Question

Identify the Ftag that is associated with the noncompliance and put a plan of correction for the organization to put in place to be in compliance in the future.

A resident (diagnosed with Parkinson’s Disease; COPD; listed as assist of two in his care plan; and had experienced two falls in last six months) fell from a recliner lounge chair to the floor in the residents’ common area of the nursing home around 7:30 PM, when he stood and attempted to walk without assistance. According to the nurse he did not identify shortening of the right leg or external rotation when he assessed the resident immediately after the fall. The resident did complain of right groin pain when he fell, during the remainder of the evening and through the night. The nurse did not evaluate the resident for a possible fracture again after the initial assessment when the fall occurred, despite complaints of ongoing paid in the right groin.   The resident’s primary physician was notified of the fall by fax at 7:31am the next morning. A second fax indicates that the physician contacted nursing administration at 8:15 am following the second fax. Physician requested an assessment by nursing administration and report back to him. Nursing Administration identified in their assessment resident has shortening of his right leg and was unable to bear weight. Resident was sent by ambulance at 9:15 am the morning following the fall to the emergency room at regional medical center. Nursing home has policy and procedure that directs staff to inform the resident’s physician immediately of a significant change, a need to alter treatment significantly or a decision to transfer.

Further investigation showed that two other residents had falls with concerns for the assessment of falls risk and interventions.

A second Resident with a history of falls experienced a fall earlier in the week from her wheelchair as she was attempting to self-transfer to bed. She sustained a bruise on her forehead. Her physician and family were notified and the resident as treated and observed by nursing staff. There is no documentation to support an assessment after this fall or new interventions attempted. The resident fell again in 5 days from her wheelchair sustaining bruising on her forehead. Following the second fall, an assessment was done and a change in intervention was implemented.

The third resident diagnosed with Alzheimer’s Dementia, had a history of falls. After further review of this resident, the resident had an alarm on, fell to the floor before staff could reach him. He had minor cuts from this fall. There was no documentation of an assessment of the fall and possible change in interventions noted that might reduce the risk of future falls.

Answer 1

1)In Parkinson's disease ,doctors should assess patient for his personal risk and assist him to manage medication and its side effects.Exercise regularly can aid the client to keep better strength,enhance stamina,improve balance and reduce the risk of falls.because,exercise will help the patient to attain more concentration and focus on activities and movements.it will reduce the progression of Parkinson's disease.modifications should be made in home also to prevent future falls.make wide pathways,remove rugs and add non skipping mats in way of showers and bathtubs to prevent slipping.Moreover,canes should be provided to the patient with Parkinson's for to get stability .Refer to physical and occupational therapist to teach exercise which can aid him to keep him mobile without getting injured.

2)for wheelchair patients some care should be taken to prevent falls.arrange room properly so that patient can get the thing easily and reachable to her.a health worker should be there to decrease the amount of unbalance.seat should be dropped in the rooms.inaddition to that,keeping alarms will notify the care giver if a patient try to stand up.Seat belt can be provided to minimize to try to stand up.The vital thing is that providing information to care givers about best practices for wheel chair transfers as well as giving reminders to patient and staff about the importance of wheelchairs safety precautions to keep the patient safe.

3)for dementia patients maximize the safety in home where the live.there may be necessary for night lights or keeping overhead lights on in the ways where the regularly used paths to bathroom or kitchen if he get up during night.an another change can be done is to move the bed room to area near a bathroom to avoid stair usage.It is vital to arrange the frequently used pathways free from clutters of furniture.Patient should have a daily routine to do it safetly and efficiently.Reminders can be placed in various places in whole house.refer to an occupational therapist so that he can help him to climb the stairs using contrasting colors.check medication of patient to understand any medicine causes dizziness.provide a cane or a walker to prevent risk of falling.batgroom should be kept dry and avoid slippery mats in the way of bath room and where tiles are present also.Teach simple exercise and movements to enhance their strength and condition.regular eye exam should done to check if any vision problems are present.music therapy can improve their coordination and reduce the risk of falls.