Implementation of a Patient Fall Prevention Program
There are a number of steps to be followed to implement the patient fall prevention program. Nurses would first need to address the issue to the administrators and hospital staff. It is the duty of the nurse to communicate with the administrative staff about the serious consequences of patient falls in the healthcare setting. Apart from getting approval from administration for implementing the program, nurse would have to deal with a number of healthcare-associated issues to commence the implementation of the program. (ACSQHC, 2009).
Operationalizing a patient fall prevention program to prevent patient falls involves a number of steps. It needs to be comprehensive with established validity and reliability (Morse, 1997). Below are some of the things that need to be kept in mind before implementing a fall prevention program:
Obtain Support from Administration
The first step involves getting the support from administration as it is crucial for the successful implementation of a fall prevention program. Support from the administration ensures adequate staff, equipment, and required renovations to the hospital’s infrastructure (AHRQ, 2013).
Conduct an Environmental Safety Check
Environmental safety check ensures that all the factors in the environment are properly evaluated. Unit is evaluated for issues like safety issues related to cluttered hallways, deficiency in handrails, unsafe equipment used, etc. Report of environmental safety check is submitted to appropriate departments so that all the identified hazards are removed.
Obtaining Baseline Data
Data regarding the number of patients falls prior to the implementation of the patient fall prevention program need to be collected to get an idea regarding the problem at hand and the resources that are necessary to bring that number down. Having a through baseline data would also help in understanding the effectiveness of the program in the form of the degree of reduction in the number of falls.
Establish a System for Monitoring
A monitoring system that records all the falls in the hospital needs to be created. The records that need to be maintained should include the circumstances of the fall, age of patients who are more prone to fall, and scores to be used for categorizing the patient falls. Systems for monitoring patients also include details regarding the circumstances under which a patient falls as a patient who falls will again fall under the same circumstances. The hospital should also constitute an interdisciplinary assessment team that will act as a forum for managing high-risk fall cases and come out with possible strategies for preventing fatal falls and the resulting injuries.
Prepare the Staff
The hospital’s staff needs to be educated regarding the new fall prevention program being introduced in the hospital. Briefing sessions and workshops elucidating the patient falls go a long way in training the staff. The staff should also be educated regarding the interventions that are specifically brought to reduce the fall rate and monitoring staff for tracking the fall rates. Training should also be imparted regarding the handling of serious falls resulting in fractures to hip and wrist (Nevitt and Cummings, 1993).
Interprets details of timelines
Nurse plays an important role in the management of the entire patient fall prevention program. Nurses are involved in various aspects of patient fall prevention program. However, it is important to understand and interpret the timelines associates with patient fall prevention program. The success of a program is associated with proper time management.
(Fitzpatrick, A. 2011).
Each step of the program can be completed within the deadline. For example, obtaining permission from the administrative staff should be completed prior to the commencement of the program. The implementation plan should be well-organized to avoid delay of applications or approvals. Nurses should also disclose the approximate time for the entire program. In a hospital with a large number of patients (with high risk of falls), the number of days associated with the patient fall prevention program would be high. Nurses should also note the delay in approvals and applications concerned with the implementation program. All delays need to be addressed to the administrative staff at the earliest. The training provided to the staff members should be completed prior to the commencement of the program. Nurses should also understand that delay in the approvals from the administrative staff, governing bodies could affect the program to a significant extent. Delays in the recruitment of trained-staff, formation of the committee and the interdisciplinary team can add to the costs of the program.
Lastly, a well-organized and well-planned time along with a nurse with time-management skills would help in the successful implementation of the patient fall prevention program.
(Child, S., et al; 2012)
Resources needed for patient fall prevention program
The implementation of the patient fall prevention program is associated with proper resource management. As mentioned earlier, nurses play an important role in the implementation of a patient fall prevention program. Evaluating the resources for the patient falls prevention program would improve the success rate to a significant extent. Educated/trained staff members and a safe healthcare environment are two key resources that would be helpful for the patient falls prevention program. Some of the other resources that are needed for the patients are assistive devices (to walk safely), 24 hours room service (bed-side staff), and a healthcare professional. (Child, S., et al; 2012)
Trained staff members would assist the patients in most of the daily activities like walking, bathing, and communication. Training of all staff members is important for the successful implementation of the patient fall prevention program. Patients who are at high risk of falls are above the age of 65 years and mostly bed-ridden. It is important that environment around the patients are safe and secure. Lighting, stairs, flooring, patient room, bathrooms, beds, elevators, and visual barriers are some key resources that need to be evaluated and managed during the implementation of the patient falls prevention program. Trained staff members are also involved in the management of the healthcare environment. More than 70% of patient falls occur during hospitalization. Finance would play a key role in the patient falls prevention program. The entire program is based on the financial budget of the healthcare center. Key resources can be purchased depending on the financial status of the program. A low budget program could hamper many factors associated with the patient falls prevention program. The success of the patient falls prevention program is associated with appropriate resource management and implementation. Lastly, the inclusion of a well-trained staff, safe environment, and high financial budget are key resources for the implementation of the patient falls prevention program. (Child, S., et al; 2012)
The communication plan
Nurses act as a communicator between the patients and healthcare professionals. Nurses and healthcare professional need to communicate with each other to solve, implement, and strategize programs associated with patient falls prevention. The communication plan would involve the key stakeholders of the patient falls prevention program. The first step in the communication plan would involve interaction of the nursing professional with the administrative staff of the healthcare center. Nurses would highlight the importance of the patient falls prevention program. They would also need to address the issue/problems associated with patient falls in the healthcare setting. More emphasis should be given to the factors associated with an increase in the number of in-house patient falls. Nurses should present the necessity of the patient falls prevention program in an efficient manner.
After obtaining administrative staff support, nurses are required to communicate with the team involved in the patient falls prevention program. It is important for the nurse to note down all grievances addressed by the train-staff and administrators. Nurses would also need to communicate with the patients for their valuable feedback before, during, and after the implementation of the patient falls prevention program. Nurses would also communicate with external resources and staff members to ensure gather all necessary information about the program. The communication plan would also involve the healthcare professionals. Healthcare professionals could provide feedback of the newly implemented form based on the health status of the patient and the environment of the healthcare setting. Nurses would also communicate with the administrative staff to discuss on the budget of the program. Patient feedback would be evaluated at all stages of the patient fall prevention program. The success of the patient falls prevention program is associated with the effective communication between thenurse, healthcare professional, administrators, staff, and the patient. (Child, S., et al; 2012)
Rough budget for the implementation of a patient fall prevention program
Prior to the commencement of the program, the budget of the implementation program should be implemented. Nurses need to estimate the financial budget of the patient program fall and address it to the administrative staff. The rough budget would include the costs associated with the training of a staff member, changes in the current healthcare environment (furniture, lightings, etc.), and the inclusion of a new committee. The costs associated with the monitoring system and the establishment of the interdisciplinary team should be taken into consideration. The rough budget would give an estimate of the total costs associated with the patient fall prevention program. (Fitzpatrick, A. 2011).
The rough budget would also include the costs associated with the data management and processing systems involved in the program. Since the program would involve ahigh number of patients, trained staff, and interdisciplinary team, the budget would be on the higher side. Nurses would also include the costs associated with the treatment and assessment of the patients who participate in the program. The inclusion of the patient fall prevention program may also incur costs associated with permissions from authorities. The compensation provided to the staff, healthcare professionals and the executive committee should also be addressed in the rough budget. The rough budget should always be on a higher side to avoid disparities between the administrative staff and a nurse.
(Fitzpatrick, A. 2011).
Rough Budget for the Implementation of Patient Fall Prevention Program
Below is a rough plan for the operationalization of a patient fall prevention program:
References
U.S. Department of Veterans Affairs (U.S. VA). National Centre for patient safety. 2004 tools kit. [Online]. 2004 .Retrieved: http://www.patientsafety.gov/SafetyTopics/fallstoolkit.
Fitzpatrick, A. (2011). Best Practices for Falls Reduction. American Nurse Today. Pdf file. Retrieved: http://www.americannursetoday.com/assets/0/434/436/440/7364/7542/7544/7634/4e4e7c0a-fddc-498a-9e6b-2f8736c36adb.pdf
Implementation Guide for Preventing Falls and Harm from Falls in Older People. Best Practice Guidelines for Australian Hospitals and Residential Aged Care Facilities. (2009). The Australian Commission on Safety and Quality in Health Care (ACSQHC). Pdf file. Retrieved: http://www.safetyandquality.gov.au/wp-content/uploads/2012/01/30567-Guidelines-ImplementationGuide1.pdf
Child, S., Goodwin, V., Garside, R., Hughes, J., T., Boddy, K., & Stein, K. (2012). Factors influencing the implementation of fall-prevention programmes: a systematic review and synthesis of qualitative studies. Implementation Science 2012, 7:91. Retrieved: http://www.implementationscience.com/content/7/1/91
Morse, J.M. (1997). Preventing patient falls. Thousand Oaks, California: Sage.
Publications, Inc.
Nevitt, M.C., Cummings, S.R., (1993). Type of fall and risk of hip and wrist
fractures: the study of osteoporotic fractures. Journal of American Geriatrics Society,
41(11), 1226-1234.
Preventing Falls in Hospitals: A Tool Kit for Improving Quality of Care. (2013). Agency for Healthcare Research and Quality (AHRA). Pdf file. Retrieved: http://www.ahrq.gov/professionals/systems/long-term-care/resources/injuries/fallpxtoolkit/fallpxtoolkit.pdf.
