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