NURS 4006: Enhancing Patient Safety: A Fall Risk Nursing Care Plan

This report addresses the critical issue of patient falls within an inpatient rehabilitation unit. It begins by analyzing collected data that reveals a concerning trend in fall incidents, highlighting the need for targeted interventions. The core of the report details a comprehensive nursing care plan designed to improve performance management and prevent falls. This plan incorporates evidence-based strategies such as recognizing pain, promoting appropriate exercises tailored to individual patient needs, equipping patients with protective gear like proper footwear and hip protectors, and considering calcium and Vitamin D supplementation to enhance bone health. The report concludes by emphasizing the importance of nursing intervention and adequate staffing to effectively reduce fall risks and improve patient safety, referencing several studies to support the proposed strategies.

Introduction
Nursing care plans are extremely effective in providing a means of communication
among the nurses and all the nurses need to be familiarized with the term nursing plan. In
most of the nursing workplaces, patient care is basically a team effort and it is accomplished
by nurses from different shifts in collaboration with the doctors. An effective nursing plan
contains all the relevant information about the patient, goals of treatment, strategies to
achieve the goal and plan for evaluation of the strategies (Fleig et al., 2016). With a glance on
the nursing care plan, understanding the main issue with the patient can be easier. In this
paper, some data collected from the inpatient rehab unit will be analyzed. From the analysis
an area will be selected which requires more attention and improvement in the performance.
The main focus of this paper is to develop a nursing care plan suggesting some strategies to
improve the performance of the selected area. Some best practices to evaluate the plan will
also be illustrated in the paper.
Analysis of the data
Data was collected from the inpatient rehab unit in four interval of time period. The
statistical data was represented in the form of mean, target and actual data. After that, the
variance or the deviation in the result from the target to actual data has also been represented.
From the wide range of data of various areas, the data regarding fall risk of the patients have
been chosen. Fall risk among the patients is most common and it is more likely to happen
among the elderly patients. This can be very dangerous if not treated properly that it might
lead to the death of the patient too. So, it was important to improve the performance to
prevent fall risk. In the datasheet, total fall per 1000 days of every interval has been shown.
During the first interval of time, the mean of total fall has been counted as 7.6 and the actual
fall is 6.96. Whereas, the target of the fall risk is 3.14 and so the variance is 3.82 which is

negative. Again, in the second data collection during the second span of time, the mean fall
was calculated as 7.68 and the actual data was zero. So, in this case the variance was 3.14
which were positive. But, in the next time period, the collected data shown a mean of 7.31,
where the actual fall was 5.97. The variance calculated from the target produced it was
negative 2.83. In the last time span, the mean was 7.38 and the actual fall was 9.19 which
presented a huge variance from the target and it was 6.05 in negative. So, the fall count
increased among the patients which were alarming from the analysis of the statistics. In order
to improve the performance management to prevent fall risk some strategies in the nursing
plan is required (Milos et al., 2014).
Nursing plan to improve performance
Many studies revealed that fall probability can be reduced when coupled with the
intervention of nurses (Morris, Bailis & Wiswell, 2014). Fall prevention is essential but it is
challenging as there is no compelling evidence that any of the intervention of nurses can be
effective enough in preventing risks of falling. However, considering multiple physical as
well as environmental factors, some strategies can be implemented in order to create a
nursing plan for falls. Some best practices in this regard are as follows.
Recognizing the pain, promoting some appropriate exercises- Incorporating
exercise program into the daily routine of the resident patients can improve their balance and
it will help to prevent the fall risk and risk of fractures resulting from falls. Many studies
revealed fact with evidence that integration of exercise has reduced the risk of fall among
patients (Duckham et al., 2015). Researchers recommended exercise program to the patients
to improve their gait, strength and balance (Fleig et al., 2016). As per the age and the physical
condition of the patient, the exercise plan must be prepared. However, a majority of
population are less likely to show their willingness of participating in any exercise program.

But, individualized based exercise should be promoted under the supervision of physical
therapist in order to prevent cardiopulmonary decomposition from performing wrong
exercises (Carande-Kulis, Stevens, Florence, Beattie & Arias, 2015).
Equipping the resident patients with some protective gear- Use of several items
that can be worn by the patients that prevent them from injuries due to fall and the items are
proper footwear, hip protectors and helmets (Stubbs, Brefka & Denkinger, 2015). As per the
requirement of the patients these equipments can be included in the nursing plan to prevent
fall injuries. In a survey of Mayo Clinic, it has been found that many falls occur due to the
improper and old footwear (Hatch & Tomé, 2017). Ill-fitting and worn out shoes can
contribute to fall as well as they can develop burn, blisters and other issues. For high risk
ambulatory elders, helmet can reduce the risk of subdural hematomas sustained from falls. In
many studies it is also found that people especially women who discontinued wearing hip
protectors were more likely to experience hip fractures due to fall (Stubbs, Brefka &
Denkinger, 2015). So, incorporating the protecting equipments in the nursing care plan can
reduce fall risk.
Considering calcium and Vitamin D supplementation- The residents of any
healthcare centre have little or no sun exposure and their Vitamin D levels are lower than the
general population. Some good evidence suggests that Vitamin D supplementation among the
older adults can reduce their osteoporosis which has contribution to the fall (Uusi-Rasi et al.,
2015). So, providing Vitamin D and calcium supplementation can enhance their bone
function which in turn reduces their fall risk.
Conclusion
Fall is common and it is associated with most of the elderly patients. The data
collected from Inpatient rehab Unit also illustrated the risk of fall among patients. If it is not

controlled then it can lead to loss of life. Preventing the risk of fall is difficult but with some
proper strategies in the nursing care plan it can be reduced. This paper described some
strategies which can help a patient in this regard. However, nursing intervention and
including more staffs for their assistance is necessary to prevent the fall risk.

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