due to massive injury
resulting from sudden fall (Mansfield et al., 2013). The risk of fall is higher in patient who have
undergone stroke or in patients who are suffering from mental illness. Researchers state that the
risk of fall is high among the patients. Almost 37.3 percent of the falls are caused to patients who

have been admitted to the rehab for major complication and stroke rehabilitation. Thus it can be
understood that fall of rehab patient is a major problem at impatient rehabilitation homes.
According to researchers, 57 percent of the falls that takes place are of patients suffering from
mental illness like anxiety disorder, mood disorders, impulse control, addiction disorder and
psychotic disorders (Wasserstein et al., 2013). Patients with the above mentioned mental issues
posses higher chance of developing mobility impairment, muscle weakness as well as loss of
body balance. This in turn makes them highly vulnerable to falls. Due to mental illness as well as
physical disability, patients often get confused and disoriented an unfamiliar environment (Chen
et al., 2015).
The nursing guidelines that are available in accordance to the Australian Commission on
Safety & Quality in Healthcare (ACSQHC) involves proper communication that needs to be
carried out which is an integral part of the service so that it is delivered in a dependable way
(acha.org.au 2018). There are need of visual identification systems which is suggested for the
patients. There is need of hourly rounding by the nurses which serves as useful strategy for the

prevention of falls and maintaining patient safety. Additionally the guidelines require that a
culture of safety is met which acts a significant factor for reducing the prevalence of falls (Leone
& Adams, 2016).
Additionally NICE puts forward certain clinical guidelines regarding the inpatient
rehabilitation enduring mental illness. The legislative guidelines includes the Mental Capacity
Act 2005, according to which the decisions needs to be made for the people who are unable to do
so. The Care Act 2014 states that the care and support to be provided for the adults, including
safeguarding adults from abuse or neglect, and the support to be provided to carers. These
guidelines are for the health and the social care workers involved in the rehabilitation care
facility. It also includes other health practitioners and the even the care workers of the non-health
sector, who might be directly involved in providing acre to the people in the rehab facility.
The practise changes that are necessary involves in terms of national variation and the
way in which they are provided. Change in practise is also required in the community
rehabilitation teams as there might be impact on the patient’s personal as well as interpersonal
and occupational functioning (NICE.org.uk, 2018).
The gap that is identified is the provision of individualise treatment to the inpatients and
lack of specific rehabilitation programs. There are no facility available for those having traumatic
injury. Certain issues related to this factor involve the activities of daily life like self-care, or life
skills and the social skills.

Question 3
Knowledge Translation or KT refers to the dissemination of results that is based on the
distribution scientific information or academic publication. In recent years, KT has gathered
increased importance in public health services and rehabilitation research (Straus, Tetroe &
Graham, 2013).
Rehabilitation comprise of special voluntary services catered to specific individuals who
need it to re-participate in regular civic life. Such Rehabilitation could be availed by a
differentially abled individual with respect to physical or mental inadequacy. As opined by

Oborn, Barrett & Racko, (2013), the aim of rehabilitation is thus to provide required support to
such individuals and empower them as well as their family members. The structure of
rehabilitation services vary widely across nations (Jones et al., 2015). Therapy is included in
rehabilitation in case of acute conditions of patients like brain or spinal cord injury (Straus,
Tetroe & Graham, 2013).
The persistent cases of knowledge-to-practice gap, in rehabilitation services, have
triggered the initiatives of Knowledge Translation (Oborn, Barrett & Racko, 2013). It has been
observed that the available data on rehabilitation practices are often fragmented and inefficiently
managed. Each disability, whether mental or physical, requires different methods of service. The
service providers and programme managers need to be aligned accordingly. In the course of
providing a certain service, these practitioners might also experience different needs. If these

needs are left unmet then then it could lead to several unwanted consequences such as delayed
discharge, deterioration in health and continued dependency on external assistance which might
restrict the expected participation in regular civic life (Albrecht et al., 2013). Such adverse
outcomes have severe financial implication for the patient’s families as well as the community to
which he or she belongs. Thus it is highly essential to regulate the standard of operational
requirements so that KT resources can be utilised to promote the behavioural practices of the
health-consultant, thereby improving the quality of patient care.
As observed by Jones et al., (2015), individuals having physical, cognitive or emotional
impairments, resulting from injury or illness, which persist over their life-time fall in the
category of ageing with disability. More than average of such knowledge gaps stem from the
elderly patient’s history in the disability field (Oborn, Barrett & Racko, 2013). The health
professional working in the geriatric division often lack sufficient specialised knowledge in
treating the ones with disability.
The term ‘Bridging’ is used to explain how such gaps in knowledge could be concealed
through collaborated training programmes and integrated exchange of specialised skills and
knowledge across various fields such as gerontology and disability (Albrecht et al., 2013).
Bridging also enables them to evaluate the team work on specific knowledge parameters.
Knowledge Translation uses this bridging method by developing instructional design principles
that are evidence based as well as user-centric thus providing concrete examples of past histories
of gaps.
Reference List
acha.org.au (2018). Retrieved from http://www.acha.org.au/references/patient-falls

Albrecht, L., Archibald, M., Arseneau, D., & Scott, S. D. (2013). Development of a checklist to
assess the quality of reporting of knowledge translation interventions using the
Workgroup for Intervention Development and Evaluation Research (WIDER)
recommendations. Implementation Science, 8(1), 52.
Chen, P., Hreha, K., Kong, Y., & Barrett, A. M. (2015). Impact of spatial neglect on stroke
rehabilitation: evidence from the setting of an inpatient rehabilitation facility. Archives of
physical medicine and rehabilitation, 96(8), 1458-1466.
Chen, P., Hreha, K., Kong, Y., & Barrett, A. M. (2015). Impact of spatial neglect on stroke
rehabilitation: evidence from the setting of an inpatient rehabilitation facility. Archives of
physical medicine and rehabilitation, 96(8), 1458-1466.
Jones, C. A., Roop, S. C., Pohar, S. L., Albrecht, L., & Scott, S. D. (2015). Translating
knowledge in rehabilitation: systematic review. Physical therapy, 95(4), 663-677.
Leone, R. M., & Adams, R. J. (2016). Safety standards: implementing fall prevention
interventions and sustaining lower fall rates by promoting the culture of safety on an
inpatient rehabilitation unit. Rehabilitation Nursing, 41(1), 26-32.
Mansfield, A., Inness, E. L., Wong, J. S., Fraser, J. E., & McIlroy, W. E. (2013). Is impaired
control of reactive stepping related to falls during inpatient stroke
rehabilitation?. Neurorehabilitation and neural repair, 27(6), 526-533.
NICE.org.uk (2018). Retrieved from
https://www.nice.org.uk/guidance/GID-NG10092/documents/draft-scope

Oborn, E., Barrett, M., & Racko, G. (2013). Knowledge translation in healthcare: incorporating
theories of learning and knowledge from the management literature. Journal of Health
Organization and Management, 27(4), 412-431.
Straus, S., Tetroe, J., & Graham, I. D. (Eds.). (2013). Knowledge translation in health care:
moving from evidence to practice. John Wiley & Sons.
Wasserstein, D., Farlinger, C., Brull, R., Mahomed, N., & Gandhi, R. (2013). Advanced age,
obesity and continuous femoral nerve blockade are independent risk factors for inpatient falls
after primary total knee arthroplasty. The Journal of arthroplasty, 28(7), 1121-1124.