Contribute to Clinical Practice: Falls Risk Assessment and Prevention

This report investigates the critical role of falls risk assessment in enhancing clinical practice and patient safety within a hospital setting. It emphasizes the importance of conducting these assessments upon patient admission to identify individuals at high risk of falls and prevent potential injuries, including those with cognitive or physical changes. The study examines the causes of falls, such as improper quality of services and patient behavior, and reviews relevant literature and data, including statistics on fall rates. It highlights the roles of various stakeholders like patients, physicians, and nurses, and discusses the importance of regulatory compliance and the implementation of fall prevention protocols. The report recommends strategies such as providing effective training and education to patients and staff, utilizing clinical audits and feedback, and employing technologies like sensor mats. It outlines key tasks and timeframes for project implementation and concludes by emphasizing the significance of these practices in achieving better patient outcomes and maintaining high-quality clinical care.

Contribute to the improvement of
clinical practice: Ensuring the
falls risk assessment is completed
upon admission to the ward to
promote falls prevent

Table of Contents
INTRODUCTION...........................................................................................................................3
Identify...................................................................................................................................3
Situation..................................................................................................................................3
Background.............................................................................................................................3
MAIN BODY...................................................................................................................................4
Assessment.............................................................................................................................4
Recommended practice and strategies....................................................................................6
CONCLUSION................................................................................................................................7
REFERENCES................................................................................................................................8

INTRODUCTION
Identify
Clinical improvement area is an effective way of improving and maintaining quality of
care in order to attain better results and outcomes. It helps in providing the best quality services
in the clinical areas and also assess fall risk assessment at the time of admission.
Situation
Aim and objectives
The key objective of this study is to evaluate clinical practice which helps in ensuring the
fall risk prevention practice in Australia. The main objective of this study is to identify the
patients who are at high risk of fall at the time of admission to the ward.
Background
Patient fall is one of the major cause of harm during treatment in hospital. It is evidence
based safety initiative which helps in prevention of fall risk by using effective clinical based
practice. This leads to major health problems which in turn leads to ineffective results and
outcomes. This study will help in identifying interventions in order to improve patients care.
The main problem of the study is that the country hospital in South Australia has only
one Acute ward. The key problem is all the patients suffering from various health problems are
admitted in the same ward. This study will focus on highlighting the risk assessment of patients
at the time of admission in order top provide proper care.
Purpose
This study will help in improvement of clinical practice which helps in fall risk
assessment. This study is carried out to find the best clinical practice and intervention to promote
falls prevention.
Definition of terms
 Fall: This is an event where person comes to rest inadvertently on floor or any other
lower level.
 Risk assessment tool: This framework helps in organising knowledge in order to prevent
falls in hospital.
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 Clinical intervention: This is a professional activity which helps in improving the
quality by giving justified recommendation.
MAIN BODY
Assessment
Review of literature
(Morgan and et.al., 2017) sought to determine the fact that, patients are admitted to the
hospital due to change in cognitive or physical condition, which is when combined with high risk
of fall assessment among patients. Patients fall results in injury which may lead to functional
impairments, chronic pain, permanent or temporary disability and death. The main cause of
patients fall is due to improper quality of services, hospital environment, patients behaviour and
characteristics, etc. (Morgan and et.al., 2017) sought to determine the fact that, fall risk of the
patient should be assessed at the time of admission which helps nurses in determining which
patients are at higher risk of falling. Obese patients and cardiac patients are at high risk of fall.
The nursing care should focus on determining the condition of the patients, medical history
which in turn helps in giving effective care.
(Barker and et.al., 2016) established that, risk of falls can be classified into accidental
falls, unanticipated fall and anticipated falls. Anticipated falls occurs when patients score on the
fall risk tool shows that the patient is at a risk of fall. Example, loss of balance, impaired vision,
impaired gait and impaired cognition. Unanticipated fall is not indicated on risk factor of
patients. This fall is unpredictable. This is the reason fall risk assessment is necessary at the
tiome of admission to the ward in order to take necessary decision. Example patient faints
suddenly. Accidental fall is when patient fall unintentionally which mainly occurs due to
slipping, tripping, equipment failure, etc. (Visvanathan and et.al., 2019) sought to analyse the
fact that, the fall rates among medical ward in Australia is approximately 27000 in the year
2012-13. The younger patients aged between 18-39 accounts to 3.2% of falls. Approximately
79% of people experience fall over 70 years of age (Prevention of falls in acute hospital settings:
a multi-site audit and best practice implementation project, 2015).
Outcome measures
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This study will help in examine the key percentage compliance which results in fall
prevention. Fall rate data will be analysed and will investigate effective common interventions in
order to promote falls prevention. This study will focus on clinical audit programme and clinical
intervention. This study will highlight on fall risk assessment at the time of admission.
Stakeholders
Stakeholders are important as they help in taking decision regarding various health
services and fall risk assessment at the time of admission to the ward (Williams and et.al., 2016).
There are various number of stakeholders involved in the clinical health program which mainly
includes clinicians, board, patients, staff members, physicians, pharmaceutical firms, etc.
Patients: They are the service users who understands the various programs and
interventions which in turn helps in improving the health.
Physicians: They are people who practice medicine and are responsible for proper health
care service and support. Physicians will help in physio referrals which in turn results in
promoting fall prevention.
Nurses and staff members: They are actively involved in giving proper care to the
patients and focus on delivering the best possible services by understanding the need of every
individual effectively (Stephenson and et.al., 2015). It helps in determining the risk of the patient
fall at the time of admission to the ward.
Regulatory compliance
Regulatory compliance helps in effectively processing the laws, rules and regulations
which relates with healthcare practices. This compliance mainly relates with privacy of patient
information, patient practices, billing practice, etc.
Australian therapeutic goods administration (TGA) is responsible for regulating the
health and care practice in Australia. They focus on providing the best healthcare practice in
order to gain better results and outcomes.
Fall prevention protocol (FPP) is an established set of rules which helps in preventing fall
(Montgomery and et.al., 2018). The clinical governance need to comply with various local
government rules and regulations. Complying with various medical standards and norms helps in
smooth functioning and better medical care.
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Intervention or anticipated change to clinical practice
Providing effective training and education to patients, family and nurses: Insufficient
training and support to patient and care takers results in patients falls. Proper education and
training helps in delivering the best possible results which in turn results in prevention of falls
among patients. Use of effective strategies and advanced technologies helps in providing the best
care to the patients (Ali and et.al., 2018). This helps in making nurse and care takers to evaluate
various different strategies which in turn results in higher organisational growth. Patients and
family members should be given proper training and education to take care of themselves and it
also results in better recovery. Adequate training should be given to employees in order to
effective assess the risk of patient at the time of admission. The nurses should focus on
implementing sensor mats to make nurses monitor to track movement of the patient.
Clinical audit and feedback: This is the summary of clinical performance in healthcare
within a specified duration of time. Feedback is necessary as it helps in taking relevant decision
which helps in better results and outcomes (Oliver, 2019). Clinical audit tool is very crucial as it
helps in improving the care and results in promoting falls preventions by improving quality of
care and service.
Key tasks for the project and the time frame
Key task Time
Framing aim and objectives 3 days
Literature review 7 days
Regulatory compliance 2 days
Clinical audit 10 days
Clinical feedback 5 days
Education and training programs 15 days
Recommendation and conclusion 5 days
Nurses should be given proper training to use sensory mat which helps in implementation
of various effective techniques on time to reduce such risk. Timing of the fall assessment helps
in better patient care which in turn leads to better result and outcomes.
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Discussion of the findings
This report takes into consideration intervention techniques which in turn helps in
maintaining better quality measures in order to improve health and care of the patients who are
suffering from patients fall. The study helps in determining effective evaluation practice and
intervention programs who are at high risk of fall at the time of admission to the ward. This helps
in quality improvement of the clinical care service in order to provide the best quality care
(Williams and et.al., 2016). The recommendable strategies are clinical audit and feedback,
proper education training, etc. Giving them proper training and education helps in improving the
care facilities. The major barrier was time constraints and effective implementation of guidelines.
Another barrier was to identify talented skilful physicians to provide better care and support.
Description of strategies
Clinical audit and feedback is very useful in giving clinical performance of healthcare. It
helps in providing specific information to health care professionals. Effective feedback helps in
continuous improvement and also leads to better results and outcomes to promote fall prevention.
The nurses should focus on using walking aid in order to improve the walking patterns of the
patients who are at high risk of fall. The physio referrals also helps patients to lower the risk of
fall prevention among patients.
Recommended practice and strategies
It has been recommended that patients should wear non- slip slippers in hospital in order
to prevent falling. Care takers and family members should focus on using cot sides and bed rails
when leaving child beside. Family members and nurses should assist patients to use wash rooms.
Developing positive working environment helps in keeping staff to promote fall prevention
(Montgomery and et.al., 2018). Nurses should focus on taking effective measures such as
implementing sensor mats to make nurses monitor to track movement of the patient. Floors
should be kept clean in order to prevent patient falls in the hospital. Nurses should give hourly
rounding to give proactive support care to patients. Use of effective technologies helps in
providing better care and services. The physio referrals also helps patients to lower the risk of
fall prevention among patients. Adequate lighting helps in promoting fall prevention. Securing
and supervising children with harness or safety belts in high chairs, wheelchairs, strollers, etc. It
has been recommended that beds should be kept lower in order to prevent patients fall. Place all
the necessary items of need within the reach of patients in order to provide better care and
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recovery (Visvanathan and et.al., 2019). All the equipments should be well maintained and
should be in a proper condition. The nurses should focus on using walking aid in order to
improve the walking patterns of the patients who are at high risk of fall. The beds should be kept
in low position with breaks at the end of bed to provide comfort care to the patient.
CONCLUSION
From the above conducted research it has been examined that, Clinical improvement area
improving and maintaining quality of care in order to attain better results and outcomes. It is
useful in providing the best quality services in the clinical areas and also assess fall risk at the
time of admission to the ward. This study further concludes that, clinical practice such as clinical
audit and feedback, giving proper training and education to patients, family and nurses helps in
promoting falls prevention. Implementation of sensory mat helps in monitoring the movement of
the patient. This study also critically evaluates the stakeholders present while carrying out the
study and determines regulatory compliance for smooth functioning.
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REFERENCES
Books and Journals
Ali, U.M and et.al., 2018. Do portable nursing stations within bays of hospital wards reduce the
rate of inpatient falls? An interrupted time-series analysis. Age and ageing.47(6). pp.818-
824.
Barker, A.L and et.al., 2016. 6-PACK programme to decrease fall injuries in acute hospitals:
cluster randomised controlled trial. Bmj. 352. p.h6781.
Montgomery, A and et.al., 2018. Effect of an evidence based quality improvement framework on
patient safety.
Morgan, L and et.al., 2017. Intentional Rounding: a staff‐led quality improvement intervention
in the prevention of patient falls. Journal of clinical nursing. 26(1-2), pp.115-124.
Oliver, D., 2019. Falls risk prediction tools for hospital inpatients: do they work?. Hospital.6.
p.08.
Stephenson, M and et.al., 2015. Prevention of falls in acute hospital settings: a multi-site audit
and best practice implementation project. International Journal for Quality in Health
Care. 28(1). pp.92-98.
Visvanathan, R and et.al., 2019. Effectiveness of an Ambient Intelligent Geriatric Management
system (AmbIGeM) to prevent falls in older people in hospitals: protocol for the
AmbIGeM stepped wedge pragmatic trial. Injury prevention.25(3). pp.157-165.
Williams, C and et.al., 2016. Establishing the effectiveness, cost-effectiveness and student
experience of a Simulation-based education Training program On the Prevention of Falls
(STOP-Falls) among hospitalised inpatients: a protocol for a randomised controlled
trial. BMJ open. 6(6). p.e010192.
Online
Prevention of falls in acute hospital settings: a multi-site audit and best practice implementation
project. 2015. [ONLINE]. Available
through:<https://pdfs.semanticscholar.org/04a5/e0216c2f40a3a866600b7947b4149fd5d9d1
.pdf>
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