Assignment Instructions/ Description
HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
Fall Prevention at Rehabilitation Center
Introduction: Falls are common incidents among hospitalized patients and represent a key health problem within the rehabilitation setting. Falls within hospitals are serious adverse events that lead to injury, lengthy hospital stays and augmented costs among patients. The majority of patient falls is not actual accidents and is unavoidable consequences of old age, but is the outcome of a lethal conspiracy of numerous intrinsic and extrinsic risk factors. Therefore, it is important to develop to gather comprehensive information about the risk factors of falling among patients for the purpose of designing and implementing preventive strategies (Najafpour et al; 2019) HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay. The purpose of the paper is to create an educational program that supports the implementation of patient risk management strategies at a rehabilitation center.
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Rationale: Fall prevention entails managing the underlying fall risk factors of a patient. Risk assessments are the foundation of a falls prevention program since it permits for more efficient utilization of resources along with focusing the attention of a patient’s team care when the patient is at an increased risk of falling. According to Gu et al (2016), a call prevention program is likely to be effectively implemented and maintained when it is compatible with an organization’s priorities and considers patients’ needs. Such a risk management strategy is lacking within the rehabilitation center’s current risk management plan.
Implementation of a fall risk management strategy will enable the organization to better meet local, state, and federal compliance standards. Several local, state and federal government agencies require healthcare organizations to have programs designed to prevent patient falls and resultant fall injuries. As Quigley and White (2013) indicate, the joint commission mandates certified healthcare organizations to undertake fall risk assessments for admitted patients to recognize the risk of patients for falls for them to implement prevention measures into the care plan. Additionally, the Center for Medicare and Medicaid Services (CMS) identifies that falls can be reasonably averted utilizing evidence-based guidelines. and does not cover care costs as a result of an inpatient falls if the falls are avertable by the organization
Support: It is projected that 700, 000 to one million patients fall in United States hospitals every year. Fall-related injuries can result in an extended stay at the hospital by six days with the cost of care averaging 13, 316 dollars per incident. As a result of a large number of factors that contribute to patient falls, the majority of fall reduction and prevention programs have implemented several strategies like improving the process of fall risk assessment, improving communication among workers concerning fall risk status and improving patient and staff education (Weberg et al; 2017).
The patient fall data is a demonstration that it is the fall risk management strategy that falls under the organization’s legal responsibility to provide a safe health care facility and work environment. Weberg et al (2017) claim that nurses have the primary responsibility of assessing, intervening and documenting fall prevention as a portion of their process of care planning, while organizations have the responsibility of executing a fall prevention program that entails monitoring, collaboration, and communication.
Implementation: There are five steps to implement a fall prevention program in the rehabilitation center. The initial step will include developing a plan for implementation of the program by obtaining support from the administration, including funding for the program. The second step is to undertake an environmental safety check on every unit to ensure the safety of the environment. The third step is to gather data on the figure of patient falls, indicating the figure of falls with injuries. The next step will involve setting up a monitoring system and developing a system for recording fall scores of a patient in the patient’s chart. The final step is to train staff to identify patients that are prone to fall and a way of recognizing fall prevention strategies.
Challenges: Obstacles that the health care organization may face in executing a fall risk management program include, insufficient assessment of risk, failure of communication of compliance with safety practice, problematic physical environments and inadequate staff training. These obstacles can be overcome by having a training program that will educate patients, members of their family and patients on the risk factors responsible for falls and specific modifications that can avert these falls. Education will assist patients, family members, and staff understands things that contribute to falls so that they will appreciate the significance of the interventions the organization wants to implement.
Evaluation: My plan to assess if the fall prevention program is successful will include the selection of an interdisciplinary assessment team that will collect and analyze data on patients who at remarkably high risk or falling or fall repeatedly. The team will also periodically review fall reports and focus particularly on institutional patterns. As suggested by Spirgiene et al (2013), ensuring the effectiveness of a fall prevention program include gathering statistics after the program implementation and subsequent analysis of data. The program should be reviewed annually, updated all through the year and data shared among staff.
Opportunities: the organization should consider conducting additional risk management improvements in adjacent areas such as hallways and waiting rooms moving forward. While not directly connected with the intrinsic risk for patient falls, the general environment in hallways and waiting rooms must be assessed to ensure that they are free of obstacles and well lit. According to Phelan et al (2015), the aim of environmental assessment is to recognize hazardous conditions within a facility or homes, such as inappropriate assistive devices, obstacles in pathways, slippery surfaces and inadequate lighting. In addition, factors like furniture height and positioning could be addressed.
References
Quigley, P., & White, S. (2013). Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations. The Online Journal of Issues in Nursing, 18(2), Manuscript 5.
Gu, Y., Balcaen, K., Ni, Y., & Goffin, J. (2016). Review on Prevention of falls in hospital settings. Chinese Nursing Research, 3(1), 7-10.
Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study. International Journal of Health Policy and Management, 8(5), 300-306.
Phelan, E., Mahoney, J., Voit, J., & Stevens, J. (2015). Assessment and Management of Fall Risk in Primary Care Settings. Medical Clinics of North America, 99(2), 281-293.
Spirgiene, L., Bosch-Leertouwer, H., & Watson, M et al. (2013). Improving patient safety: implementation of falls prevention strategy in hospital. Gerontologija, 14(4), 235-242.
Weberg, D., Porter-O’Grady, & Malloch, K. (2017). Leadership for Evidence-Based Innovation in Nursing and Health Professions. Burlington, MA: Jones & Bartlett Publishers.
The purpose of this assignment is to create an educational program that supports the implementation of risk management strategies in a health care organization.
In this assignment, you will develop an outline for an “in‐service”‐style educational risk management program for employees of a particular health care organization that will then form the basis for a PowerPoint presentation in Topic 5. Select your topic for this educational session from one of the proposed recommendations or changes you suggested in the Risk Management Program Analysis – Part One assignment to enhance, improve, or secure compliance standards in your chosen risk management plan example.
Create a 500‐750-word comprehensive outline that communicates the following about your chosen topic:
- Introduction: Identify the risk management topic you have chosen to address and why it is important within your health care sector.
- Rationale: Illustrate how this risk management strategy is lacking within your selected organization’s current risk management plan and explain how its implementation will better meet local, state, and federal compliance standards.
- Support: Provide data that indicate the need for this proposed risk management initiative and demonstrate how it falls under the organization’s legal responsibility to provide a safe health care facility and work environment.
- Implementation: Describe the steps to implement the proposed strategy in your selected health care organization.
- Challenges: Predict obstacles the health care organization may face in executing this risk management strategy and propose solutions to navigate or preempt these potentially difficult outcomes.
- Evaluation: Outline your plan to evaluate the success of the proposed risk management program and how well it meets the organization’s short-term, long-term, and end goals.
- Opportunities: Recommend additional risk management improvements in adjacent areas of influence that the organization could or should address moving forward.
The purpose of this assignment is to create an educational risk management presentation.
Building upon the outline for an educational session you created in the Educational Program on Risk Management Part One: Outline of Topic 2 assignment, develop a 12-15 slide PowerPoint presentation that expands in greater detail on how and why your organization should implement your proposed risk management strategy. Incorporate any instructor feedback from the Topic 2 assignment into this presentation and include talking points in the speaker notes section of each slide.
Keep in mind that the PowerPoint is meant to serve as a visual aide to bolster your presentation and is intended to highlight main ideas and key points. Do not use dense blocks of text or more than 7 bullet points of text per slide. However, you may include supplementary images, graphs, and data where relevant.
To successfully complete this assignment, include the following sections as per your outline from Topic 2, though you may include any additional sections as needed:
- Introduction
- Rationale
- Support
- Implementation
- Challenges
- Evaluation
- Opportunities
You are required to support your statements with a minimum of six citations from appropriate credible sources.
Educational Program on Risk Management
Introduction
Fall rate high among inpatients & rehabilitation settings
Adverse events associated with falls:
Injuries
Lengthy hospital stays
Increased healthcare costs
Patient falls avoidable
Purpose:
To create an educational program that supports the implementation of patient risk management strategies at a rehabilitation center HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
Falls are common among inpatients and especially within the rehabilitation settings. Falls are normally associated with adverse events such as serious injuries, increased length of hospital stay, and increased healthcare costs. Therefore, it is necessary to address falls and implement appropriate preventative measures because the majority of patient falls are preventable. Identifying the risk factors for falls among patients is very important in preventing falls (Najafpour et al; 2019). Therefore, this presentation presents an educational program that supports the implementation of patient risk management strategies at a rehabilitation center.
Rationale
Fall prevention involves managing risk factors
Risk assessment:
Backbone of falls prevention programs
Allows efficient utilization of resources
Allows individualized care
A fall prevention program should be compatible with:
uPatient needs
uOrganizational priorities
uThe rehabilitation center lacks an effective risk management plan
Fall prevent involves managing the primary risks factors for falls among patients. Accordingly, fall risk assessment forms the foundation of fall prevention programs because it allows provision of individualized patient care in regard to preventing falls and also allows efficient utilization of resources. A fall prevention program should focus on the patient needs and be well-suited to the organizational priorities (Gu et al; 2016). The rehabilitation center lacks such a risk management program and hence this provides the rationale for this education program to support implementation of a fall risk management program. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
Rationale Cont.
uA fall risk management program will enable the organization:
uTo better meet local, state, and federal compliance standards
uHealthcare organizations required to have fall prevention programs
uJoint commission mandates healthcare organizations:
uTo undertake fall risk assessments for inpatients
uTo identify risk of patients for falls & integrate into the care plan
uCenter for Medicare and Medicaid Services (CMS):
uUse of evidence-based guidelines to prevent falls
uDoes not cover care costs for preventable inpatient falls
Implementation of a fall risk management strategy will enable the organization to better meet local, state, and federal compliance standards. This is because several local, state and federal government agencies require healthcare organizations to have programs designed to prevent patient falls and resultant fall injuries. For example, the joint commission mandates certified healthcare organizations to undertake fall risk assessments for admitted patients to recognize the risk of patients for falls for them to implement prevention measures into the care plan (Quigley and White (2013). Similarly, the Center for Medicare and Medicaid Services (CMS) recommends healthcare organizations to use evidence-based guidelines does not cover care costs as a result of an inpatient falls if the falls are preventable by the organization. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
Support
u700, 000-1,000, 000 patient falls occur in US hospitals annually
uFall-related injuries can lead to:
uIncreasing hospital stay by 6-days
uCare cost $13, 316 per fall event
uTherefore, fall prevention/reduction strategies important
uFall prevention strategies include:
uImproving the process of fall risk assessment
uPatient and staff education on falls
uImproving communication among healthcare providers about fall risk for patients
Statistics indicate that about 700, 000-1,000, 000 patient fall occur within the hospitals in the US every year. Fall-related injuries can result in an extended stay at the hospital by six days with the cost of care averaging $13, 316 per every fall incident. Therefore, it is important to address various factors that contribute to falls in one way or another. Many fall prevention programs normally integrate aspects such as improving the process of fall risk assessment, improving communication among healthcare providers regarding fall risk status and improving patient and staff education about falls (Weberg et al; 2017).
Support Cont.
uThe high incidence of falls indicates the need:
uTo address falls
uTo implement fall risk management strategies
uOrganizations have a duty to ensure patient safety
uAs part of care , the nursing staff should:
uAssess, intervene & document fall prevention aspects
uOrganizations have the duty of:
uImplementing fall prevention programs that include monitoring, collaboration, and communication
The high rate and high incidence of falls among patients indicates the need for healthcare organizations to implement fall risk management strategies. Therefore, organizations have the legal responsibility to provide a safe health care facility and work environment and preventing falls is one of the duties of ensuring patient safety. Nurses have the primary responsibility of assessing, intervening and documenting fall prevention aspects as a part of their process of care planning. On the other hand, organizations have the responsibility of executing a fall prevention program that entails monitoring, collaboration, and communication (Weberg et al; 2017).
Implementation
uImplementation of a fall prevention program will include:
uDeveloping a plan by obtaining administration support
uUndertake an environmental safety check on every unit
uCollecting data on rate of falls
uImplementing a monitoring system
uDeveloping system to record patient fall scores
uTraining staff to identify patients at high risk of falls
uEnsuring the staff know fall prevention strategies
Implementation of a fall prevention program in the rehabilitation center will include five steps. The first step will be to develop a plan for implementation of the program by obtaining support from the administration, including funding for the program. The second step will be to perform an environmental safety check on every unit to ensure the safety of the environment. The third step is to gather data on the figure of patient falls, indicating the figure of falls with injuries. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay The next step will involve setting up a monitoring system and developing a system for recording fall scores of a patient in the patient’s chart. The final step will include training staff on how identify patients that are at risk of falls and educating them regarding fall prevention strategies.
Challenges
uResistance to changes by the nursing staff
uLack of sufficient assessment of fall risk
uFailure of the staff to comply with the safety practices
uProblematic physical environments
uInadequate staff training
Some of the projected obstacles during the implementation of the fall risk management program includes resistance to change by the nursing staff. Evidence indicates the nursing staff may resist changes due to projected increased workload or due to disruption of a familiar workflow pattern (Tyler et al; 2014) HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay. Other obstacles that may hinder successful implementation of the fall risk management program include lack of sufficient assessment of fall risk by the staff; failure of the staff to comply with the safety practices; problematic physical environments that may trigger falls; and inadequate staff training about falls.
Overcoming the Challenges
uEducating patients and their families about:
uRisk factors for falls
uModifications to preventing the falls
uEducating important in:
uInformation patients, families & staff about risk factors to falls
uThis will make them embrace the fall prevention program
The identified obstacles can be overcome by having a training program that will educate patients, members of their family and patients regarding the risk factors responsible for falls and the specific modifications that can prevent these falls HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay. Education will assist patients, family members, and staff understands things that contribute to falls so that they will appreciate the significance of the interventions the organization wants to implement and thus willingly embrace the fall prevention program.
Evaluation
uEffectiveness of a fall prevention program can be evaluated by:
uCollecting data pre-post program implementation
uReviewing the program annually
uUpdating the program regularly
uSharing data with the staff
uTherefore, the interdisciplinary assessment team will:
uCollect and analyze data on patients at high risk for falls
uPeriodically review fall reports & especially the institutional patterns
uCompare fall rate pre & post program implementation
uReduced fall rate will indicate the efficacy of the program
The efficacy of a fall prevention program can be evaluated by colleting statistics before and after the implementation of the program. The data is then analyzed to see of the fall rate has reduced after project implementation (Spirgiene et al; 2013). Therefore, in this case an interdisciplinary assessment team will collect data before and after the program implementation and analyze the rate of falls. The ream will also periodically review fall reports and particularly organizational patterns. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
Opportunities
uAdditional risk management improvements done in:
uAdjacent areas like hallways & waiting rooms
uThe areas should be:
uFree of any physical obstacles
uFloor should not be slippery
uWell lit
uAddress the issue of furniture height and positioning in all units
There are other ways that the organization can address the issue of falls. This includes conducting additional risk management improvements in adjacent areas such as hallways and waiting rooms moving forward. It should be ensured that the environment in hallways and waiting rooms is well lit, not slippery and free of physical obstacles, that could lead to patient falls (Phelan et al; 2015). It is also important to ensure that the height of furniture and positioning are appropriate and do not encourage falls.
References
uGu, Y., Balcaen, K., Ni, Y., & Goffin, J. (2016). Review on Prevention of falls in hospital settings. Chinese Nursing Research, 3(1), 7-10.
uNajafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk Factors for Falls in Hospital In-Patients: A Prospective Nested Case Control Study. International Journal of Health Policy and Management, 8(5), 300-306.
uPhelan, E., Mahoney, J., Voit, J., & Stevens, J. (2015). Assessment and Management of Fall Risk in Primary Care Settings. Medical Clinics of North America, 99(2), 281-293.
uSpirgiene, L., Bosch-Leertouwer, H., & Watson, M et al. (2013). Improving patient safety: implementation of falls prevention strategy in hospital. Gerontologija, 14(4), 235-242. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
uTyler, D. A., Lepore, M., Shield, R. R., Looze, J., & Miller, S. C. (2014). Overcoming resistance to culture change: nursing home administrators’ use of education, training, and communication. Gerontology & geriatrics education, 35(4), 321–336.
uQuigley, P., & White, S. (2013). Hospital-Based Fall Program Measurement and Improvement in High Reliability Organizations. The Online Journal of Issues in Nursing, 18(2), Manuscript 5.
uWeberg, D., Porter-O’Grady, & Malloch, K. (2017). Leadership for Evidence-Based Innovation in Nursing and Health Professions. Burlington, MA: Jon. HLT-308V – Educational Program on Risk Management – Part One & Two – Fall Prevention Essay
u