Transcript Document

NU499 Capstone Project
Kaplan University
Lynette Gullion
Professor Joan Haizlip
December 13, 2011
• Location: Silverdale, Washington
• Preceptor: Susan Hensley
• Identified
Nursing Issue: The need for a
fall risk assessment and intervention
process in the urgent care treatment room.
Assessment
 PATIENT POPULATION IN TREATMENT ROOM:
 65 years of age and older
 Multiple co-morbidities and/or disabilities
 Obese
 Non-compliant
 Wound care
The Problem
 30% of community dwelling adults, aged 65 and older
fall every year (Salminen, Vahlberg, Salonoja, Aarnio, & Kivela,
2009)
 Falls are the most common cause of injury in this
group (Salminen, et al., 2009)
 20% of these cases require medical assessment and
intervention (Salminen, et al., 2009)
 Injurious falls in older adults leads to negative effects
on lifestyle, quality of life and good health (Roe, Howell,
Riniotis, Beech, Crome, & Ong, 2009).
Common Risk Factors for Falls
 Arthritis, diabetes
 Visual and hearing problems
 Unsteady gait or balance problems; use of assistive
devices
 Decreased activity levels
 Effects of medications such as dizziness or sleepiness
(Banez, Tully, Amaral, Kwan, Kung, Mak, Moghabghab, & Alibhai,
2008).
Implementation of a fall risk assessment and intervention policy for
treatment room patients
Interventions
 Write and get approval for fall prevention policy
 Implement the Fall Risk Screen outpatient tool studied
by Jack C. Montgomery VA Medical Center
(Meader, Jones & Healsy, 2010)
Dissemination
 Staff meetings to include all necessary staff members
 Contact urgent care director to include providers in
plan
 Emails sent to staff for reference
 EPIC classes arranged
 Super users
 Poster boards or hand held cheat sheets
Evaluation
 Evaluation of any intervention or process change is
crucial in the nursing process
 Six month (or less if needed) evaluation of process
-Are staff members using the tool consistently?
-Collect pre and post policy implementation data regarding falls
-Is the process appropriate for this facility (treatment room)?
-Staff meetings to obtain staff input, positive or negative
-Adjustments as needed and start all over again
References
Banez, C., Tully, S., Amaral, L., Kwan, D., Kung, A., Mak, K., Moghabghab,R., & Alibhai,
S. (2008). Development,implementation, and evaluation of an interprofessional falls
prevention program forolder adults. Journal of the American Geriatrics Society, 56(8),
1549-55. Retrieved from
http://search.ebscohost.com.lib.kaplan.edu/login.aspx?direct=true&db=rzh&AN
=2010255505&site=ehost-live
Roe, B., Howell, F., Riniotis, K., Beech, R., Crome, P.,& Ong, B. (2009). Older people
and falls: Health status, quality of life, liefestyle, care networks, prevention and
views on service use following a recent fall. Journal of Clinical Nursing, 18(16), 2261-2272.
doi: 10.111/j.1365-2702.2008.02747.x
Salminen, M., Vahlberg, T., Salonoja, M., Aarnio, P., & Kivel, S. (2009). Effect of a risk
based multifactorial fall prevention program on the incidence of falls. Journal of the
American Geriatrics Society, 57(4), 612-619. doi: 10.1111/j.1532-5415.2009.02176.x