Essay on Safety Score Improvement Plan in Inpatient Rehabilitation Unit

Introduction

Patients who are in rehabilitation units stand the risk of falls and this event can increase the stay of patients in hospitals. Patients stand a high risk because some of them may have been admitted in the hospital with mobility difficulties, from cerebral vascular accidents. Studies of these accidents in hospitals attest that 1-5 of 10 patients in these units fall once during their hospitalization (Fuzhong, Harmer & Fitzgerald, 2016). In addition, a study shows that about 9%-33% of these patients reveal injuries related to the falls. It is imperative to note that injuries resulting to these fall have the ability of increasing morbidity and well as reducing the mobility of patients.

This may have an effect on the independences of patients as well as increasing patient’s anxiety or even depression. The Influence of falls not only affects the patient but also the cost of healthcare. Falls can have a high cost on the inpatient rehabilitation unit with unit not receiving reimbursements from centers of Medicare. Falls can be preventable in these hospital units through utilization of effective strategies (Guse et al., 2015). Utilization of evidence-based strategies can be of positive benefits. The nursing leadership should perform this activity through instilling a culture of safety within the organization.

Study of Factors

In the United States of America, about 700000 to 1 million patients suffer from fall on an annual basis. This population represents a huge number of patients from the rehabilitation and the neurology units. Most of the hospitals in the country record the number of falls on a monthly basis. The method of reporting the falls utilizes Patient Safety Quality Improvement reports (Guse et al., 2015). Each organization should utilize this reporting tool in analyzing and identification and the reasons for error. The nursing leadership should be in the forefront in identifying the various problems that might affect the system. The problem in such organizational units may result in processes or weaknesses in the system that might cause people to make errors.

Data collection is also an important aspect while developing the reports. The other important information that might have an impact on the risk of falls includes the level of staffing, status of a patient and the environment. Nurses play an integral part in the implementation as well promotion of policies with regard to falls in rehabilitation units (Wilson et al., 2016). On the other hand, communication is an integral quality in ensuring dispensation of dependable and safe care.

Communication is essential is fostering relationship between patients and caregivers. Caregivers should relay important details to patients that might reduce the possibility of falls. Communication is also important between caregiver that fosters provision of care services. The current policies of Inpatient Rehabilitation Units require caregivers to concentrate more on older adults (Fuzhong et al., 2016). This is because the possibility of injury during fall is higher with an increase in age. The aspects related to falls come under the criteria of individual factors or environmentally related.

Individual aspects to the risk of falls include aspects related to the age of a patient, chronic conditions or Cognitive deficits. The other aspect relating to the environment includes medications, footwear of patients, and support from caregivers or the various features of a place. If patients undergo a fall from multiple risk factors, the potential for injury may be higher (Wilson et al., 2016). The perception of many people is that falls are inevitable in older people.

This however not the absolute truth if such individuals understand that some of the factors to falls are intrinsic. Some of the prevention strategies may include caregivers providing balance exercises to patients. Patients may also be talked into accepting to be careful. Being careful as a precaution may be enough in preventing future falls (Wilson et al., 2016). It is therefore important for caregivers to employ effective evidence-based strategies to preventing falls in rehabilitation units. On the other hand, these safety procedures should be introduced to all members of staff in the unit. Constant reviews on the policies should also take place in organization in order to correct certain mistakes that might arise during implementation.

Recommendations

A fall risk assessment, management and screening are required as a plan to improve the impact of falls in a clinical environment. The Clinical Practice guideline is instrumental at providing services to falls relating to inpatients in rehabilitation units. The guidelines recommends that screening is done to patients who are 65years and older who are at high risk of experiencing falls (Fuzhong et al., 2016). The screening procedure involves asking individual patients if they experienced falls in the last 1 year and if they ever received medication related to falls. If a patient provides a positive answer to the first questions, they get into the second form of assessment.

People who have fallen more than twice a year without injury should have their gait and balance evaluated (Fuzhong et al., 2016). The strategy of collecting information about falls in the healthcare institution begins with patients completing a brochure concerning the issue. The brochure is in the form of a questionnaire where individual patient states whether they have experienced falls or have received medication related to falls in the past. Those who have experienced problems related to the issue provide further information.

The next step of data collection revolves around caregivers analyzing the gait and strength balance using various strategies. The strategies include having patients to undergo 4 stage balance or 30 second chair stand (Fuzhong et al., 2016). From these steps, caregivers are able to diagnose the source of the problem affecting the patient. Patients that reveal gait and strength problems would require more attention and more education.

The quality indicators include a record on the history of falls on individual patients. The indicator will be able to identify the number of falls a patient undergoes over a particular period as well as its circumstances. The other aspect related to the history of falls might include corroboration with a witness will be helpful in documenting the recurrence of falls. The other important quality indicator concentrates on the effects of medication on falls. The key medication in consideration relates to the various psychoactive drugs that are able to sedate a patient (Wilson et al., 2016). The indicator will provide formidable information with a reduction of the medication or omitting some medications.

The guidelines related to monitoring the application of the guidelines will include provision of scores in relation to gait and strength of patients. The criterion of monitoring follows three important scores that reports moderate, serious and safe scores. The basis of the scores will be instrumental in ascertaining whether to change the policies of the organization. If through implementation of the findings does not yield positive impacts the process begins again. Training of caregivers should be a continuous process that covers communication, safety strategies and research skills (Guse et al., 2015). This will enable them to analyze data from questionnaires, communicate utilizing latest technologies and in using various internet platforms.

References

Fuzhong, L., Harmer, P., & Fitzgerald, K. (2016). Implementing an Evidence-Based Fall Prevention Intervention in Community Senior Centers. American Journal Of Public Health, 106(11), 2026-2031.

Wilson, D. S., Montie, M., Conlon, P., Reynolds, M., Ripley, R., & Titler, M. G. (2016). Nurses’ Perceptions of Implementing Fall Prevention Interventions to Mitigate Patient-Specific Fall Risk Factors. Western Journal Of Nursing Research, 38(8), 1012-1034. doi:10.1177/0193945916644995

Guse, C. E., Peterson, D. J., Christiansen, A. L., Mahoney, J., Laud, P., & Layde, P. M. (2015). Translating a Fall Prevention Intervention Into Practice: A Randomized Community Trial. American Journal Of Public Health, 105(7), 1475-1481. doi:10.2105/AJPH.2014.302315