Implementation of ICT for Fall Prevention in Geriatric Ward (NURS2006)

This Clinical Practice Improvement (CPI) project, conducted by a student, focuses on implementing an ICT-based intervention program to reduce falls in a geriatric ward. The project aims to minimize falls by 50% within four months by exploring the effectiveness of ICT education in the elderly community, evaluating the impact of the ICT program on fall reduction, and understanding the elderly's responsiveness and perception of ICT-based fall prevention devices. The project aligns with clinical governance principles, particularly minimizing clinical risk related to falls. The project utilizes the PDSA (Plan-Do-Study-Act) cycle for intervention design and implementation, including a comprehensive educational campaign involving community nurses and ICT specialists. Barriers to implementation, such as staffing shortages and resistance to change, are addressed. The project's evaluation will be based on survey data, clinical records, and adherence to best practice principles to determine the intervention's success and potential for replication. The report includes detailed references and follows the assignment's checklist to ensure all requirements are met.

Running head: CPI PROJECT ON FALL PREVENTION
CPI project on fall prevention
Name of the student:
Name of the university:
Author note:

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CPI PROJECT ON FALL PREVENTION
NURS2006 ASSIGNMENT 5
Clinical Practice Improvement Project Report
Student Name, FAN and ID:
Project Title:
Implementation of ICT based intervention program istoppfalls in the geriatric ward to
minimize falls by 50% within the next 4 months
Project Aim:
The aims and objectives of the CPI project includes:
 To explore the effectiveness of implementation of the ICT education in the elderly
communities.
 To evaluate the effectiveness of ICT program on reducing the rate of falls in the
geriatric unit.
 To understand the change in responsiveness and perception of the elderly
populations to ICT based fall prevention devices
Relevance of Clinical Governance to your project
Among the various approaches that have been taken to ensure optimal quality in the care
services that are being provided to the patients, the concept of clinical governance had been
one of the greatest aspects (O’Brien, 2015). Clinical governance can be defined as the
systematic framework which helps in facilitating continuous improvement to the care
services being provided to the patients and achieving best clinical outcomes for the patients
in all circumstances. It has to be mentioned in this context, implementing any change to the
care services in an attempt to improve the care services or minimize any risk is directly
linked to the concepts of clinical governance.
There are four key principles of clinical governance, the first element is clinical
performance and evaluation which is associated with utilizing, monitoring and
disseminating the evidence based clinical practice into the care services to improve

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CPI PROJECT ON FALL PREVENTION
practice or avoid any risks. The area of concern for the project is preventing the incidences
of falls for the elderly patients in the facility, the intervention proposed will be based on
the trail studies that have been published before. The second pillar is professional
development and management, which facilitates clinical development and maintenance of
the professional standards by the means of implementing different innovative changes
(Pearson, 2014).
The third pillar is the consumer value which encourages the care service providers to
involve the consumers in the improving the care practices and the care services that are
being provided to the patients. The project has also incorporates the perception and voice
of the consumers while implementing the change and incorporated the fall prevention
standards of the NHSQS into designing the intervention. The fourth pillar of clinical
governance is clinical risk, which concentrates on minimising risk and improving the
overall clinical safety of the services (Uhb.nhs.uk, 2018). The falls is a major clinical risk
to the elderly patients and hence the project also aligns effectively with the fourth pillar of
the clinical governance.
Evidence that the issue / problem is worth solving:
There is mounting evidence that indicates at fall related fractures being one of the greatest
contributing factors leading to hospitalization for the elderly population all across the
world. as peer the statistical data, it has to be mentioned that the percentage of older adults
suffering a fall in the residential aged care centres is close to 50%, and 40% of the number
of falls are recurrent falls (Barry et al., 2014). Considering Australian statistics, 30% of the
total number of adults aged 65 years or living in Australia have encountered at least one
fall per year. Along with that, it has to be mentioned that 40% of the total injury related
deaths reported for this age group relates to the incidences of falls (Ww2.health.wa.gov.au,
2018).
Falls is a very common challenge that the older adults have to encounter, and there are a
variety of contributing factors that trigger falls for this target population (Bullo et al.,
2015). Thus, prevention of falls and fall related injuries in older people has become a
public health priority. It has to be mentioned that there have been many intervention
options that are available to avoid instances of falls such as bed rails, non-skid footwear,

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and physical environment de-cluttering. Although, as discussed by Kojima (2015), the
impact of these interventions are effective in the health care setting, for the home based
setting the impact of these interventions are limited. On the other hand, the ICT based
interventions can be adapted to the home setting as well empowering the elderly
population to avoid the risk of falling without the need for being admitted to an aged care
facility (Hawley-Hague et al., 2014). Hence, this project has aimed to enhance the
awareness and education of the elderly population of the local area regarding the
implementation of ICT devices such as istoppfalls in their homes to reduce the rate of falls
in the elderly population.
Key Stakeholders:
Community nurse:
The community nurses will the agent of change implementation who will be the
individuals providing the educational interventions to the elderly population regarding the
implementation of ICT.
ICT specialists:
The ICT specialist technicians will also collaborate equally to the educational programs
with the community nurses to provide education to the target elderly population regarding
how to install the device and how to use it effectively.
Nurse managers:
The nurse managers will lead the educational intervention workshop team and will
supervise the entire arrangements, manage the scheduling of the staff that will be involved
in the program and ensure evidence based practice of the program.
Target population:
The participants of the program will be the community dwelling elderly people aged 65
and above selected randomly.

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Interviewers and data analysts:
The survey and interview post the implementation of the educational intervention will be
carried by the interviewers and the data collected will be statistically analysed taking the
assistance of the interviewers and data analysts.
Consumer voice:
The consumer voice will be the representative of the elderly and their spouse to share the
perception, doubts, preferences and grievances.
CPI Tool:
Clinical practice improvement is a project framework that is utilized on the health care
scenario to improve the current status of the care practices or implement a change to avoid
a clinical risk. There are various CPI tools to implement the change, although, for this
particular project we will be utilizing the PDSA or Plan-Do-Study-Act cycle to design the
intervention program and implement it successfully in the chosen population (Gschwind et
al., 2014). In order to justify the use of the PDSA cycle as the tool for this CPI project, it
can be mentioned that PDSA cycle helps in testing and implementing continuous
improvements in the context of quality control in the health. Along with that PDSA tool
helps in optimal resource allocation and systematic and time completion of the project as
well (Knudsen et al. 2018). There are four elements of the PDSA tool:
Plan:
The project will continue for 4 months, the first month will be devoted to the
multidisciplinary team researching the incidence of falls in the local community, the
contributing factors behind the incidences of falls, and lastly the awareness and knowledge
among the target population regarding the ICT devices using the primary and secondary
resources. Based on the research, a random sampling of the target population will be
selected with respect to the baseline data collected and informed consent will be taken

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from them regarding the program to ensure abiding by the ethical code of conducting the
research on human subjects.
Do:
After the selection and preparation of the target population of 50 elderly individuals
belonging to the age group of 65 years and above, the implementation of the project
intervention will commence. The educational intervention will be given on a bi-monthly
basis and each of the participants will be given an interactive seminar workshop regarding
the ICT programs like istoppfalls and its implementation to help avoid the risk of falls in
the home setting.
Study:
This is the phase where the impact of the intervention implemented is assessed (Taylor et
al., 2014). This will be done on the basis of monthly follow up interviews and surveys to
assess how many individuals have invested in ICTs and the rate of reduction in the
incidences of falls. Finally, after the completion of intervention, data will be collected from
the local clinics and facilities to assess the reduction rate in the number of hospitalization
due to fall injuries.
Act:
This is the phase where the progress of the project will be assess and the success of the
project will be determined based on the evidence based best practice principles such as
timeliness, appropriateness, involvement of stakeholders, and clinical governance. The
team of data analysts will decide whether or not the project has succeeded to reduce the
rate of falls and enhanced the use of ICT to understand whether the project should be
replicated on a larger scale or else it should be ceased.
Summary of proposed interventions:
The proposed intervention will be an educational campaign which will focus on enhancing
the awareness of the target population regarding the implementation of the ICT devices to
avoid the risk of falling among the elderly populations.
The educational intervention will be given to the target population by the community nurse
in collaboration with the ICT specialists (Oepen et al., 2018). The educational workshops
will be arranged every alternate week on the Sundays and participation will be absolutely

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free of costs.
After each session, the participants will be given informative pamphlets on the use of ICT
devices, easy installation and FAQ regarding the implementation of the services. The
pamphlets will also contain information of istoppfalls installation and usage.
Lastly, after each session, the participants will be allowed to have a one to one interaction
session where the participants will be able to clear any doubts they have regarding the ICT
device istoppfalls.
Barriers to implementation and sustaining change:
There are various challenges that are associated with implementation and sustainability of
the changes that have been implemented. First and foremost, the lack of staffing and
resources will be the most important challenge. The community nurses are often dealing
with additional workload due to short staffing, making time for participating in the
program will be a very important challenge (Nyman et al., 2013). Along with that the
limited availability of time, money and other resources will also be a considerable
challenge for the project. Lastly, resistance to change will also be a very important
challenge. The non-compliance among the target group to participate in the program can
also act like a notable threat to successful completion of the project (Qin & Baccaglini,
2016).
Evaluation of the project:
The last phase of the project will be the evaluation of the intervention or change that has
been implemented in the health care scenario. The evaluation will be based on the survey
data after the completion of the program on incidence of falls and installation of the ICT
devices. Along with that, data will also be collected from the local clinics on the instances
of falls that has been reported and the rate of reduction after the intervention has been
implemented (Barry et al., 2014). Lastly, the data will be analysed and co-related with
respect to the best practice principles, timeliness, appropriateness, involvement of
stakeholders, participant’s experience on intervention, and clinical governance. This will
help in understanding whether or not the project has achieved the selected outcome or goal

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that has been set for the project.

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References:
Barry, E., Galvin, R., Keogh, C., Horgan, F., & Fahey, T. (2014). Is the Timed Up and Go
test a useful predictor of risk of falls in community dwelling older adults: a systematic
review and meta-analysis. BMC geriatrics, 14(1), 14.
Bullo, V., Bergamin, M., Gobbo, S., Sieverdes, J. C., Zaccaria, M., Neunhaeuserer, D., &
Ermolao, A. (2015). The effects of Pilates exercise training on physical fitness and
wellbeing in the elderly: a systematic review for future exercise
prescription. Preventive medicine, 75, 1-11.
Gschwind, Y. J., Eichberg, S., Marston, H. R., Ejupi, A., de Rosario, H., Kroll, M., ... & Aal,
K. (2014). ICT-based system to predict and prevent falls (iStoppFalls): study protocol
for an international multicenter randomized controlled trial. BMC geriatrics, 14(1),
91.
Hawley-Hague, H., Boulton, E., Hall, A., Pfeiffer, K., & Todd, C. (2014). Older adults’
perceptions of technologies aimed at falls prevention, detection or monitoring: a
systematic review. International journal of medical informatics, 83(6), 416-426.
Knudsen, S. V., Laursen, H. V. B., Bartels, P. D., Johnsen, S. P., Ehlers, L. H., & Mainz, J.
(2018). Can Quality Improvement improve the Quality of Care? A systematic review
of effects and methodological rigor of the Plan-Do-Study-Act (PDSA) method. Bmj
Quality and Safety.
Kojima, G. (2015). Frailty as a predictor of future falls among community-dwelling older
people: a systematic review and meta-analysis. Journal of the American Medical
Directors Association, 16(12), 1027-1033.

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Nyman, S. R., Ballinger, C., Phillips, J. E., & Newton, R. (2013). Characteristics of outdoor
falls among older people: a qualitative study. BMC geriatrics, 13(1), 125.
O’Brien, K., 2015. Clinical governance and patient safety. Core Topics in Obstetric
Anaesthesia, p.219.
Oepen, D., Fleiner, T., y Hausmann, A. O., Zank, S., Zijlstra, W., & Haeussermann, P.
(2018). Falls in hospitalized geriatric psychiatry patients: high incidence, but only a
few fractures. International psychogeriatrics, 30(1), 161-165.
Pearson, B. (2017). The clinical governance of multidisciplinary care. International Journal
of Health Governance, 22(4), 246-250.
Qin, Z., & Baccaglini, L. (2016). Distribution, Determinants, and Prevention of Falls among
the Elderly in the 2011–2012 California Health Interview Survey. Public Health
Reports, 131(2), 331-339.
Taylor, M. J., McNicholas, C., Nicolay, C., Darzi, A., Bell, D., & Reed, J. E. (2014).
Systematic review of the application of the plan–do–study–act method to improve
quality in healthcare. BMJ Qual Saf, 23(4), 290-298.
Uhb.nhs.uk. (2018). The main components of clinical governance. [online] Available at:
https://www.uhb.nhs.uk/clinical-governance-components.htm [Accessed 21 Nov.
2018]
Ww2.health.wa.gov.au. (2018). Falls Prevention Model of Care. [online] Available at:
https://ww2.health.wa.gov.au/~/media/Files/Corporate/general%20documents/Health
%20Networks/Falls%20prevention/Falls-Prevention-Model-of-Care.pdf [Accessed 21
Nov. 2018].