Introduction
The paper at hand is aimed at elucidating the problem of falls prevention. It is assumed that this problem is particularly acute with elderly patients – it leads to negative health complications and impedes the treatment process. Therefore, a thorough analysis of the relevant scientific literature has been carried out to work out an effective intervention plan.
As a result, it is proposed to implement a fall prevention program that would base on the complex approach. Otherwise stated, the proposed program considers both intrinsic and extrinsic risk factors and implies a team-based collaboration.
Change Model Overview
Any clinical implementation requires a relevant implementation plan that would guide nurses in their activity. The Johns Hopkins Nursing Evidence-Based Practice (JHNEBP) model is a helpful, well-constructed approach that worked out to assist nurses in their decision-making. Nowadays, this approach is widely applied to clinical practice due to its simplicity and efficiency. Nurses prefer this model as it offers useful tools that are aimed at guiding the process step-by-step.
Otherwise stated, the model provides a concise action plan. The approach implies a convenient three-level structure; hence, there are three key stages: posing questions, collecting evidence, and performing a translation. The main target resides in ensuring consistent incorporation of the research findings into clinical practice (Center for Evidence-Based Practice, n.d.).
Practice Question
Recruit Interprofessional Team
It seems to be evident that the implementation of a fall prevention program requires a team-based approach. The team is expected to be composed of specialists of different profiles to ensure a complex approach to the problem solution. Hence, it is assumed that apart from the team leader, the proposed team should comprise a falls consultant, a charge nurse, a nurse specialist, and a psychologist.
Develop and Refine the EBP Question
The key EBP question resides in whether a complex approach based on the consideration of both intrinsic and extrinsic factors and realized by a multi-profile team shows better results than the methods that focus on a particular technique, such as the frequent rounding, for instance. The targeted population is elderly patients, the age, and the health problems of which increase the risks of falls.
It is proposed that the intervention is aimed at eliminating the entire scope of the risk factors that are most likely to lead to falls. As a result, the intervention plan implies considering both intrinsic and extrinsic factors in trying to prevent falls.
In the framework of the proposed plan, it is suggested that the complex approach to falls prevention and a team-based method is compared to the techniques that focus on a particular aspect, such as equipment, psychological prerequisites, etc.
The targeted outcome is to reduce the risk of falls in elderly people and prevent complications related to falls.
Define the Scope of the EBP
Falls are a problem that is particularly acute among elderly patients. According to official statistics, about 2.5 million elderly people are taken to emergency departments because of the fall injuries, and almost half of them have to be hospitalized (Center for Disease Control and Prevention, 2016). The falls that occur to inpatients are also frequent and hurt the treatment process.
The major problem resides in the fact that falls lead to serious consequences such as fractures, brain injuries, etc. Therefore, it might be claimed that falls impede the process of treatment significantly, reduce its effectiveness, and reverse its progress. As a result, various programs are worked out to reduce the risks of falls.
Determine Responsibility of Team Members
As has been already mentioned above, the fall prevention team is supposed to comprise a fall consultant, a charge nurse, a nurse specialist, and a psychologist. The fall consultant is a valuable team member that is expected to consult the others about the nature of falls and their principal determinants. The charge nurse and the nurse specialist are supposed to carry out the relevant procedures and represent the direct link between the team and the patients. Lastly, the psychologist can help to work out the prevention strategy that would consider both physical and psychological peculiarities of elderly patients that make them particularly exposed to falls.
Evidence
Conduct Internal/ External Search for Evidence and Appraisal of Evidence
To examine the relevant problem, profound research has been carried out. In the framework of this study, various scientific articles have been selected. Among the examined articles, four of them turned out to be the most relevant to the problem.
It was considered critical to examine different kinds of data to receive a complex idea of the problem and different interventions that might be proposed. Also, the JHNEBP model has been applied to the basic framework for the research activity.
Summarize the Evidence
First and foremost, the articles’ examination has shown that the fall prevention field still has critical scientific gaps. Otherwise stated, the problem requires further study (Lea et al., 2012). Secondly, it has been empirically proved that fall prevention implementations require a team-based approach. In other words, various specialists need to be involved in the problem-solution (Healey, 2010).
Another study revealed the low efficacy of an interdisciplinary fall prevention program that focuses on the extrinsic factors only (Schwendimann, Bühler, De Geest, & Milisen, 2006). Lastly, some experts recommend focusing on different factors that serve to be the determinants of fall risks. Thus, Graham (2012) suggests considering both intrinsic and extrinsic factors while working out a fall prevention program.
Develop Recommendations for Change Based on Evidence
Basing on the scientific evidence collected in the course of the research, a series of relevant recommendations might be offered. First and foremost, the development of a fall prevention program requires a complex approach that would consider all the associated aspects including the staff, the patients, the conditions, etc. Secondly, the change needs to be realized by a team composed of different specialists. Lastly, the fall prevention program should be targeted at eliminating both intrinsic and extrinsic risks.
Translation
Action Plan
First of all, a pilot implementation should be carried out. The initial program length will make a month, during which a sample group of 20-30 elderly patients will be welcomed to participate in a fall prevention course. The program will include daily physical activities, psychological seminars, and the implementation of some useful technologies such as bed alarms, etc. The frequency of falls will be measured both before and after the course’s completion.
It is assumed that the pilot implementation will help to define the key drawbacks of the program and eliminate them. As long as the program is properly refined, it can be implemented at an organizational level.
Evaluating Outcomes and Reporting Outcomes
The desired outcomes are the reduction of the frequency of falls among elderly patients by 25% and more. The statistical data needs to be gathered before the program’s implementation and upon its completion so that the key stakeholders can track the positive change. Some measurements can also be carried out in the course of the program to receive a more detailed idea of the change.
Identify Next Steps
As long as the program is successfully implemented into a particular organization, the experience might naturally attract other health care centers. The key benefit of this program resides in the fact that it can be applied to any health care unit. Those organizations that are satisfied with the temporary results of the implementation will be welcomed to adopt the program regularly.
Disseminate Findings
It is considered critical that the health care community is informed about the positive results of the proposed change. Thus, it is suggested that a special web platform is created that provides the program participants with the opportunity to share their experience. Moreover, the team members will be welcomed to elucidate their professional achievements in the relevant scientific sources.
Conclusion
Thus, the literature analysis has shown that the problem of falls needs to be addressed complexly. As a consequence, the change model that has been designed implies a team-based collaboration. It puts a particular emphasis on the elimination of all the risk factors: intrinsic and extrinsic. The model can be applied to any health care unit that makes it particularly beneficial from the translation perspective.
References
Center for Evidence-Based Practice. (n.d.). Johns Hopkins Nursing Evidence-Based Practice Model. Web.
Center for Disease Control and Prevention. (2016.). Important Facts about Falls. Web.
Graham, B.C. (2012). Examining evidence-based interventions to prevent inpatient falls. Medsurg Nursing, 21(5), 267-270.
Healey, F. (2010). A Guide on How to Prevent Fall and Injury In the Hospitals, Clinics in Geriatric Medicine. Nursing Older People, 22(9), 1896-1905.
Lea, E., Andrews, S., Hill, K., Haines, T., Nitz, J., & Haralambous, B. (2012). Beyond the ‘tick and ‘: Facilitating best practice fall prevention through an action research approach. Journal of Clinical Nursing, 21(13-14), 1896-1905.
Schwendimann, S, Bühler, H., De Geest, S., & Milisen, K. (2006). Falls and consequent injuries in hospitalized patients: effects of an interdisciplinary falls prevention program. Web.