Capstone Project in Nursing: Fall Prevention in Elderly Care Settings

This capstone project in nursing delves into the critical issue of elderly falls within healthcare settings. The project's core objective is to identify the factors contributing to falls, reduce their frequency, and implement effective prevention strategies to ensure patient safety and maintain high-quality care. The project begins with an overview of the capstone experience, definitions of falls, and the elderly population. It then explores the causes of falls, the importance of self-assessment, and the application of the Gibbs reflection model to analyze experiences and inform future practice. The project also includes a detailed professional portfolio, a learning experience summary, and self-reflection. The student identifies the need for training and policy implementation to improve fall prevention in aged care facilities, including self-assessment and reflection. Through the Gibbs model, the project analyzes a specific incident involving an elderly patient fall, examining feelings, learning from the experience, exploring alternative approaches, and creating an action plan for similar situations. The project emphasizes the importance of staff empowerment, the implementation of evidence-based practices, and continuous improvement to enhance the safety and well-being of elderly patients.

Running head: CAPSTONE PROJECT IN NURSING 1
Capstone Project in Nursing
Student’s Name
Institutional Affiliation

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Capstone Project in Nursing
Primarily, the capstone experience program remains a value-based plus an essential need
in healthcare settings. Chiefly, the capstone experience lets a nurse to increase his learning and
creativity plus to apply their clinical practice knowledge effectively. More so, it enables the
nurse to advance and improves governance skills, self-assessment, examination, plus thinking
capabilities. Besides, the project encourages nurses towards the identification of the problems
and to find their solutions through critical thinking. The experience remains crucial to aid nurses
to realize their future goals (Neal-Boylan, 2014). Chiefly, the capstone experience project topic
avoids falls from elders and acute care injury settings. Importantly, patients' safety and quality
clinical areas are essential for the achievement of the anticipated outcome. Patients' safety and
quality ensure there is standard and cost-friendly caution (Stevens, & Miller, 2016). The primary
project objective is the identification of elements that cause elderly falls. It also decreases the
number of falls and prevents falls. Thus it implements the prevention strategies for falls towards
the maintenance of patient’s security and excellence care.
Usually, the experience aid to find the frequency plus reasons for falls in aged care home
settings. The project also comprises minimization strategies in falls, avoidance plan, execution in
care home settings, and the results. Notably, the elderly are affected more by the diseases than
the younger generation (Allen et al., 2017). More so, older people usually are in a care home and
have different problems in the care home setting. In the health care setting falls are rampant
issues, and stands as the everyday challenges. Lately, patient falls has occurred four times in the
aged care setting in a month. As a result, it vital to minimize falls in aged care homes to uphold
patients’ quality care safety (Lilley, Collins, Snyder, & Savoca, 2014). As such, the capstone
project experience topic was chosen for implementing fall prevention and control methods to

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uphold security plus excellence care to patients. Notably, the capstone program starts with the
experience, falls, and elderly definition. The following essay will explain the elements that cause
elderly fall, critical reflection, and capstone experience analysis by use of Gibbs reflection
model. To support the project, the model discusses a detailed professional portfolio for
supporting the capstone experience project. To sum up, it provides a capstone experience
program, learning experience, and self-reflection summary during the project.
Capstone experience entails "a concluding familiarity that provides guidelines for
learners to mix extraordinary knowledge and central studies, spread, evaluate, and skills acquired
(Wagenaar, 1993, p.209). Notably, the experience project is an elderly strategy of the prevention
program. Agreeing to the World Health Organization (WHO) (2002), ageing incorporates
anyone who is above 65 years. Notably, patient fall is rampant in the elderly. Falls related
wounds and falls are the significant prevalence of death cause in the elderly (WHO, 2016).
According to WHO, fall entails an event that leads an individual on the ground or another lower
(2016). More so fall-related wounds may be non-lethal or lethal. Approximately four hundred
and twenty-four thousand mature adults perish worldwide yearly because of falls (WHO, 2016).
Australian Institute of Health and Welfare argues that a third falls annually, and the patient fall is
typical in both the aged care facilities and hospital settings (2014). Mainly, dementia patients are
at higher threat of falls concerning the elderly. The reasons include decreased attention,
confusion, agitation, abnormalities (Kurrle, Hogarth & Hill, 2010). Therefore falls awareness
minimization plus prevention among the aged care facilities is vital in the clinical area.
For this reason, self-assessment is an efficient method of self-learning. The key reason
behind this is because self-assessment gives ideas on weaknesses and strengths on performance
and aids in recognizing learning wants to reinforce clinical skills to boost theoretic and clinic

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performance (Austin & Arnott, 2017). It argued by Boud (1995) that, self-assessment
incorporates individual involvement in the identification of standards and creating judgments on
how the criteria and standards have been met (p. 5). Importantly, self-assessment aid in the
maintenance of professional and personal competence. Notably, self-assessment includes
surveillance, self-valuation, plus own judgment (Bose, Oliveras, & Edson, 2001). The
investigator I applied aided me to realize my negative and positive points. I know the regions
that are essential to improve, which is very vital. More so, I know I require more information
about falls and strategies of minimization among the elderly. Besides, I need leadership skills for
implementation of policy in clinical settings plus enrolling for falls assessment and prevention
courses in elderly. Moreover, I need to put the methods into practice in aged care homes. From
self-assessment, I had an overview of myself. More so, it aided me in understanding issues
deeply, gave me confidence, and directed me on how to upgrade my career path and attain my
objectives. Primarily, my goals in the capstone program, include: Firstly, to learn the definition
and meaning of falls in the elderly. Secondly, identifying the elements causing falls in aged care
homes. Thirdly, collecting data through an online search, online government report, and falls
prevention related courses in the elderly. Fourth, I shall use the PowerPoint presentation
concerning the topic other members to see. Fifthly, there is a need for staff members to be
empowered to put the methods into the clinical settings and evaluate the program.
Primarily, reflection entails the process of self-motivation. Meditation incorporates
evaluation, to think critically, and to learn from training to have insights training plus on self-
evaluation (Asselin & Cullen, 2011). Bulman & Schutz (2008) argues that reflecting involves
experience practice appraising to be analyzed and applied to change plus inform about future
training. Mainly, meditation is a clinical practice tool, evidence based practice, and curriculum.

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Besides, it helps in advancing medical training. More so, thoughtful writing has crucial
accountability in EBP (Burton, Lepp, Morrison, & O'Toole, 2015). Also, reflective writing
remains a nursing teaching tool for scholars and assist in recording and nursing generation of
information. Notably, reflection needs a broader perception of healthcare issues and self-
awareness valuation (Craft, 2005, p.53). The frequently used reflection model remains the Gibbs
model (1988). However, the ideal is tough to remember.
Therefore, an original model for reflecting identified as reflection ideal was introduced
(Barksby, Butcher & Whysall, 2015). The ideal is stress-free to recall plus has seven phases. The
beginning phase starts with R, meaning recalling an incident or condition. It entails a small
description of the case and event plus details about the situation (Barksby, Butcher & Whysall,
2015). Currently, my services are for older people in geriatric medicine plus neuro-trauma high
dependency division. In both old care units, I work part-time by checking on both the older
adults plus neurotrauma dependents patients. In an aged care home, we receive elderly patients
who have a fall-related wound plus other complications. The postoperative delirium, dementia,
plus infection is common in the elderly and causes agitation and confusion that lead to falls
(Bradley, 2013). I noted in nursing that in these two divisions, falls are rampant in the elderly.
In both divisions, some patients had fallen and had falls wounds. As usual, one time,
while I was in a morning shift, a patient with femur fracture fixation and open reduction the
previous night. The patient had remained stable over the night though he became confused in the
morning and started screaming after handing over. Besides, he fell as he tried to move from the
bed. There was patient relocation to a different nurse who used to prepare patients' medicines all
through the period. After I recognized the patient lied on the floor, I asked for help. In addition to
the fall, the patient had a head injury. Notably, the number of falls increased daily in both wards.

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As a result, I realized the primary issue in this aged care home was elderly fall and fall correlated
wounds.
The second phase begins with E meaning to examine study activities and the event
present throughout the condition (Barksby, Butcher & Whysall, 2015). With the help of other
nurses, we transferred the patient to the bed and attended vital signs and neurological
observations. The patient was assessed from top to bottom to detect whether there were other
wounds. The victim bled on the head and was an application of pressure on the head by use of
combine. When suffering decreased, it was saturated and dressed. Computerized Tomography
was ordered for the patient's brain by the doctor.
Thirdly, the phase starts with letter F standing for feelings. The nurse needs to identify
and recognize the emotions experienced during the situation (Barksby, Butcher & Whysall,
2015). As a practitioner, I felt unhappy because of the case since couldn't halt the patient’s fall
and save him from wounds. Besides, it was vital to apply top to bottom assessment and cognitive
assessment of the victim before the start of the shift. As a result, there is baseline data about the
victim (Hrabok, 2013). Since the nurse had to do incident reporting and documentation, she was
anxious about the fall. The practitioner was angry with the night nurse who improperly handed
over. The fall error was because the night-time nurses forgot to inform the medical practitioner
that the patient gets agitated and confused. As such, there is a requirement to apply the
Identification, Situation, Background, Assessment, and Recommendation (ISBAR) tool. As a
result of the ISBAR handover tool, there is a risk minimization about missing patient data (New
South Wales Health, 2013). However, the medical practitioner claims the fall isn't the patient's
fault since the victim is unaware of his action and confused. Thus the nurse actions indicate a
lack of care and safety to the patient.

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The fourth stage is to learn from experience, which starts with letter L. It means there is a
need to locate learning from the condition and to study from involvement (Barksby, Butcher &
Whysall, 2015). The nurse agrees there stays a need for the patient assessment. The assessment
comprises physical examination, intellectual need to be familiar with neurological status and to
ensure the patient is safe. The nurse claims that she will request for help in case the patient
becomes more agitated and confused. Besides, the nurse acknowledged she lacked enough skills
on falls prevention methods.
Moreover, the next phase begins with E standing for exploration. There is a need to
review the episode and options identification in this phase in case of event reoccurrence
(Barksby, Butcher & Whysall, 2015). There is a need for training on elderly falls prevention and
minimization approaches online. I helped the nurse to get online resources about elderly fall
prevention. Besides, I presented the New South Wales Falls Prevention program and Health
Education, and Training Institute (HETI) and acquired electronically connected training about
elderly falls avoidance methods. From this situation, I learned there is a need for new nurses and
graduate education on elderly fall prevention. As a result, I learned in case of such a situation
reoccurring; nurses need to be familiar with the plan.
Besides, there is letter C, meaning creation. The phase clarifies creation in that it entails
creating an action plan for a similar situation to reoccur or elderly fall prevention and plan
creation for future reference (Barksby, Butcher & Whysall, 2015). Later as a practitioner
initiated self-rating concerning the problem and found out what causes of elderly falls in aged
care homes. As a result, I found the need to gather information about the falls in the elderly in
detail since I lacked enough knowledge of the falls-related wounds. In the beginning, I lacked the
confidence to deal with the issue and found it hard coping with the problem though later I

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worked on it. Firstly, I evaluated the knowledge I had about the topic. Proper topic knows how it
is vital to understand the issue deeply. I gathered information. As a result, I prepared a
PowerPoint presentation on elderly falls to be presented to nurses. More so, I encouraged
completion of online HETI training which relates to fall prevention on the elderly.
The latter stage begins with T standing for time. There is a requirement for setting the
period for plan implementation. The time limit I set was three to six months. There was an
explanation of the fall assessment forms plus plan in admission and whenever needed. There was
a falls prevention day celebrated every Friday for reminding and learning about falls prevention
in aged care homes. More so, three were regular rounds to ensure patients were comfortable and
safe. Management plans and falls risk assessment forms were checked every Friday. The files of
patients with high fall risk were stacked with steep fall risk stickers. Therefore everyone knew
high fall risk patients. Before there was the use of green armbands for fall risk patients, these
armbands were banned because of skin irritation and many bands on patient hands. More so,
there were monthly meetings for the project's progress evaluation. Moreover, online information
and clinical support to nurses aided in elderly falls minimization and prevention. I feel that this
model of reflection is useful since it stress-free to implement plus remember (Barksby, Butcher
& Whysall, 2015). Always I recall, “Falls prevention is everyone’s business,” sentence (Clinical
Excellence Commission, 2013).
The following progression assists to enhance knowledge in nursing plus improving
leadership qualities. Chiefly, leaders may bring changes in aged care homes (Stanley, 2011).
Besides, it aids me to understand different leaders’ skills and various leadership types, which
include congruent, transactional, and transformational leadership. I have adored transformational
leadership. Primarily, transformational leaders through the identification of needs and support for

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goal achievement motivate followers. Though it is challenging, it creates invention plus conveys
the change in an aged care home (Gabel, 2013). The capstone experience has granted the
presentation self-confidence. As a result of the three PowerPoint presentations in the aged care
home, I feel confident about the medical area. Besides, it assisted in attaining goals and
enhancing my skills in identifying the problems related to the aged care home, analyzing,
preparing, implementing, and evaluating the plan.
The professional portfolio entails the necessity of the Australian Health Practitioners
Regulation Agency (AHPRA). After getting an audition from AHPRA, there is a need for
displaying a portfolio for registration in the health profession to the AHPRA (AHPRA, 2016).
Chiefly, the professional portfolio is a manuscript which entails career goals, experience plus
competencies. The collection helps nurses to achieve future constant professional development
and goals (Oermann, 2002). Notably, “ this portfolio incorporates the planned pool of varying
information types plus sign that show individual’s constant professional growth actions,
experience, skills plus professional goals and achievements” (Andre & Heartfield, 2011, p.4). In
the nursing profession, the professional portfolio is vital. The main reasons include: First, it aids
to maintain and gain the practice of registration in medical settings. Second, the portfolio
provides the data for constant development professional actions with proof. In addition, it
displays the level in performance or improvement needed (Andre & Heartfield, 2011).

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Current Position Description:
As a full-time nurse, I deal with patients with spine and head injury division and focuses on older
people in the elderly care home.
Summary of Capstone Experience outcomes:
Objective:
Identifying the causes, prevention, or minimization of elderly falls is the objective.
Identification of the problem:
Elderly falls in aged care nursing homes are frequent, and the number of falls was increasing
daily. More so, it is vital to find fall prevention mechanisms and implement those methods. It
helps in decreasing the amount of the fall in the aged care home and preventing any more
elderly.
Implementation of the solutions:
There was fall hazard evaluation after the identification of problems in the aged care home.
Notably, this was done when the condition of the patient altered. The New South Wales Health
fall evaluation form was applied in evaluating the fall threat of the patient. The practitioners
record risk management document when the patient is prone to falls. Later there is the
implementation of the plan. Afterwards, steep fall hazards stickers are stuck on the patient's file.
As a result, everyone will be aware of high fall risk-prone patients. Besides, most nurses do
courses online. There is an arrangement for regular meetings to assess the plan. I also encourage
nurses to enrol for twelve weeks' dementia course.

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