Design for Change Proposal
Every year, approximately 30-40% of orthopedic patients identify falls as the reason for why they address the emergency departments of their local hospitals (Hill et al., 2015). Besides, nowadays, falls are the frequent causes of mortality and morbidity among older adults (Ambrose, Paul, & Hausdorff, 2013). Patients have to understand that they are responsible for the majority of falls that may influence the quality of their lives. They need to use any possible means to protect themselves, and nurses should provide patients with appropriate opportunities and credible, informative sources. Therefore, a nursing plan should be focused on patient education, the increased patients’ awareness of fall preventive programs, and the decreased number of fall cases.
Change Model Overview
The implementation of the offered plan is not an easy task. Still, certain preparations and knowledge should help to take all steps properly and promote a number of positive outcomes for patients and nurses. In nursing research, the ACE Star Model of Knowledge is frequently used as an effective approach to change evidence in practice and consider the connection between the nature of knowledge and the transformations that could be offered (Stevens, 2013). This model consists of the following aspects: discovery research with the help of which it is possible to indicate what has been already offered and if the steps were successful, evidence summary that aims at developing the synthesis of knowledge on the subject, translation into action that includes the guidelines and recommendations, practical integration where the best ideas are offered and used, and the evaluation of outcomes and the process.
Define the Scope of the EBP
Practical and theoretical considerations are the main characteristics of the scope of the chosen EBP. The plan is based on the necessity to improve patients’ awareness of why falls have to be prevented, what alternatives for patients are, and why nurses have to demonstrate their best skills in the development of the offered fall preventive programs. Approximately 2 million American people fall annually, and the cases are repetitive (Ambrose et al., 2013). 30% of such cases result in death, and 60% of patients get serious injuries (Ambrose et al., 2013). Instead of avoiding falls, people rely on the services offered in hospitals and neglect the possible precautionary methods. To avoid falls, people have to understand the environmental challenges, proprioception, and even reaction time (Sherrington & Tiedemann, 2015).
Stakeholders
To achieve the goals and succeed with the plan, it is necessary to attract several people. It is expected to cooperate with six more people: three hospital nurses, one ED nurse, one administrative worker, and one research worker.
Determine Responsibility of Team Members
Each team member performs an important role in the project. Three nurses have to communicate with patients and improve their knowledge of falls. Besides, administrative work may help to organize the work of nurses, control the events, and make notes of the results achieved. An emergency nurse should be a part of the team to provide the information on the orthopedic adult patients who address the ED. Finally, one research work is required to control the latest innovations in fall preventive programs and the results of their implementations.
Evidence
The results of the search prove that patients demonstrate different attitudes to falls and their outcomes. The reasons for falls vary considerably: a mismatch between the environmental requirements and people’s physiological functions, personal inattentiveness, and patients’ unwillingness to be educated (Sherrington & Tiedemann, 2015). It is suggested to pay attention to character evidence and clarify if person’s character predetermines the possibility of falls, circumstantial evidence and investigate if people have an appropriate environment for work and life (Sherrington & Tiedemann, 2015), and digital evidence with the help of which the latest achievements in fall preventions could be gathered regarding such health factors as hypertension, medical history, drop attacks, etc. (Ambrose et al., 2013). Quality improvement of healthcare and nursing processes are the aims of knowledge transformation (Stevens, 2013). As soon as nurses start communicating with patients and explain to them or their family members about the threats and outcomes of falls at a different age, it is expected to observe the changes in human behavior and the decrease of fall cases.
Summarize the Evidence
The investigation of the behavior of 3606 patients shows that it is possible to decrease the number of falls, the quality of fall injuries, and the number of orthopedic patients in the EDs and hospitals (Hill et al., 2015). The main intervention is the patient education program within the frames of which patients learn why they should pay attention to the number of falls in their everyday life and what preventive steps could be taken. However, patients could hardly find credible sources and guides. Therefore, nurses should lead the education process and communicate with their patients about falls, their outcomes, and possible prevention. Communication and the exchange of knowledge are the priorities of the offered plan.
Develop Recommendations for Change Based on Evidence
The recommendation is to focus on communication between nurses and patients and the identification of the role of a nurse in this process. It is not enough to expect that patients try to take care of themselves and avoid falls. The task is to make nurses convince their patients to think of falls. Nurses have to be properly trained to educate their patients and help them recognize the options.
Translation
Action Plan
There are four main steps in the plan:
- Discussions and training with nurses on how they should communicate with patients.
- Presentations available to nurses, patients, and other hospital inhabitants based on statistics and facts on falls in everyday life to make patients comprehend their alternatives and their health outcomes.
- Direct communication between nurses and patients.
- The investigation of the outcomes of the same patients in three months.
Process, Outcomes Evaluation, and Reporting
In three months, it is expected to communicate with the same patients and indicate if they suffer from fall injuries, clarify if they use the offered ideas, and discuss if they develop the same topics with their relatives and friends. Nurses should demonstrate a list with a decreased number of patients with fall injuries.
Identify Next Steps
The same communications should be offered to other hospitals and medical centers. People should also have access to free nursing centers where they may receive a brief course on how to avoid fall injuries in everyday life.
Disseminate Findings
The communication of findings should be developed in two directions: internally, the results should be demonstrated, and the changes in numbers should prove the effectiveness of the idea to improve patient education; externally, a research article could be published online with the results achieved so that other organizations could use the ideas.
Conclusion
In general, falls remain to be a crucial problem that causes numerous injuries and changes in health among adults. People have to know how to avoid falls and how to improve their health. Nurse-patient communication as the main part of a fall preventive education program is the core of the offered plan. Nurses should understand how to present interesting and credible information, how to make patients pay attention to it, and how to help patients avoid falls. Training of nurses and the development of communicative skills are the basic features of a fall prevention program that is offered to patients.
References
Ambrose, A.F., Paul, G., & Hausdorff, J.M. (2013). Risk factors for falls among older adults: A review of the literature. Maturitas, 75, 51-61. Web.
Hill, A. M., McPhail, S. M., Waldron, N., Etherton-Beer, C., Ingram, K., Flicker, L.,…Haines, T. P. (2015). Fall rates in hospital rehabilitation units after individualised patient and staff education programmes: A pragmatic, stepped-wedge, cluster-randomised controlled trial. The Lancet, 385(9987), 2592-2599. Web.
Sherrington, C., & Tiedemann, A. (2015). Physiotherapy in the prevention of falls in older people. Journal of Physiotherapy, 61(2), 54-60. Web.
Stevens, K. (2013). The impact of evidence-based practice in nursing and the nest big ideas. The Online Journal of Issues in Nursing, 18(2).