The risk management topic for this assignment will be reducing falls in the Regency convalescent home. Since this convalescent home offers long-term nursing care for the elderly, one of the widely spread problems experienced in the organization is patients falling. Therefore, falls are the most common safety risk in this long-term care center. Some of the nursing home residents have been reported to be falling more than once in a year, leading to complications and even fall-related fatalities (Aguwa, 2019). Moreover, people living in convalescent homes and who suffer falls are at a higher risk of hip fractures than those living outside institutions.
Rationale
To reduce falls in the organization, there needs to be a system approach that achieves a change in the organization through modifying workflow simultaneously, decision-making and communication. This may not be an easy thing to achieve. In Regency convalescent home, there is no nursing education program on multifactorial guidelines on fall-prevention in place to boost the confidence of the stuff and hence reducing falls (Normile, 2016). There is a lack of comprehensive fall-prevention programs in the organization and hence the need to step-up. The implementation of the strategy can better meet the federal, local, and state compliance by following specific procedures throughout staff education. For instance, the organization can use the principles from AMDA (American Medical Directors Association) fall prevention guidelines (Aguwa, 2019). They can also gain self-efficacy in preventing falls by using the STEADI toolkit.
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Support
According to research, about a third of patients older than sixty-four years who are non-institutionalized fall annually. In comparison, about 45%-70% of those living in nursing homes fall each year. In both cases, the older the patient, the higher the risk of falling (Series, n.d). Besides, it is the organization's responsibility to ensure change and reduce injuries resulting from falls in the nursing facility as part of ensuring patient safety (Ibrahim et al., 2019). Moreover, it has been reported that about one thousand eight-hundred patients who suffer from a fall in long-term care facilities die every year ((Aguwa, 2019). CDC reports the financial budget of fall to be $30 million, leading to severe monetary consequences for long-run care facilities.
Implementation
To implement a fall’s prevention strategy in the Regency convalescent home, the managers can offer education to nursing-care staff on the multifactorial fall’s-prevention techniques. These include; education on how to identify and eliminate environmental factors that could predispose one to fall, such as removing any barriers such as cables (Aguwa, 2019). Also, educating care nurses on patient meditation, relevant exercises, and proper equipment to help the patients in movement around the facility. Besides, the direct-care nurses can be educated on the STEADI toolkit based on breaking the barriers of fall-prevention in convalescent homes.
Challenges
Most of the interventions designed in the strategy are mostly applicable in a hospital setting. They are thought to may have some effectiveness in preventing falls also in long-term care facilities. However, there may be significant variations resulting from the population (Taylor et al., 2005). For instance, convalescents have an issue maintaining cognition and balance; they are fragile and may have problems accomplishing daily living activities such as regular exercise. Therefore, to overcome these barriers, the STEADI toolkit and strategies given by ADRA can be used during the implementation.
Evaluation
Regency convalescent home has several goals, including ensuring the staff's stability, increasing resident mobility, safely reducing hospitalizations, and decreasing symptoms of pain, to mention a few. The attainment of these goals using the strategy can be evaluated by analyzing whether there is a decrease in fall-related fractures, depression, and pain medication use resulting from falls (Vu et al., 2006). Besides, this strategy is aimed at eliminating the fear of falling, and hence its success can be evaluated by monitoring whether there is increased use of the lower extremes.
Opportunities
Other risk-management improvements in the organization include reducing the spread of diseases and infections in the convalescent home. This is increased in nursing homes due to the nature of aging. Therefore, the organization should look for strategies to contain infections that may be spread from the hospitalization of some patients. These include quarantine and ensuring techniques for testing individuals for infectious diseases.
References
Aguwa, H. (2019). Nursing Education to Prevent Resident Falls in Long-Term Care.
Ibrahim, J. E., Holmes, A., Young, C., & Bugeja, L. (2019). Managing risk for aging patients in long-term care: a narrative review of practices to support communication, documentation, and safe patient care practices. Risk Management and Healthcare Policy , 12 , 31.
Normile, D. (2016). Fall Prevention in Older Adults Who Reside in Nursing Homes.
SERIES, C. B. E. Creating an Educational Plan That Meets the Learning Needs of Nursing Staff. Clinical Journal of Oncology Nursing , 10 (2).
Taylor, J. A., Parmelee, P., Brown, H., & Ouslander, J. G. (2005). The falls management program: A quality improvement initiative for nursing facilities. Book The Falls Management Program: A Quality Improvement Initiative for Nursing Facilities (Editor ed.^ eds.) .
Vu, M. Q., Weintraub, N., & Rubenstein, L. Z. (2006). Falls in the nursing home: are they preventable? Journal of the American Medical Directors Association , 7 (3), S53-S58.
