The key items in delivering high-quality patient care are excellent skills of health care professionals and detailed analysis of the incidents, resulting in better understanding of the current needs of the existing system. Therefore, all possible decisions should be taken into account to improve patient care. It is advisable to use stakeholder analysis to identify the parties which interests would influence the implementation of a quality improvement plan and calculate the costs.
It is a general opinion that falls are a serious burden for elderly people in long-term care setting. Therefore, the causes of such falls should be examined carefully to prevent their occurrence. If a fall occurs, the medical professionals are obliged to complete an incident report that helps to analyze the causes and take some precautions. It is stated that the main causes of falls are incorrect weight shifting, hit or loss of support, and collapse (Robinovitch et al., 2013). The activities that influence the falls usually include walking forward, sitting down or standing quietly.
To implement the improved practice, it would be beneficial to use better screening for falls in elderly people. The first step of fall risk screening is to use a survey for evaluation of the probability of fall for a patient and calculate the likelihood of falling based on the period of six months. The results of such screening are compared to the fall logs for twelve months as a second step. It is emphasized that “reporting performance information in the right format is critical to successful quality assessment” (Spath, 2013, p. 69). The information about falls should be presented in the format convenient for assessment, such as graphs or charts. The reports should include physical and mental state of the patient. This method might help to identify patients who are in the fall-risk group and single out repetitive fallers to take measures for extra-care. The researchers note that “these analyses can help the LTC professionals to focus and allocate more resources to truly high-risk fallers” (Nguyen, & Garg, 2017, p. B16).
The potential challenges of the suggested steps include the probability of incorrect assessment of the fall-risk group and its extension. Therefore, constant screening and evaluating of data are required to take appropriate measures to prevent falls. The possible fall prevention strategies also include encouraging elderly people to do exercises to improve their coordination, strengths, and balance. The patients should utilize handrails and other facilities that help to keep balance. The rooms of the patients who are in a fall-risk group should be not far from the nurse’s station. The floor of the premises should be free from any litter and objects. It is advisable for the patients to use prescribed wheelchairs and walkers that are fitted to them correctly. The use of such medications as sedatives should be minimized as well.
Fall screening is a cost-effective tool for improving patient care. The studies based on the logs of falls are believed to be effective for evaluating the risks for the potential fallers. Therefore, this change will influence both patients and personnel and is expected to improve the quality of services.
Implementing a quality improvement plan requires close collaboration with the selected individuals in the practice environment. Nowadays, the nurses are “partners with multiple care providers and pivotal players in open-systems organizations” (Yoder-Wise, 2015, p. 327). Thus, they should use their knowledge in helping to single out the corresponding fall logs. The volunteers and their patient’s families might be involved in the process as well, assisting in monitoring of incidental falls.
Falls are a burden for elderly people in long-term care organizations. This issue needs some new approaches to provide better patient care. The suggested approach to quality improvement is providing better fall risk screening. The challenges and cost-efficiency of the plan were discussed as well.
Nguyen, T., & Garg, A. (2017). Improve screening for falls in the elderly population in a long term care setting. Journal of the American Medical Directors Association, 18(3), B15-B16.
Robinovitch, S. N., Feldman, F., Yang, Y., Schonnop, R., Leung, P. M., Sarraf, T., & Loughin, M. (2013). Video capture of the circumstances of falls in elderly people residing in long-term care: An observational study. The Lancet, 381(9860), 47-54.
Spath, P. (2013). Introduction to healthcare quality management (2nd ed.). Chicago, IL: Health Administration Press.
Yoder-Wise, P. S. (2015). Leading and managing in nursing (6th ed.). St. Louis, MO: Mosby.