Nursing 403 – Therapeutic Nursing Interventions – Preventing Falls

 

Purpose of Assignment

The purpose of this paper is to define a clinical problem, review the literature for appropriate research supported nursing interventions, critique current practice and provide a plan for changing or adapting clinical practice.

 

Approach to Assignment

To begin this assignment, I first chose a problem on the unit where I work that has lots of area for improvement. Once I chose the topic of patient falls, I then went to my boss and gathered data about the falls on our unit including the number of falls, reasons for the falls and current prevention strategies. I then researched strategies being used by other hospitals and approved by the Joint Commission. I was then ready to start compiling my thoughts into a paper.

 

Reason for Inclusion

I included this paper as one of the additional assignments completed during this program to show my ability to creatively solve a problem in the “real world” of nursing. I also wanted to use this paper satisfy the requirement of one assignment from this current semester being included in my portfolio, seeing as I just wrote this paper in nursing 403.

 

Curricular outcomes

 

Critical thinking

• Evaluates nursing care outcomes through the acquisition of data and the questioning of inconsistencies.

        I evaluated the nursing care outcome of “no falls while in the hospital” in this paper. I used data that I collected from my personal unit and experience as well as data from other hospitals and the Joint Commission to evaluate this outcome. I questioned inconsistencies in the fall prevention mechanisms being using on my floor, seeing as these inconsistencies had a great deal to do with the high number of falls on my unit.

 

• Revises actions and goals based on evidence rather than conjecture.

        I discussed revising nursing interventions and actions to meet the goal of no falls while in the hospital in this paper. I based the nursing interventions of purposeful hourly rounding, implementing a patient safety team and the use of proper footwear at all times on research studies I found in nursing journals online. I also based these interventions on the current data from my place of work.

 

• Engages in creative problem solving.

        This entire paper is focused on solving the problem of patient falls in the hospital. I discuss several options for solutions including hourly rounding, a patient safety team and proper footwear. I discuss two falls that I was personally involved in and how these falls could have been prevented. I use my creativity to solve the problem of patient falls in the hospital setting.

 

Nursing Practice

• Performs direct and indirect therapeutic interventions that incorporate principles of quality management and proper safety techniques based on assessment findings.

        Based on the assessment that there are far too many inpatient falls at my work, I use this paper to explain some nursing interventions that can help alleviate this problem. The direct nursing interventions I perform in this paper include placing fall risk wrist bands, fall risk stickers and proper footwear on patient’s feet, completing purposeful hourly rounding on patients and joining the patient safety committee at my work. The indirect therapeutic interventions I use to prevent falls include doing research on fall prevention in other hospitals and bringing this research and intervention ideas to my boss.

 

• Establishes and/or utilizes outcome measures to evaluate the effectiveness of care.

        In this paper I establish that the outcome measure in question is the ability to prevent falls in the inpatient setting. I utilize this outcome measure to evaluate the effectiveness of care through fall prevention on my unit. I take the number of falls on our unit and compare it to the quality of fall prevention strategies implemented for those particular patients. I then take this data to create new and more direct methods of fall prevention to help my unit achieve this outcome measure.

 

Communication

• Expresses oneself and communicates effectively with diverse groups and disciplines using a variety of media in a variety of contexts.

        I am able to express myself effectively through my writing to my instructor and peers through this project. To complete the project, I used a variety of media including paper writing, verbal communication and research on the internet to enhance the communication of my ideas to my instructor.

       

• Produces clear, accurate and relevant writing using correct grammar, spelling and punctuation.

        I received an A on this project in Nursing 403. I received full credit for the grammar, spelling and punctuation portion of the rubric and was able to effectively communicate my thoughts through my writing to my ODU professor.

 

• Accesses and utilizes data and information from a wide range of sources to enhance patient and professional communication.

        I used eight different sources for my research for this paper. These references included research articles, journal entries and Joint Commission standards. I was able to use these references to enhance my paper and create several different options for preventing falls on my unit. These references allowed me to express my thoughts in a clear and direct manner to my instructor.

 

Teaching

• Uses information technologies and other appropriate methods to communicate health promotion, risk reduction and disease prevention across the life span.

        I use this paper to communicate the importance of fall risk reduction to my peers, my boss and my instruction. I utilized the information technologies of the ODU virtual library, several online nursing journals and the Joint Commission website to conduct research for this project.

 

Research

• Differentiates between descriptive nursing literature and published reports of nursing research.

To complete the research necessary for this paper, I had to weed out the non-reliable sources. While using Google, I found several articles that nurses had written about fall prevention; however, these articles were simply their personal opinions about how to best manage patient falls rather than research based studies. I had to use my research skills to weed out these non-reliable sources so that I could focus on only research-based articles and studies for my paper.

 

• Evaluates research that focuses on the efficacy and effectiveness of nursing interventions.

        While conducting my research, I had to choose the three nursing interventions for preventing falls that had the most solid research and seemed to be the most highly successful in research studies. To do this, I had to evaluate the effectiveness of many different fall prevention strategies in order to find the most effective ones.  

 

• Shares research findings with colleagues.

        I shared my research findings with my professor by writing and submitting this paper. I then shared my findings with my boss. She then allowed me to pass along the information at our next unit meeting to my colleagues. We are now working on implementing some of the fall prevention strategies that I researched on our unit.

 

Leadership

• Delegates and supervises the nursing care given by others while retaining the accountability for the quality of care given to the patient.

        In this paper I discuss a new fall prevention checklist that has been recently implemented on our unit. This checklist involves the RN delegating the job of ensuring that known fall risk patients have their bed alarms on at all time. The checklist is filled out by myself, the charge nurse, at the beginning of the shift and then given to the CNAs. They must sign the checklist every 4 hours stating that they have gone into the room and ensured the bed alarm is on. They must then return this list to the charge nurse at the end of the shift. This allows me to delegate nursing care to the CNA while retaining responsibility for the patient.

 

Professionalism

• Demonstrates accountability for one’s own professional practice.

I discuss two scenarios in this paper in which one of my own patient’s fell. I take full responsibility for these situations and remain accountable and honest about the events leading up to and after the falls.

 

• Advocates for professional standards of practice using organizational and political processes.

        In this project I advocate for the professional standard of practice regarding a patient’s right to remain safe and free from falls while in the hospital using my personal organizational process. I went to my boss to gather data about falls prior to beginning the assignment and then went back to her afterwards to share my research findings with her. We have now teamed up to come up with new strategies to prevent falls on our unit in order to uphold the stated standard of practice.