Evidence-based practice (EPB) can be defined as the judicious use of current evidence that is aligned to the values of the patient and the clinical expertise necessary in guiding the decisions made in the health care system. EPB is essential in improving the quality of life and safety for the patient which translates to improved outcomes. One of the main problems facing hospitals is the growing numbers of falls among patients above the age of 65, which is a health issue that impacts on health care costs and the quality of healthcare (Lee, Lee & Khang, 2013). The paper seeks to analyze the best practice to implement that will prevent the falls and describing the steps necessary in implementing the best new practice. Finally, the paper will support the implementation of the practice by supporting the claims through literature review.
Best New Practice to Implement
The PICOT question to guide in the implementation of the new practice is whether the adoption of risk assessment tools will reduce falls among patients aged 65 years and above. Fall-related injuries are estimated to cost the US healthcare system about $54.9 billion as discussed by Lee, Lee & Khang, (2013) by 2020. The CDC also approximates the number of deaths from falls to increase by 30% as of 2017. Different risk assessment tools are available which aid in preventing falls for patients over the age of 65 during hospitalization. Risk fall assessment is essential for fall prevention. These practical tools include STRATIFY scale, MORSE fall scale, STEADY and finally the John Hopkins Fall Risk Assessment Tool. The best tool to be adopted in the organization is the MORSE full scale.
The MFS is a rapid and straightforward tool for evaluating the patient's risk of falling. A significant number of nurses using this tool rate it as easy to use and more than half of the nurses who use this tool state that it takes less than a minute to rate the patient's risk of falling. The Morse Fall Scale has sic variables that are easy and quick to score. The tool has proven to have both reliability and predictive validity and is widely used in acute care in the hospital setting. Items on the scale include the history of falling where the maximum score is 25 and is awarded to patients who have fallen with the period of admission or if there is a history of psychological falls. The minimum score of 0 is awarded to patients who have not fallen. Calibrations in the MFS should be changed to suit the specific health unit or set so that the prevention protocols are targeted and effective (Cruz et al., 2015)
Steps in Implementing the Best New Practice
Essentially, the use of MFS to assess the risk of falls is standard procedure, in the acute care setting; there is no need for consent from the patients. The amount of time needed to complete the project is approximately one year, which might disrupt the normal running of hospitals. This will allow the researcher to evaluate whether repeated use of MFS helps patients in acute care avert falls. Resources required will include training of registered nurses to carry out the assessment and MFS forms that will be used during the assessment. The nurses will evaluate all the patients above the age of 65 years in acute care, for adequate results, these evaluations will be carried out every day. The nurses will ask the patients relevant questions based on the attributes in the MFS and fill out the forms appropriately. Data collecting will include a record of the number of fall before implementation of the MFS and after the implementation of the MFS; nurses will be required to fill in the data in the hospital electronic database. Data analysis will include both qualitative and quantitative data analysis tools. Implementation of the MFS is cost effective and appropriate and will require a small budget plan for training the nurses. Repeated use of MFS to avert falls for patients above the age of 65 years is appropriate and effective.
A study by Lee et al. (2013) provides solutions on how to prevent falls in the geriatric population. This study states that fear of falling is a geriatric syndrome that may increase the risk of falling among older patients. The authors report that screening for falls is an essential step in preventing falls among older patients. The Timed up and go test has been recommended as a useful tool for fall risk assessment. This study concludes that screening for fall is essential in preventing falls. Patterson et al. (2018) conducted a retrospective electronic record review to assess the utility of the Hendrich II fall scores in predicting falls among patients who are 65 years and older. The conclusion from this research shows that scores routinely collected from the Hendrich II score correlated with falls that occurred, but there was minimum utility as a stand-alone screen for fall risk. When combined with other extractable covariates, the tool performs better. Sarmiento & Lee (2017) analyze the STEADI initiative developed by the CDC to reduce the risk of falls in older patients. This analysis concluded that there is a need for the CDC'S STEADI initiative in reducing falls among the older patients
The growing number of fall-related deaths and injuries are preventable by introducing relevant tools that access the risks associated with the falls. Different scholars have supported the need for the adoption of these tools. Through preventing falls, the hospitals improve the overall healthcare quality of the patient and cut on the medical costs.
Cruz, S., Carvalho, A. L., Barbosa, P., & Lamas, B. (2015). Morse fall scale user's manual: Quality in supervision and in nursing practice. Procedia-Social and Behavioral Sciences, 171, 334-339.
Lee, A., Lee, K.-W., & Khang, P. (2013). Preventing Falls in the Geriatric Population. The Permanente Journal, 17(4), 37-39. http://doi.org/10.7812/TPP/12-119
Patterson, B. W., Repplinger, M. D., Pulia, M. S., Batt, R. J., Svenson, J. E., Trinh, A., ... & Shah, M. N. (2018). Using the Hendrich II inpatient fall risk screen to predict outpatient falls after emergency department visits. Journal of the American Geriatrics Society, 66(4), 760-765.
Sarmiento, K., & Lee, R. (2017). STEADI: CDC's approach to make older adult fall prevention part of every primary care practice. Journal of safety research, 63, 105-109.
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