Health Care Organization Nursing Homes

Question: Describe about the Health Care Organization for Nursing Homes. Answer: Risk of fall among older people has become a serious health issue and the high rate of fall effects the reputation of health care organization too. As a nurse, I am also required to assess older patient properly to identify fall risk in them and prevent the incidence of fall in hospital. However, as I am a new graduate nurse, I am not confident about my fall risk assessment skills. I feel that I lack the knowledge of a systematic way of doing assessment and I need to immediately consult my nurses to know enhance my nursing skill in this area. I can improve my skills by first getting to know process by which assessment is carried out for monitoring fall risk in older people. The Fall risk assessment study by Hickman (2007) mentioned that assessment is dependent on reviewing a variety of factors like level of mobility among older patients, function of lower part of the body, clarity of vision, effect of medications, past medical history and current health issues and type of footwear used by patients. I feel that these are useful information that I will try to consider whenever I start assessing any patient for risk of fall. External factors in hospital also lead to falls such as type of flooring, hazards like unhygienic hospital environment and spillage of water in different areas, lack of monitoring among hospital staff (Australian Institute of Health and Welfare (AIHW) (2006). I will also try to analyse both intrinsic and extrinsic factors to effectively carry out assessment and report about assessment information. Other type of guideline given by other RNs were also useful as they stressed that fall risk assessment should be carried out within 24 hours to identify those who are at higher risk. This is also the purpose of the doing assessment-to identify high risk patients and accurately take actions for such patients (Waldron et al. 2012). I also learnt that knowing about the factors leading to fall also facilitate quick assessment. For example it is important to consider medical aspects leading to fall. In the context of medical factors, a patient who has a history of fall, takes medication that increases risk of fall, have disease that affect stability and possess signs of seizures have more chances of falling. Other factors contributing to fall are altered mental status, impaired daily life activities and behavioral aspects like patients who are more prone to risk taking behavior and lacks understanding of health condition (Burkett and Scott 2015). I feel that knowledge of risk factors will be helpful in efficiently carrying out risk assessment. I also got information use of different fall risk assessment tools also promote effective screening of falls. An experimental study showed that nursing staffs were satisfied with the outcomes of using a modified fall risk assessment tools. It helped in increasing the screening rate for fall. The screening rate was higher in patients who were assessed using fall risk assessment tools compared to control group patients (Hsu 2016). Other risk assessment instrument that nurse can use to examine risk factors include Berg Balance Test, Timed Get Up and Go test and Gait index. This form of instrument is relevant to risk factors of fall and it helps in analyzing presence of these risk factors in patients (Currie 2008). A research by (Anderson et al., 2012) also showed that nurses can enhance effectiveness of fall prevention program by systematic use of management practices. It will enable proper interaction between each nurse and also facilitate reducing incidence of falls in hospital settin g. Another significant thing that I realized during learning about fall risk assessment skills is that continuous quality improvement is required to prevent fall injury in hospital setting (Garling 2008). Nursing strategies like individualized attention to high-risk patients and giving them health education to modify their behavior can also be useful in preventing fall. Other fall prevention approach includes regularly reviewing patients medication to identify side effects of medication (Anderson et al. 2012). As a nurse, my strategy in this case will be to make patients aware that the medication pose them at risk of fall and so they should not immediately get up from bed and be cautious. After consulting other experienced nurses, I am now more confident and I have got the knowledge that multifactorial assessment after considering fall history, mobility, visual impairment, environmental hazards, cognitive impairment and other factors gives more effective results of risk in hospital setting. When risk assessment process is carried out effectively, then I can quickly move to intervention to prevent fall among older patients. Reference Anderson, R.A., Corazzini, K., Porter, K., Daily, K., McDaniel, R.R. and Coln-Emeric, C., 2012. CONNECT for quality: protocol of a cluster randomized controlled trial to improve fall prevention in nursing homes.Implementation Science,7(1), p.1. Australian Institute of Health and Welfare (AIHW) 2006, Chronic Diseases and Associated Risk Factors in Australia Canberra, Cat. No. PHE8. Burkett, E and Scott, I. 2015 CARE-PACT: A new paradigm of care for acutely unwell residents in aged care facilities. Australian Family Physician, Vol. 44, No. 4, 204-209 Currie, L. (2008). Fall and Injury Prevention.Agency for Healthcare Research and Quality (US). [online] Available at: https://www.ncbi.nlm.nih.gov/books/NBK2653/ [Accessed 17 Oct. 2016]. Garling, P. 2008, Final Report of the Special Commission of Enquiry; Acute Care Services in NSW Public Hospitals Vol I, Released 27 November 2008. Waldron,N.,Hill,M.A. Barker,A.2012,Falls prevention in older adults,Australian Family Physician,vol.41,no.12,pp.930-933 Hickman, L., Newton, P., Halcomb, E.J., Chang, E. and Davidson, P., 2007. Best practice interventions to improve the management of older people in acute care settings: a literature review.Journal of advanced nursing,60(2), pp.113-126. Hsu SS, e. (2016).Fall risk factors assessment tool: enhancing effectiveness in falls screening. - PubMed - NCBI. [online] Ncbi.nlm.nih.gov. Available at: https://www.ncbi.nlm.nih.gov/pubmed/15362009 [Accessed 17 Oct. 2016].