An Assignment Submitted by
Rationale and Outline
Falls are a major cause of injuries, morbidity, and even mortality for all individuals and especially in the case of older adults. During the past three months around 10 incidents of falls were registered in the busy 36-bed medicine floor unit, where the majority of them occurred during the trips to the bathroom. Due to the possible negative outcomes for the health of the patients that may cause serious injury, it was essential for the healthcare unit to implement effective measures to minimize the factors causing the falls and prevent their occurring in future. The main aim of this project was to develop effective measures that would decrease the falls to at least 50 percent.
Project Description
It was also admitted that falls may lead to psychological and social consequences that may prevent individuals from adequate functioning (Perell-Gerson & Edelstein, 2008). Several studies conducted in this direction revealed that falls are a multilayered, complex issue that requires ongoing vigilance and constant improvement to maintain the safety of the patients, where the approach regarding falls has to be individual (Wolf et al., 2013). Also, it was determined that patients perceive falling as a sign of their disability and try to cover it not cooperating and agreeing for the interventions in order to decrease the risks of falling (Wolf et al., 2013). There are multiple measures used for fall prevention, including the instruction of patients, supervision made by nurses, more attentive monitoring of patients at-risk, and the utilization of visual aid for educating the patients about the causes of falls and their prevention (Lampiasi & Jacobs, 2010). To eliminate the risks and minimize the falls among patients, it was decided to implement several practical measures.
For this purpose, it was decided to recruit half of the registered nurses and patient care associates to create preventive measures. In the result, after the several in-service meetings, the team has created a visual poster board depicting brief information on the consequences of falls and preventive measures hindering patients from falling, which included non skid socks, bed locked in lowest position with side rail up, landing mat on the floor, use of bed alarm, call bell within reach, hourly rounding done by RNs and PCAs. It was aimed to educate the patients about the risks, outcomes, and preventive means of falls.
Significance to Nursing
Nurses have to ensure patient safety and make sure which includes the prevention of falls and injuries related to them. In this case, the nurse acts as a leader to guide the patients when they are particularly vulnerable. Injuries experienced by patients in the healthcare facilities are partial the responsibilities of nurses. According to Quigley et al. (2007), when a fall occurs in the hospital, it is reported to the management documenting the circumstances surrounding this incident. If it is revealed that the fall is associated with the inadequate preventive measures, poor management of the infrastructure in the facility, or faulty monitoring techniques, the nurses, as well as the entire facility, may be held responsible for this incident both legally and morally. In this case, the nurses are required to implement effective and sound measures to prevent the falls and minimize their occurrence.
Application of Leadership Theory
The current project was guided by the Transformational Leadership theory that requires the leaders to interact with the followers in the way of creating a stable relationship based on trust, which will enable both parties to cooperate better and prevent negative incidents from occurring (Burke, 2007). The main aim of transformational leadership is to change the perception and attitude of followers through their charismatic personality, which in the case of falls prevention enables the nurses to instruct the patients and change their attitude towards the falls. Rules and regulations are flexible, guided by group norms. These attributes provide a sense of belonging for the followers as they can easily identify with the leader and its purpose. Also, this framework enables to organize the staff members and provide effective instructions regarding the necessary procedures and actions needed to prevent falling, as the transformational leadership is able to guide the followers by flexible and regulated norms accepted in the group.
Therefore, using the transformational leadership theory, the current project was managed to involve the needed number of staff members who were willing to help the patients and spend extra time for developing the preventive measures. This framework enabled the implementation of the project to be more effective, as the patients were attentive to the personnel, willing to follow the precaution measures. Also, transformational leadership enabled the participants to use the most appropriate method of preventing the falls and eliminating their further occurrence. According to the framework, the leader has to provide clear instructions and guide the followers unobtrusively for making sure the patients would not resist new rules, as it is believed that strict tone of the instructions can induce the opposition.
Implementation Process
The entire process of implementation was mostly successful, where no serious threats and problems were indicated. At the same time, it is important to mention that in the beginning of the recruitment process, some of the staff members did not show enthusiasm for the collaboration. In the majority of cases, the participants complained that they do not have enough time for designing new methods of falls prevention. Also, some of them implied that not in all cases the nurses and medical personnel in general is responsible for these incidents, as all necessary measures regarding the infrastructure were applied. Consequently, it was essential to familiarize the participants with the possible outcomes of the falls including the legal side of the problem. In addition, the information regarding the consequences of falls for the patients’ health was provided to the staff members who resisted the participation.
During the further process of implementation, no serious problems were detected, as the staff as well as the patients perceived the measures adequately and enthusiastically. The success of the implementation procedures was related to the framework of the transformational leadership that helps to provide clear instructions, yet making it a priority of the followers to follow them. One of the crucial advantages of the project is the appealing to the cause-and-effect relationship in terms of falls and their outcomes. Also, the success of the prevention procedures roots in the simplicity of the measures, their universality, and functionality.
Evaluation
The main objective of the project was to decrease the falls to 50 percent and prevent their further occurrence. To address these aims, the half of the staff members in the healthcare unity was recruited for the means of collaboration and design of the preventive measures. During the meetings it was decided to elaborate a poster board that includes all possible outcomes of the falls and their prevention. In the result, all measures and processes used for the implementation were successfully applied. The patients and the participants collaborated successfully with each other, which showed promising results. It is anticipated that the falls will be decreased to minimum in the nearest future, as the awareness among the staff members and patients was increased in terms of fall prevention. It is important to notice that the main problem that was indicated during the implementation process concerned the lack of awareness and faulty information regarding the problem, which was targeted and eliminated by the described measures.
References
Burke, K. M. (2007). Leadership competencies for clinical nurse managers: The renaissance of transformational leadership. Nursing Education Perspectives, 28(4), 219-229.
Lampiasi, N., & Jacobs, M. (2010). The role of physical and occupational therapies in fall prevention and management in the home setting. Care Management Journals, 11(2), 122-136.
Perell-Gerson, K., & Edelstein, J. E. (2008). Complexities of fall prevention. Journal of Rehabilitation Research & Development, 45(8), 7-18.
Quigley, P., Neily, J., Watson, M., Wright, M., & Strobel, K. (2007). Measuring fall program outcomes. Online Journal of Issues in Nursing, 12(2), 25-63.
Wolf, L., Costantinou, E., Limbaugh, C., Rensing, K., Gabbart, P., & Matt, P. (2013). Fall prevention for inpatient oncology using lean and rapid improvement event techniques. HERD: Health Environments Research & Design Journal, 7(1), 85-99.
