FP

Fall Prevention Program Project                         

As you investigated in your textbook, falls are a geriatric syndrome that is considerably important, and, devastating outcomes can result from a single event. When the elderly patient relies on an institution to keep them safe and they end up falling and injuring themselves, or worse, the event becomes very costly and there is a loss of confidence among all the parties involved. Fall prevention programs are now mandated among several accrediting agencies for all kinds of facilities and even have importance beyond the legal implications.

For the elderly, many institutions utilize many resources to establish programs that work and can really prevent these devastating events. Whether it is an acute care facility such as a hospital, Assisted Living Facility, Chronic long-term facility, Nursing home, home environments, or any other facility for the elderly they all have the same goal when it comes to falls. Many programs have been designed and no two are exactly the same. For decades healthcare professionals have been investigating falls in a particular facility or environment.

Development of a Fall Prevention Program

Safety for elders is always an overriding concern for healthcare delivery agents since without a safe environment the elder will be injured and therefore their health will decline. Considering the environment and the lack of safety could potentially result in a fall. Fall prevention programs are always being developed for the safety of the elder in different environments. The following assignment will enlighten you as to the elements of a good, evidence-based fall prevention program.

Instructions:

1. Read up about falls in a particular environment of your choosing.

2. Develop a story about a patient: you decide the age, sex, past medical history.

3. Once you have a background, you can start developing your prevention program now based on one of your patients/residents (granted if you pick a hospital there could be any age but remember you want to base this on an elderly person).

4. Begin your paper with the place you choose and how it will approach the safety of the organization, then introduce the patient you have and how that person will be safer and how they will be screened in the system. You can then fill in the rest with the program you developed and how it will affect your patient and the rest of the patients in your facility.

5. Follow the  Grading Rubric as you develop this story.

6. Your paper should:

· be 4-5 pages long, maybe longer if you want. (excluding the title page and references page)

· must have at least three references that are from journals that are evidence-based and peer-reviewed journal.

· Cite your sources - type references according to the  APA Style Guide

Here are the parts of your paper and you should start out by listing these first:

I. Introduction (name & place)

II. Fictitious patient

III. 3 instruments (eg. TUG, MMSE, Medications, etc.)

IV. Fictitious results (results realistic)

V. Intrinsic/Extrinsic factors

VI. Resources for establishing the program

VII. How will you institute the program

Falls Resources

1. View the  Falls Presentation

· Important information about falls in older people.

2. Then view the  Fall Case Scenario to increase your knowledge.

Fall Prevention Project

Jane Doe

NUR3289- Foundations of Gerontology

Current date

Dr. A. Frados, Professor

Developing a Falls Prevention Program

The fall prevention program’s name is AMTAR, which means A Matter of Training,

Acting, and Repeating. AMTAR is a six-month fall prevention program that seeks to help geriatric

patients to decrease fall risk. AMTAR fundamentally involves screening and assessing patients for

fall risks and then using the results to intervene to improve safe mobility and enhance their ability

to perform minor tasks. Consequently, a nurse any caregiver will be responsible for delivering

AMTAR. The patients will work with all the clinicians to identify achievable objectives, examine

the barriers to attaining the goals, and make action plans.

The Type of Facility

After considering the options, especially that patients discharged have partially recovered,

the type of facility to implement AMTAR in the hospital, specifically in the recovery room.

Contextually, most falls occur in the recovery room, where the nurses place patients who have had

an operation under anesthesia (Vitor et al., 2015). Subsequently, falls in the hospital, particularly in

the recovery room, present psychological sequelae, leading to delays in functional recovery and

prolonged hospitalization. Therefore, AMTAR will approach the organization’s safety by

repetitively educating the patients and following up with role-play on measures and strategies for

preventing and lessening the impact of falls.

Description of the Patient

Joan is a 71-year old patient with an extended history of high blood pressure. Recently, she

has complained of acute chest pains for the last few months. Meanwhile, Mrs. Joan has had a

history of hypertension that doctors had managed to control using diuretics. Joan’s daughters first

admitted her to the hospital in 2016, when she complained of severe intermittent headaches,

nosebleeds, chest pains, and fatigue.

After examination by the doctor, the chest X-ray at that time revealed extensive pulmonary

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congestion, and an electrocardiogram showed a mild atrioventricular block. Apart from blood pressure, the patient has never experienced any other illness. After close monitoring by a cardiologist for the past three years, Joan improved until three months ago when she was admitted because of severe chest pains, fatigue, and nosebleeds. The doctors used her medical history and recommended surgery to help solve the problem.

Consequently, the family agreed to an operation known as renal denervation, which involves

inserting a device through a catheter in the groin to relieve high blood pressure. After the surgery,

Joan has now stayed in the recovery room for two days with other patients, who all are at risk for

falls. Therefore, the AMTAR falls prevention program will first target Joan because of her

condition to test whether the measure will achieve its objectives.

Instruments or Evaluations Specific to the Patient

During the screening, the patient will first answer questions regarding if she has ever had a

fall before, if she feels unsteady when walking or standing, and if she is worried about the

possibility of falling (Phelan et al., 2015). During the actual assessment, the caregivers will test

Joan’s balance, gait, and strength using the 4-stage balance test, 30-second chair stand test, and the

tug. Meanwhile, the benchmark for the second and third positions is 30 and 10 seconds, or also if

she can stand on one leg for at least 5 seconds (Phelan et al., 2015). While the prospect of other

evaluation techniques may work with this specific patient, the need to immediately identify the risk

of fall supports the need for physical instruments.

After the assessment, the investigator arrived at various conclusions that would determine

Joan’s fall risk. Under the tug test, Joan took more than 15 seconds to move from sitting on a chair,

standing, and then walking at a regular pace. For the chair stand test, Joan could only stand and sit

with her arms crossed over the chest for only a few times over 30 seconds. Lastly, the 4-stage

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balance test demonstrated that Joan could not stand on one foot for at least five seconds. Therefore,

the three evaluations indicated that the patient was at a higher risk of falls.

Initiating the Program

Implementing AMTAR would first require the approval of all stakeholders, especially the

hospital management. The project leader will meet with the leaders and request permission to start

testing AMTAR among patients. After consent, forms will be necessary because the patients will

have to consent to undergo various assessments to determine their fall risk. Further, AMTAR also

requires the circulation of brochures with specific dates to implement the program. Also, the

pamphlets will detail a change in behavior regarding falls, where the other aim would be to collect

opinions regarding the convenience of AMTAR in the recovery room.

Most importantly, training will be the most critical aspect of AMTAR. Under education,

the prevention program will seek to mentor the nurses assigned to patients in the recovery room on

the three evaluation techniques. The clinicians will learn how to assess the balance, power, and gait

of the patient. Training will also be crucial when dealing with the patients, where the nurses will

communicate risk and instruct the patients on the various ways of preventing falls (Phelan et al.,

2015). In this context, AMTAR will also entail sticking a leaflet with a fall prevention manual on

all walls of the recovery room. Therefore, AMTAR will need consent from management, the

training of personnel and the patients, and the circulation of training material.

Risk Factors Relevant to this Situation

Joan is a 71-year older adult who has to deal with various risk factors. Under external risk

factors, the AMTAR will consider that the patient is a recovery room full of people with the same

problem. Specifically, the extrinsic factors center around the positioning of beds and chairs, a

slippery floor, and mistakes committed by other patients. Further, all patients in the recovery room

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joints contribute to falls because of surgery, where an error from one individual may cause falls.

Meanwhile, the mistakes may include spillage of food or drinks and moving beds and chairs

inappropriately.

Additionally, the intrinsic factors to this situation will involve Joan’s specific condition.

First, Joan has just recently come from the operation room, meaning that she is weak and cannot

support her weight. Further, the patient’s age is a concern as she has experienced a significant

decline in standing or walking with ease due to unstable joints. The other intrinsic factors include

dizziness, confusion, and a history of falling. Based on the identified factors that could increase the

chances of falling, AMTAR will then educate and recommend to the caregivers and the nurses how

to mitigate falls.

Instituting AMTAR

The first strategy is to ensure that nurses understand their roles and have the knowledge and

tools to implement AMTAR. Consequently, the implementation team will coordinate and guide the

implementation process. Further, based on the three evaluation measures conducted on Joan,

AMTAR will recommend exercising to improve balance and strength and reviewing the recovery

room daily for any potential hazards (Shier et al., 2016). The other critical process would be to

monitor the implementation process of AMTAR, mainly through gathering feedback from

clinicians and patients on the program’s impact (Shier et al., 2016). Lastly, AMTAR will seek to

sustain management support by regularly informing the senior leaders about the project’s progress.

Therefore, the AMTAR project will operate through monitoring and evaluation, and

communication with executives.

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References

Phelan, E. A., Mahoney, J. E., Voit, J. C., & Stevens, J. A. (2015). Assessment and management of

fall risk in primary care settings. Medical Clinics, 99(2), 281-293.37.

Shier, V., Trieu, E., & Ganz, D. A. (2016). Implementing exercise programs to prevent falls: a

systematic descriptive review. Injury Epidemiology, 3(1), 1-18.

Vitor, A. F., Moura, L. A., Fernandes, A. P. N. L., Botarelli, F. R., Araújo, J. N. M., & Vitorino, I.

C. C. (2015). Risk for falls in patients in the postoperative period. Cogitare Enferm, 20(1),

29-37.