Preventing Falls and Harm from Falls - 800 Words

This article discusses the risk factors, assessment, and management of patients who are at risk of falling. It also provides advice on how to minimize the risk of falling. The article is based on a simulation around Mrs. Betty Graham, who had experienced a fall at home. The article provides resources and references for further reading.

QUESTIONS PREVENTING FALLS AND HARM FROM FALLS – 800 Words
Consider your practice in Lab class week 4 or 5 (Simulation around Mrs. Betty Graham,
who had experienced a fall at home): Located in Activity 1 folder
Resources:
https://www.myagedcare.gov.au/getting-started/healthy-and-active-ageing/preventing-
falls-in-elderly
http://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0009/258471/nsw-falls-prog-
hosp-present-prevent-falls-and-harm-from-falls-in-hosp-july-2013.pdf
ACTIVITY REPORT: PREVENTING FALLS AND HARM FROM FALLS (2-3 pages approx.)
1. Write a statement in your own words to demonstrate your understanding of Patient
Safety:
Patient safety can be considered as a discipline and a responsibility of the healthcare
providers in a healthcare facility. As a discipline, it involves the healthcare professionals
taking part in preventing occurrence of medical errors, reducing the errors if in case they fail
to prevent, and finaly is analysis of the medical errors mentioned that often lead to
avoidable adverse effects such as staggering of which can have a risk of falls to the patient in
question.
2. Patients should be screened for risk of falling on admission. List 4 other occasions
when further or repeat assessment should occur:
The assessment of falls can be repeated when the patient is transferred from one unit to
another.
When the patient’s condition changes significantly. The patient’s condition can change
abruptly into worse. This can increase the rate of falling.
After a fall. When a patient fall, a repeat of the risk of falling assessment should be done.
It can also be repeated regularly to those patients who have a longer stay in a healthcare
facility.

3. Identify 3 risk factors Betty Graham has for fall now she is in hospital. Are these
intrinsic or extrinsic risk factors?
Extrinsic risk factors that Betty Graham has in the hospital include;
Obstacles and tripping hazards;
when the healthcare facility is poorly designed or poorly maintained, it may obstacles that
blend into the background. Some maybe unexpected while others cannot be easily seen.
When any of the three mentioned types of obstacles are found along the way that the
patients are using while going to toilets. Mrs. Graham can, therefore, triple on them.
Tripling leads to imbalance problems that can alter with the level of the center of gravity of
the patient and this can lead to falls.
The hazards can be either temporary such as boxes, rubbish, cables, or they can be
permanent such as machines that are poorly located, neighboring hospital beds in the ward,
and ground fittings or fixture. Hazards can lead to falls as well (Zhao & Kim, 2015, pp 29-43).
Slippery surfaces
When the healthcare facility's floor become wet maybe due to cleaning or leaks, it becomes
slippery causing the patient to slide, losing balance and ending up falling.
An intrinsic factor that Betty Graham has in the hospital is the fear of fall.
The fear of a previous fall that happened to Mrs. Graham while in the bathroom can be a
potential cause of excess disability. She may also feel unsteady and that's can cause falls.
(Zia et al., 2015, pp 330-337; Cox et al., 2015, pp 78-82; Dauphinot et al., 2015, pp 565-570).

4. Identify three priority actions you can take as a nurse to minimize Betty’s risk of
falling
Now that Mrs. Graham has a risk of falls, immediately she is admitted to the ward I will
secure a wrist band identification. This will remind the other healthcare practitioners to
implement behaviors that minimize falls.
The second action I will take is managing the fear of fall. I will set with her small achievable
goals to make her feel more confident again. I will encourage her to challenge any negative
thoughts. I will help the practice techniques that will make her relax. A physiotherapist can
also be asked to help Mrs. Graham exercises that will make her gain strength (Kumar et al.
2016, pp 345-352).
The third thing is maintaining a constant awareness of the environment by taking the
following actions;
Eliminating tripping and slipping hazards and ensuring that the patient’s bed height level is
maintained at the lowest level suitable for the transferred patient. I will also familiarize Mrs.
Graham to the layout of the room and reducing the extent of the rearrangement of the
furniture Mrs. Graham’s room. Lastly, is encouraging Mrs. Graham to don shoes or slippers
with non-skid soles when walking to different places (Luzia, et al., 2015, pp 632-640;
Tabloski, 2014).
5. What advice can you give Betty to minimize her risk of falling?
I will advise Mrs. Graham to understand the value of confidence. I will let her know that one
of the best ways of reducing fear is of any kind is gaining confidence. She should, therefore,
work to improve her strength and balance.
I will advise her to wear safety shoes and clothing. She should be aware that long skirts can
get caught causing a fall. Missing buttons

The last thing is advising her to know what to do just in case the fall happens despite the
prevention strategies. So, she should take some moments to stay put, assess any pain. The
shock resulting from a fall can alter the blood pressure. She can, therefore, take some
moment and allow the blood pressure to stabilize before getting up.

Complete an ACTIVITY REFLECTION (1 page) on your personal learning
What 3 key things did I learn?
I learned the risk factors of falls of which are divided into two. That’s the intrinsic risk factors
that are related to the patient. The second class is extrinsic risk factors these are related to
the surrounding environment. Among the intrinsic factors include age above 65 years and
fear of falling for another time. Some of the extrinsic factors include obstacles and slippery
floor.
Another objective learned is the assessment of risk of fall. Its frequency and indication. It is
started when the patient is admitted and can be repeated due to some different reasons
including after a fall, and even during a significant change in patients' condition.
The last thing I have learned is the management of those patients that are at risk of falling.
When it comes to managing the elderly, nurses have a role in giving advice and education on
what the client should do when she experiences a fall.
How will I apply this to my practice?
Knowledge on the risk of fall assessment will help me in future be in a position where I will
be able to select effectively those who are at risk of falling to be given special management
plans.
The knowledge on the types of risk factors of falls will help me educate my future clients on
how they can identify the risk factors and be in a position of preventing them early enough
before falls could injure them.
Lastly, the knowledge of nursing roles in the management of those patients who have an
increased risk of falling for example, the elderly, will help me give out quality care by
prioritizing the interventions in their order of priority on how and when should be
implemented while managing clients who have been involved in falls.

What do I need to do to continue to develop?
I have to keep on with further reading to be more knowledgeable on the topic and related
ones. More textbooks and published research articles on falls and management of falls can
be read to gain more knowledge on how to manage those who are injured after they fall.
I also need to practice in the knowledge learned to master the skills required caring for the
elderly and those who are at risk of falling.

References.
American Geriatric Society,British Geriatric Society (2010) Prevention of Falls in Older
Persons.www.medcats.com/FALLS/frameset.htm (Last accessed: August 19 2011.
Cox, J., Thomas-Hawkins, C., Pajarillo, E., DeGennaro, S., Cadmus, E. and Martinez, M., 2015.
Factors associated with falls in hospitalized adult patients. Applied Nursing Research, 28(2),
pp.78-82.
Dauphinot, V., Faure, R., Omrani, S., Goutelle, S., Bourguignon, L., Krolak-Salmon, P. and
Mouchoux, C., 2014. Exposure to anticholinergic and sedative drugs, risk of falls, and
mortality: an elderly inpatient, multicenter cohort. Journal of clinical
psychopharmacology, 34(5), pp.565-570.
Doherty M, Crossen-Sills J (2009) Fall risk: keep your patients in balance. Nurse Practitioner.
34, 12,46-51
Kumar, A., Delbaere, K., Zijlstra, G.A.R., Carpenter, H., Iliffe, S., Masud, T., Skelton, D.,
Morris, R. and Kendrick, D., 2016. Exercise for reducing fear of falling in older people living in
the community: Cochrane systematic review and meta-analysis. Age and ageing, 45(3),
pp.345-352.
Luzia, M.D.F., Almeida, M.D.A. and Lucena, A.D.F., 2014. Nursing care mapping for patients
at risk of falls in the Nursing Interventions Classification. Revista da Escola de Enfermagem
da USP, 48(4), pp.632-640.
Page P (2010) Standing strong: brining evidence to practice for a community-based fall
prevention
exercise program. Topics in Geriatric Rehabilitation. 26, 4, 335-352
Tabloski, P.A., 2014. Gerontological nursing. New York, NY, USA: Pearson.
Zhao, Y.L. and Kim, H., 2015. Older adult inpatient falls in acute care hospitals: intrinsic,
extrinsic, and environmental factors. Journal of gerontological nursing, 41(7), pp.29-43.
Zia, A., Kamaruzzaman, S.B. and Tan, M.P., 2015. Polypharmacy and falls in older people:
balancing evidence-based medicine against falls risk. Postgraduate medicine, 127(3),
pp.330-337.