AbstractFall Prevention Post AnesthesiaPurposeThe projects goal was to develop a plan for the role of nurses as change agents to improve the prevention of patient falls in the Post Anesthesia Care Unit (PACU). The aim was to establish baseline knowledge and prior training regarding patient safety and fall prevention according to the post-anesthesia recovery unit protocol and educate staff on implementing strategies to reduce patient falls after surgery.BackgroundPostoperative falls are rarely considered possible complications that should be accounted for in the clinical care practice after surgery. However, there is a considerable prevalence of postoperative falls in PACU and other post-surgery care units, such as patients' homes. Lam et al. (2016) posit that an overall 1.6% incidence of postoperative falls is based on a review of 5 years records of in-patient surgery procedures. The authors observe that successful management of surgery and anesthesia does not guarantee the absence of adversities and…...

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References

Cuttler, S., Barr-Walker, J., & Cuttler, L. (2017). Reducing medical-surgical in-patient falls and injuries with videos, icons, and alarms. BMJ Open Quality, 6(2), e000119.  https://doi.org/10.1136/bmjoq-2017-000119 

Lam, C., Hsieh, S., Wang, J., Pan, H., Liu, X., Ho, Y., & Chen, T. (2016). Incidence and characteristic analysis of in-hospital falls after anesthesia. Perioperative Medicine, 5(1).  https://doi.org/10.1186/s13741-016-0038-z 

Marquis, B., & Huston, C. (2020). Leadership roles and management functions in nursing (10th ed.). LWW.

EBP Programs
There are two important things to remember when it comes to the health issues of older adults. First, older and senior adults account for the lion's share of healthcare problems and costs as compared to the younger groups. This makes sense as the body is aging and/or shutting down not to mention that the bad habits (if any) of a person in their younger years truly start to take hold and render their effects once a person reaches their 50's, if not before. Second, there are common sense and evidence-based ways to handle these issues and help improve healthcare outcomes. Rather than try to "reinvent the wheel" and/or go with unproven methods in general, it is generally better to go with what is known to be effective based on past research and initiatives. While the older groups of Americans will always have more health problems than the younger ones,…...

According to the Centers for Disease Control, muscle-related problems and a lack of exercise account for about 24% of the falls in subacute facilities. Other causes, which can also be easily addressed within subacute facilities, "include wet floors, poor lighting, incorrect bed height, and improperly fitted or maintained wheelchairs" (Falls in nursing homes, 2010, CDC). These types of environmental hazards are estimated to cause 16% to 27% of falls for patients. Even seemingly unavoidable problems such as medications that interfere with coordination can be mitigated by flagging the individual as taking such a drug, and notifying staff that additional care of the patient is required.
In the instances of patients with dementia, or those who cannot care for themselves enough to learn to improve their balance skills to mitigate the risk of falls, measures other than educational endeavors should be undertaken. "Grab bars, adding raised toilet seats, lowering bed heights,…...

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References

Barclay, Linda. (2003). Vitamin D may reduce falls in elderly nursing home patients. Cochrane Database of Systematic Reviews. Retrieved through Medscape on December 29, 2010 at  http://www.medscape.com/viewarticle/716100 

Falls in nursing homes. (2010). Centers for Disease Control (CDC). Retrieved December 28,

2010 at  http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html 

Haines, Terry P., Kim L. Bennell, Richard H. Osborne, & Keith D. Hill. (2004). Effectiveness of targeted falls prevention programme in subacute hospital setting: randomized controlled trial. British Medical Journal, 328(7441): 676. Retrieved December 28, 2010 at

Patient Safety Against Injurious Falls
Description

A White-Paper Testimony on Current Risks

With more than a thousand preventable deaths a day, the need to pay greater attention to improving current patient safety conditions and standards is unquestionable (Gandhi, 2014). This was the gist of a testimony to the U.S. Senate Committee on Health, Labor, Education and Pensions Subcommittee on Primary Health and Aging. The white paper discussed the current safety risks faced by ambulatory patients in the hospital setting. This has been the direction of the patient safety movement since 15 years with emphasis on ambulatory safety problems. Recent studies identified the major safety issues confronting hospital settings. These include medication safety, missed or delayed diagnoses, transitions of care, patients' non-adherence to medication (Gandhi) and poor clinician communication with patients (Schnall et al., 2012). The last issue was the finding of a recent survey of 162 registered nurses attending an APN education program.…...

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BIBLIOGRAPHY

Ballinger, C. And Brooks, C. (2013). An overview of best practice for falls prevention from an occupational therapy perspective. The Health Foundation. Retrieved on April 14, 2015 from  http://patientsafety.health.org.uk/sites/default/files/resources/an_overview_of_best_practice_for_falls_prevention_from_an_occupational_therapy_perspective_0.pdf 

Child, S. et al. (2012). Factors influencing the implementation of fall prevention programmes: a systematic review and synthesis of qualitative studies. Systematic Review: Implementation

Science. Retrieved on April 11, 2015 from  http://www.implementationscience.com/content/7/1/91 

Ensign, M.R. (2008). Ethical issues and the elderly: guidance for eldercare providers. Ensign Law. Retrieved on April 14, 2015 from http://www.ensignlaw.com/Ethical%2020Issues%20and%20Elderly.html

Falls PolicyFalls among the elderly are a serious problem, both in terms of the potential for injuries and the cost of healthcare. As the population ages, the number of falls is expected to rise, making the development of effective prevention policies more important than ever. As the CDC (2021) points out, more than one in four older adults (age 65 and older) experience a fall, resulting in 3 million emergency department visits, 950,000 hospitalizations and 32,000 deaths. Falls are preventable, however, and this paper will discuss public health policy related to this health issue.Key information on public health policy, including the stakeholders, with regard to falls prevention among elderly adults is how to standardize, regulate and mandate practices to prevent falls. One of the key public health policy issues with regard to falls prevention among elderly adults is the role of stakeholders. Stakeholders include government agencies, healthcare providers, insurers, and…...

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References

Braveman, P., Arkin, E., Orleans, T., Proctor, D., Acker, J., & Plough, A. (2018). What is

health equity?. Behavioral Science & Policy, 4(1), 1-14.

CDC. (2021). CDC Foundation Launches National Program to Educate Older Adults and

Hourly Nurse ounds, Can They Make a Difference?
[Author Name(s), First M. Last, Omit Titles and Degrees]

Pressure ulcers or as some refer to as bed/pressure sores or decubitus ulcers are categorized as localized areas of damaged tissue that is caused by shearing forces and excess pressure usually from maintaining the same position over a long period of time. Pressure ulcers typically happen in people who have nerve damage and/or limited mobility. When the person feels pressure, from sitting or lying on any certain body part, this often results in nutrient and oxygen deprivation to the wound or affected area. Strategies to circumvent this involve repositioning. epositioning consists of moving the person into a different position to give the body the ability to redistribute or remove pressure from the affected area. "Pressure ulcers are distressing events, caused when skin and underlying tissues are placed under pressure sufficient to impair blood supply. They…...

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References

Callahan, L., McDonald, S., Voit, D., McDonnell, A., Delgado-Flores, J., & Stanghellini, E. (2011). Medication review and hourly nursing rounds: An evidence-based approach reduces falls on oncology inpatient units.Nursinglibrary.org. Retrieved 12 December 2015, from  http://www.nursinglibrary.org/vhl/handle/10755/164025 

Marsden, G., Jones, K., Neilson, J., Avital, L., Collier, M., & Stansby, G. (2015). A cost-effectiveness analysis of two different repositioning strategies for the prevention of pressure ulcers. J Adv Nurs, 72(12), 2879.  http://dx.doi.org/10.1111/jan.12753 

Moore, Z., & Cowman, S. (2012). Repositioning for treating pressure ulcers.Cochrane Database Of Systematic Reviews.  http://dx.doi.org/10.1002/14651858.cd006898.pub3

RESPONSE 2 (PRESENTATIONS)Response 2 (Presentations)Presentation 1In the first presentation my colleague focused on small nursing informatics project that would help in reducing hospital falls. My colleagues presentation highlights the two technological tools that can be implemented in falls prevention. Although my colleague provides solutions on how falls can be prevented in hospitals, the presentation does not explain how the said solutions can be implemented. For instance, in instructing nurses who care for patients who are prone to falls, Morris (2017) suggests that for the said process to be successful, it would be prudent to include leadership at board and ward levels. Apart from assessing the root cause and testing the proposed solutions as highlighted by my colleague, the presentation would have incorporated risk management strategies. Essentially, a standardized assessment tool could be used in this case to screen for fall risk (Currie, 2008). According to the author, a tailored multimodal…...

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References

Chiuazzi, E. & Wicks, P. (2021). Beyond the Therapist’s Office: Merging Measurement-Based Care and Digital Medicine in the Real World. Digit Biomark, 5,176–182. DOI: 10.1159/000517748

Currie L. (2008). Fall and Injury Prevention. In R. G. Hughes (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US.  https://www.ncbi.nlm.nih.gov/books/NBK2653/ 

Lewis, C. C., Boyd, M., Puspitasari, A., Navarro, E., Howard, J., Kassab, H., Hoffman, M., Scott, K., Lyon, A., Douglas, S., Simon, G. & Kroenke, K. (2019). Implementing Measurement-Based Care in Behavioral Health: A Review. JAMA Psychiatry, 76(3):324-335. doi: 10.1001/jamapsychiatry.2018.3329.

Falls
THE ISSUE OF ACCIDENTAL FALLS

At some point, anyone who had learned how to walk has had the experience of falling down -- it is a universal experience for infants as they gain ambulatory ability. In hospitals, however, the accidental fall is the most reported type of patient safety incident, with elderly patient populations displaying a particular vulnerability (Oliver 2007, p.173). Approximately one-third of adults over the age of sixty-five will experience an accidental fall this year (CDC 2012, n.p.) Fischer (2005) offers some clarification as to how these incidents should be defined -- the simplest basic definition is "a sudden, uncontrolled, unintentional, downward displacement of the body to the ground or other object" (p822). This definition takes into account the unpredictable nature of the incident, and the fact that it frequently involves a certain loss of control on the part of the patient; it also reminds us that the fact…...

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References

CDC (2012). Adult falls. Web. Accessed at: http:/ / www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.htm

Currie, LM. (2006). Fall and injury prevention. Annual Review of Nursing Research. 24(1):39-74.

Fischer ID; Krauss MJ; Dunagan WC et al. (2005). Patterns and predictors of inpatient falls and fall-related injuries in a large academic hospital. Infection Control and Hospital Epidemiology. 26(10):822-7.

Grubel, F. (1959) Falls: A principal patient incident. Hosp Manage. 88:37-8.

Fall Among the Elderly Age Group
Falls among the Elderly Age Group

Biological Factors

Unintentional falls

Expected falls and unexpected falls

isk Elements for Falls

Outline of Several Different Strategies

Counseling and Health Education Strategies

Single Strategies

Primary Strategies

Exercise and physical activity 8

Nursing-Home Strategies

Interventions of Unidentified Effectiveness

Developed Based on your Understanding of the Public Health Problem

Schedule an appointment with your Medic

Keep moving

Wear sensible shoes

According to JM (2009), "As people get older, falls turn out to be a typical and often hurting issue that occurs among those that are in the elderly category, producing a huge quantity of illness, death and use of health care services as well as premature nursing home admittances ( p. 42)." However, falls are a difficult, multi-faceted problem that comprises of social, medical, and financial elements. Medically, the mixture of a high occurs of falls and an increased vulnerability to injury makes the elderly population susceptible to falling down. Illnesses for example, age-related physiological changes…...

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References

A., B. (2012). Research methods in health: investigating health and health services. United Kingdom: Open University Press.

Campbell AJ, R. M. (2013). Rethinkingindividual and community fall preventionstrategies: a meta- regression comparingsingle and multifactorial interventions. Age and Ageing, 21(6), 656-662.

JM., H. (2009). Cognitive and Emotional benefits of exercise may mediate fall reduction. British Medical Journal, 128, 325(.

Lord SR, T. A. (2013). The effect of an individualized fall prevention program on fallrisk and falls in older people: A Randomized Controlled Trial. Journal of the American Geriatrics Society, 14(8), 1296-1304.

OsteoporosisIntroductionOsteoporosis is a health condition that weakens bones, making them fragile and more likely to break. It develops slowly over several years and is often only diagnosed when a minor fall or sudden impact causes a bone fracture. Osteoporosis affects all the bones in the body, but fractures are most common in the wrists, hips, and spine. This paper will describe symptoms of this condition, diagnostic tests that might be used, common treatments, and primary prevention methods.SymptomsOsteoporosis is frequently referred to as a \\\"silent disease\\\" due to its subtle nature (Wu, 2021). Its progression can remain hidden for many years, exhibiting no noticeable symptoms until an unexpected bone fracture occurs. Nevertheless, in certain cases, there might be some observable signs. One such sign can be a gradual decrease in height over time, accompanied by a stooped or hunched posture. This can happen as a result of the weakening of the…...

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ReferencesMohd Azmi, N. F. I., Aznul Hisham, M. H., & Jamil, N. A. (2023). Development and Evaluation of an e-Book for Bone Health and Osteoporosis Education in Adolescents. Nutrients, 15(8), 1899.   Shummar, Z. H., Mohammad, S. S., & Iqbal, M. N. (2023). Role of Dual-energy X-ray Absorptiometry Scan (DEXA) Assessment of Preoperatively Osteoporosis in Spine Surgery Patients. Acta Biomed, 94(2), e2023089. DOI: 10.23750/abm.v94i2.15487 Wu, S. S. (2021). The Application of Interlaminar Spacer in Osteoporosis Spinal Stenosis Patients. Osteoporosis Of The Spine: Asian Perspectives, 278. https://doi.org/10.1142/9789811220814_0014 Xiao, P. L., Cui, A. Y., Hsu, C. J., Peng, R., Jiang, N., Xu, X. H., ... & Lu, H. D. (2022). Global, regional prevalence, and risk factors of osteoporosis according to the World Health Organization diagnostic criteria: a systematic review and meta-analysis. Osteoporosis International, 33(10), 2137-2153.  https://doi.org/10.1007/s00198-022-06454-3  https://doi.org/10.3390/nu15081899 

Fall Prevention
All Staff

Falls in the Nursing Home

There has been an increase in falls in the nursing home. A number of things can cause residents to fall (Patient falls: How to prevent them). Illnesses, such as dementia among others, can cause residents to be confused. Confusion with residents requires continual monitoring in keeping the resident safe. Muscle weakness and instability cause falls when residents are confused, or when the resident insists on doing things themselves and maintaining their own independence in spite of the weakness or instability issues. Medications can also cause confusion. Sedatives and anti-anxiety medications are a particular concern in causing confusion. Medications can also cause drowsiness that can cause falls if patients are not put to bed when the medications are given.

Environmental factors also play a role in falls. Wet floors, poor lighting, incorrect bed height, improperly fitted shoes, unmaintained wheel chairs, or items on the floor that…...

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Bibliography

Falls in Nursing Homes. (n.d.). Retrieved from Centers for Disease Control and Prevention:  http://www.cdc.gov/HomeandRecreationSafety/Falls/nursing.html 

Patient falls: How to prevent them. (n.d.). Retrieved from patient Safety Partnership: http://www.patientsafetypartnership.org/Patient_Falls.html

Fall Reduction Project: An Evaluation of the Implementation Process Chapter 3: Implementation
In Brief
Blank hospital had a significant increase in falls in the inpatient acute care setting. For this reason, the need for an immutable and comprehensive fall strategy was identified at the hospital following an evaluation of the various costs (both financial and ethical) associated with falls deemed preventable. Towards this end, a fall prevention project was undertaken. I was responsive for overseeing the fall prevention project implementation.
1. Description of Steps
· Pre-implementation phase
· Implementation phase
· Sustainment phase
1.1. Pre-implementation Phase
The pre-implementation phase took a total of 2 months. In essence, pre-implementation phase was meant to prepare the entire facility for the actual phase of implementation. Towards this end, various steps were undertaken. These will be highlighted below.
1.1.1. Identification of Improvement Opportunities
This was founded on the collected fall data. There was an observed increase in the number of falls in the inpatient units.…...

Prevention Plan
Today, research shows that many people are today suffering from mental disorders as a result of alcohol and drugs addiction. This has caused parents, the elementary schools, communities as well as, mental health professionals to express their concern in regards to drug addiction in order to develop a prevention plan that will help teens/high school student before they become addicts. Drug addiction in families contributes to an extensive list of serious mental illness; as a result developing an invention plan is a good idea because it will minimize the chances of occurrence. The primary goals of the prevention plan include;

To reduce the use, the types of substances used as well as limiting the number of users

To ensure that the use of drugs and alcohols in teens/students are delayed. Delaying the use of drugs and alcohol reduces harm during a child's development as well as reducing the risks for developing…...

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References

Alexander, B. (2010). The Meaning of Addiction 3.A Theories of Addiction. Overcome Addiction Life Process Program. Retrieved November 19, 2013, from   / www.mentorfoundation.orghttp://lifeprocessprogram.com/the-meaning-of-addiction-3-theories-of-addiction 

Givaudan, M., & Pick, S. (2001). 1 A Preventive Program for Substance Abuse in Mexico: Best Practices . 1 www.mentorfoundation.org 1 A Preventive Program for Substance Abuse in Mexico: Best Practices . Retrieved November 21, 2013, from  http://www.mentorfoundation.org/pdfs/prevention_perspectives/3.pdf 

Keegan, K., & Moss, H. (2008). Chasing the high: a firsthand account of one young person's experience with substance abuse. New York: Oxford University Press.

"Twenty-three million Americans experience workplace bullying within their work lifetimes" (cited in Seagriff, 2010, p. 575). With the economic challenges Americans are facing recently, tensions in the workplace are also on the rise, as employees increasingly worry that their jobs are in jeopardy. This fear over possibly losing their job means many employees will not risk reporting bullying to their employers.
Interdependence conflicts, as mentioned, are another common type of workplace conflict. This type of conflict centers on an employee's dependence of another person's assistance, input or output to perform their job (Kankanhalli, Tan, & Kwok-kee, 2007). In other words, task interdependence varies depending on the extent which an employee needs materials, information or support from their workplace peers, in order to do their job. "Task interdependence alters the course and consequences of conflict. Some have asserted that because high task interdependence implies the need for intensive interactions among members,…...

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References

Bacal, R. (1998). Conflict prevention in the workplace: using cooperative communication. Winnipeg: Bacal & Associates.

Bhattacharya, S. (19 Sept 2010). "Resolving conflict at work." Busienss Today, 19(9). p. 127-129.

Booher, D. (May 1999). "Resolving conflict." Executive Excellence, 16(5). p. 5.

Budd, J. & Colvin, a. (Jul 2008). "Improved metrics for workplace dispute resolution procedures: Efficiency, equity and voice." Industrial Relations, 47(3). p. 460-479.

Incontinence is another condition not frequently intimated to their doctor. Less than a third of them actually report falls despite the availability of initiatives and measures, which can address falls. These include home-based exercises, home environment assessment, cataract surgery, medication review and Vitamin D and calcium supplements (CFA).
Falls Prevention Intervention

Studies reveal the importance of physical activity in preventing or reducing the risk of falls among older persons in the community and at home (Rose 2007). There is, however, limited evidence at present that physical activity benefits very weak ones in care facilities. Physical activity promises benefit to healthy older adults against the risk of falls. Those at moderate risk, on the other hand, will gain more from structured exercise programs aimed at risk factors, which can be manipulated or changed. They can be adjusted to progress according to the individual's capabilities and earlier physical activity experience. And those at…...

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BIBLIOGRAPHY

Cripps, R. 2001, 'Deaths from falls in the elderly top 1,000-year,' Australian Institute of Health and Welfare [Online] Available at  http://www.aihw.gov.au/media-release=detail/?id=6442464404 

CFA 2011, 'Fall rates need to fall further,' Continence Foundation of Australia [Online]

Available at  http://www.continence.org.au/news.php/38/fall-rates-need-to-fall-further 

Ory, M.G. et al. 2009, 'Implementing and disseminating on evidence-based program to prevent falls in older adults, Texas, 2007-2009,' Preventing Chronic Disease [Online]