Question

As the newly hired manager of a 60-bed sub-acute nursing unit, you have been tasked to create a Fall Management Program that will reduce the rates of resident falls by 30% in the next quarter. As you study the monthly quality assurance data, you note the following trends:

• Monthly fall rates average about 40 falls; this number exceeds the state and national average for comparable settings by almost 50%
• The average age of the residents who sustained a fall is 77
• The average length of stay on this unit is 4 weeks as most residents come for short term rehabilitation following hospitalization
• More than half of the falls last month occurred in the resident bedrooms and another 30% occurred in their bathrooms
• 40% of the falls over the past 3 months occurred on weekends
• Five residents accounted for almost a third of the falls

Describe how you will achieve your goals using a systems approach. What other data would you look at before planning your interventions? What approaches would you take? How would you implement this new program (a change initiative) to ensure enduring success? What systems would you put in place to evaluate its effectiveness? Differentiate between those interventions that are individual-based vs. systems-based (i.e., organization-wide).

As the newly hired manager of a 60-bed sub-acute nursing unit, you have been tasked to create a Fall Management Program that will reduce the rates of resident falls by 30% in the next quarter. As you study the monthly quality assurance data, you note the following trends: Monthly fall rates average about 40 falls; this number exceeds the state and national average for comparable settings by almost 50% The average age of the residents who sustained a fall is 77 The average length of stay on this unit is 4 weeks as most residents come for short term rehabilitation following hospitalization More than half of the falls last month occurred in the resident bedrooms and another 30% occurred in their bathrooms 40% of the falls over the past 3 months occurred on weekends Five residents accounted for almost a third of the falls . . . Describe how you will achieve your goals using a systems approach. What other data would you look at before planning your interventions? What approaches would you take? How would you implement this new program (a change initiative) to ensure enduring success? What systems would you put in place to evaluate its effectiveness? Differentiate betweern those interventions that are individual-based vs. systems- based (i.e., organization-wide)

Answer 1

The falls are the critical accidents that occurs in the hospitals and the nursing homes. These incidents would be reducing the quality of the life of the care receivers. This would also deteriorate the comprehensive care provided by the health care team.

To prevent and manage the falls of the vulnerable group of people the system approach can be utilize wereby the complete assessment of the vulnerable group must be done. The system approach to the assessment of the gait balance seeks towards the identification of the impairments in the subcomponents of the postural control and the compensatory strategies used to compensate for these impairments. The components assessed are the biochemical which includes strength, range of motion, stiffness and alignment. Motor Co ordination, sensory organisation.

The other data looked before planning includes the other components of assessments,this comprise of a full history collection, medical evaluation for pathogens, including vision, medication review, evaluation of gait, postural control, mental function. The other assessment would include rombergs test, postural Reflexes and functional reach test.

The approaches would include from physical function maintenance, nutritional intake, vitamin d screening, managing the complications of chenic diseases, optimising the quality of life, maintaining the milieu environment.

The approaches using the technology which includes the detectors to predict the motion and gives the alarm to the care givers, bedside alarms can be the best to assist the patient in taking him, bathroom alarms helps the care givers to immediately assess the patient.

This can be implementing by educating the care givers and the receivers in the management by setting the alarms, doing the safety rounds by nurses, sitters in reducing falls.

Identifying the high risk people and assisting them to meet their activities.

This goal of prevention and management of goals can be achieved by maintaining the mobility and balance and identifying those at risk of a fall. The approach of intervention would include the management of underlying pathologies, strength and balance training by the team, education regarding the safety measures.

The system to evaluate the effectiveness is the risk fall ratio could be calculated, care receivers feedback, residents reports of treating falls, improved quality of life.

The individualised based approach is were the patient takes initiative in caring for himself and preventing the fall by calling for the assistance in meeting his needs, whereas as system approach is the multidisciplinary approach which includes the complete assessment and inclolvement of all health care team and the collaboration of the patient and the family.