Prevention of Fall Amongst Older People

This report discusses the prevention of falls amongst older people, including clinical governance, proposed interventions, and evaluation of the project. The report highlights the relevance of clinical governance to fall prevention and the key stakeholders involved in the process. The proposed interventions include multifactorial approaches, assessment of risk factors, involvement of physiotherapy, care of osteoporosis, improvement of social and personal behaviour, vitamin supplements, and treatment for other body impairments. The report also discusses the barriers to implementation and sustaining change, such as lack of accurate technology and personal beliefs and cultures. Finally, the report evaluates the project and suggests the use of PDSA as a tool for determining the effectiveness of strategies.

Running head: PREVENTION OF FALL AMONGST OLDER PEOPLE
Prevention of fall amongst older people
Name of the student
Name of the university
Author note:

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PREVENTION OF FALL AMONGST OLDER PEOPLE
NURS2006 ASSIGNMENT 5
Clinical Practice Improvement Project Report
Student Name, FAN and ID:
Jasakamalkaur Kaur0436 2198883
Project Title:
Falls incidence reduction and mitigation of resultant health complications
in a population group of senior citizens residing under care facilities.
Project Aim:
To decrease the incidence of falls amidst 230 Australian citizens residing under care facilities
with the aid of interventions directed at multifactorial and single platforms for a duration of
seven months.
Relevance of Clinical Governance to your project
Clinical governance is defined as the set of frame work that aid in maintaining superior care
and facilitate the quality of the care provided by the health care professionals within the
clinical setting (Van Zwanenberg& Edwards, 2018). Clinical governance generally obtained
by the extracting data from the evidence based practices, health care professionals, evaluation
of the data relevant to the issues, proper management of the issues and policies to reduce
incidence.
Clinical governance highly relevant to fall and subsequent injury due to risk factor in elder
people in Australia. It is also relevant to the identify risk factor such as the prevalence of fatal
injuries pertaining to the head and facial regions of the concerned patient, along with the
threat of partial or complete loss of mobility..Five different pillars are relevant for managing
injuries resulting from falls in patients such as clinical performance, evidence based care and
effectiveness, clinical risk and professional management along with consumer values (Tuan,
2016). In this context, the sudden fall considered as one of the major issues in elder people of
Australia and older people experiences the physical injury and psychological distress due to
ended up in hospital.. So, fall prevention in older individuals is related to the clinical risk
pillar of clinical governance since it focuses on the safety of every older individual and
residential care(Tuan, 2016).
Evidence that the issue / problem is worth solving:

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PREVENTION OF FALL AMONGST OLDER PEOPLE
Fall is one of the major cause of disability and death in older people , especially
women.According to the statistics of south Australia, 2017, approximately 110 people of 65
years or more than 65 years were admitted to the hospital due to the hip fracture.Australian
Bureau of Statistics reported that approximately 1200 deaths post fall
were registered in 2008 and the risk was increased every year by 2% due
to risk factors (Vlaeyen et al., 2015).Global report of WHO also suggested that 1.3
million patient over the year experienced death due to sudden fall in residential care and each
fall cost average approximately $ 1000(El-Khoury et al., 2015).
In residential or hospital setting, most of the sudden fall of older individuals is unintended
and the consequences are physical injury, long term limb impairment, emotional distress,
social isolation, impairment of daily activity and death. However, the causes of sudden fall
are preventable and can be avoided by collaborations of different health care members and
certain precautions.
Key Stakeholders:
Excellent teamwork is obtained by involvement of staffs in the direct care of the patient and
resolving the issues successfully. Involvement of multidisciplinary team members is essential
for implementation of falls prevention strategies. Australian commission on the safety and
quality in health care listed number of worker in health care setting for preventing the issue.
1. medical practitioners:
Medical practitioners are responsible for preventing sudden fall in diverse ways such as
proper interventions and diagnosis (Arena et al., 2015). They also actively participate in
implementing the strategy.
2. Health manager: health care mangers involve in the proper assessment and actively
participated in the implementing standard fall prevention strategies.
3. Registered nurses: nurses are the most trusted health care since they provide the direct care
to the professionals. They communicate with the patient and the family members to provide
adequate information and patient history (Forsythe et al., 2016).
4.Allied health professionals:
Allied health professionals are present for managing falland various plans for assessing

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PREVENTION OF FALL AMONGST OLDER PEOPLE
environment, the atmosphere of care and individual needs. (Forsythe et al., 2016).
5.Supporting workers:
Supporting workers actively take part in the strategies pertaining to the assistance other
health professionals in daily activities such as food preservation, transferring things,
maintenance of hygiene.
CPI Tool:
Clinical practice improvement is defined as a n improving strategy of the quality of the care
bin clinical premises through the superior diagnosis methods, access to the advanced
technology, planning and interventions and evaluating the efficiency of the interventions.
(Kayhan, Kar& Şahbaz,2015). For implementing superior strategies in the clinical setting
different frame works are used mostly for the small projects.
PDSA can be the excellent tool for this prevention in which the cycle starts with the
developing strategies considering all the area of concern and proposing an idea for specific
intervention for solving this issue. This followed by the collecting data of frequent fall in
older individuals. In this project, the importance of plan to do study act is to identify the
reason behind the certain fall in residential care for strategizing the plan (Knudsen et al.,
2017). The strategy is made to reduce the fall in older patient where interventions, data
methods, key stake holders should be selected. For reducing the fall, planning should be
made such as taking the history of the patients, medication review, environment
status, vitamin supplements, facility of physiotherapy,and health status of
patient. Then interventions execute in the larger scale and frequent study and improvements
should be monitored by data collection (Oliver et al., 2017). Conclusion is made after
comparing the results of the patient for better outcome in future for the issue. Therefore,
PDSA is appropriate tool for determine the effectiveness of strategies for the issue in order to
improve quality.
Summary of proposed interventions:
In order to implement proper plan, detailed observation and analysis should be done for the
cause and incident report of fall. Since fall is multifactorial, the multifactorial approaches
such as assessment of risk factors along with mobility of the individuals, involvement of
physiotherapy , care of osteoporosis, improvement of social and personal behaviour , vitamin

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supplements, treatment for other body impairments, use of restrictive side-rails also prevents
bed-related falls in elderly people in residential facility, use of flat footwear(El-Khoury et
al., 2015).a study suggested thatZhang et al., (2015), light exercise in home helps to
stabilize gait, restore the movement and helps to improve the cognitive behaviour of
individuals.
In conclusion from the study, the strategy for preventing fall always differs depending on
health status and age of the patient and cognitive activity related to fall. Considering all the
possibilities, health care professionals should provide feedback on the efficiency of the
interventions and effectiveness using the PDSA cycle for executing the plan in larger scale.
Barriers to implementation and sustaining change:
Lack of accurate, advanced technology and lack of sound knowledge of the practitioner act as
a major barrier of the practice. Majority of the patient reject options of these interventions
due to the personal beliefs and cultures which is the massive hindrance to clinical practice
(Willson et al., 2017). Implementing these changes are challenging in certain areas since
evaluation of effectiveness of multifactorial approach is challenging and time
consuming.Limited resources, improper budget plan, lack of time, feeling of loss of
independence by resident, health condition of patient, lack of effective communication in
between health professionals, influence of society, and lack of assessment tools and so on.
Clinicians and mangers played significant role in resolving the barriers through the effective
planning such as implementing the inventions such as medications free of charge , motivation
of staffs, effective communication, proper education (Lamb et al., 2015). Recruiting
more health professionals and care givers with sound skills can reduce the issue.
Evaluation of the project:
The main objective of the study is to prevent fall patient through implementing various
approaches in clinical setting. Effective evidence based practices along with different studies
and data should be followed by all the stakeholders in order to manage the fall (Carande-

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Kulis et al., 2015). In clinical setting, nurses play important role in proper communication
patient and providing adequate knowledge, maintaining safety (Knudsen et al., 2017). The
efficiency of the different implemented therapies can be compared through the chart and
statistical data.
Thus, to in order to make the intervention plan successful and execute in future, appropriate
assessment of the patients, proper documentation of efficiency and involvement of all key
stakeholders are important.

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