PROPOSAL Essay Example

  • Category:
    Nursing
  • Document type:
    Research Proposal
  • Level:
    Undergraduate
  • Page:
    4
  • Words:
    2414

Funding proposal on prevention of falls at an aged care facility

Project summary

Falls’ prevention is a major issue when it comes to maintaining both the quality of life (Qol) and the autonomy of residents in facilities of aged care (Gibson et al, 2008). Government policies within the present years have concentrated on supporting aged people in their own homes meaning that the residents’ profile in facilities of aged care has changed. Aged people are frequently introduced to environments that are new once they become physically frail or are suffering from the progressive symptoms of dementia (Gibson et al, 2008). This project will seek to be funded on health promotion with respect to falls prevention program for fifty participating residents within a 120 bed aged care facility. It is imperative to provide a realistic advice on assessment as well as development of plans of care together with guidelines on available resources for helping residents to maintain autonomy (Andrews et al, 2012). When the facility is supported through funding, the priority of the resources will be to implement strategies that will prevent falls of aged people in the residential facility.

Background

Falls are frequently regarded as accidents; even though falls are seldom completely accidental (Neyens et al, 2009). Falls are normally as a result of an occurrence where a number of threatening factors merge and interact, a number of which can be changed. This implies that falls cannot just take place. In majority of situations there exists a cause why an individual falls. Falls can lead to disability, significant injury, and death can also occur in clients that are older (Bourke et al, 2005). Research shows that falls are considered the most leading reason of injury that is unintentional within aged individuals leading to hospitalization (Neyens et al, 2009). While an individual who has fallen might feel less self-assured, it is imperative that they are reassured that positive steps can be considered in order to avoid falls. Research also indicates that nearly 40 percent of every admission to the residential care can be pointed to aged people falling.

Clients with more risk factors are more expected to fall (Bourke et al, 2005). Hence, it is proper to say that when a client does more things to reduce or eliminate his or her risks, she or he is less expected to fall. According to the research on falls prevention, this is the case.

According to Beasley (2009) falls’ risk factors in aged people entail and not limited to:

  • Activity whereby one experiences weakness of the muscle via lack of physical activity or exercise

  • Clothing and footwear: there can be problems brought about by footwear or clothing that are not fitting

  • Eyes: problems of vision such as poor eyesight or the use of improper glasses can lead to poor vision

  • Balance: poor balance can bring about difficulty in walking

  • Medication: certain medications have side effects that might cause falling (Hartikainen, 2007)

  • Health factors like arthritis, Parkinson’s disease, fright of falling, poor nutrition, incontinence, and memory can cause falling

  • Environment: even though falls seem to take place more frequently once a client becomes of age, it is actually imperative to consider that falling is not a typical element of ageing (Andrews et al, 2012).

Beasley (2009) states that it isvery important to work in collaboration and raise awareness not just within ourselves, but among aged people, kin and significant others as well, because falls are actually preventable. Remembering that risk factors’ identification is the initial step to prevent falls is very crucial. Absence of exercise results in muscle weakness and raises an aged client’s possibility of falling. The body requires good strength in order to support the weight of the body while standing, as well as balance while walking and carrying out daily activities like standing up, getting out of and in bed, and going down or up stairs (Andrews et al, 2012). According to Lea et al, (2012) supporting the advantages of physical activity and exercise in aged people is imperative so that clients within the residential care facility may stay healthy, fit and independent. Andrews et al (2012) argued that the leading location of clients falling within residential care is within the bedrooms of the residents, followed by passageways and bathrooms. Falls are frequently linked to rushing, or hardship conditions like walking on surfaces that are slippery (Andrews et al, 2012).

Determinants of health

A lot of factors merge together to influence the individuals as well as the communities’ health (WHO, 2008). Whether individuals are well or not, is established by their situation and environment. Significantly, factors like where people live, the condition of their environment, income, level of education, genetics, and their relationships with family and friends all have significant effects on health, while the more frequently considered factors like access as well as use of services of healthcare regularly have less effect. In general, the health’s determinants are classified as follows according to the WHO (2008):

  • The economic and social environment,

  • The person’s individual behaviours and characteristics, and

  • The physical environment.

The background of people’s lives verify their health, hence blaming people for having improper health or crediting them due to good health is not appropriate (WHO, 2008). People are expected to have the ability to directly have control of several health determinants. Social status and higher income are equated to better health. Low levels of education are equated to lower self-esteem, more stress and poor health. In terms of physical environment; healthy workplaces, clean air, safe water, safe houses, roads and communities all add to proper health. Inheritance also plays a significant role in establishing lifespan, healthiness in addition to the possibility of developing particular illness (WHO, 2008). Coping skills and personal behaviour like keeping active, drinking, smoking and balanced eating and the way people handle stresses in life all influence health (WHO, 2008).

Project Aim & Objectives

Specific aim (the first 9 months)

  • To implement a program of strategies of reducing falls in the residential aged care facility.

Specific objectives with regards to the Ottawa Charter for health promotion (Andrews et al, 2012) (10 to 15 months)

  • To design the policy and service so as to provide infrastructure that is supportive.

  • To enhance workforce development so as to establish and offer suitable infrastructure

  • To provide individual capacity building so as to increase the skills, knowledge, behavior and attitudes of falls prevention.

Work Plan & Timetable

There are various strategies for decreasing falls of patients and this have been documented (Beasley, 2009). With regards to this project, the objectives will be met through these strategies. The strategies that have actually been highlighted in the plans are those that are able to be administered. Every risk level has other strategies to execute and it may be regarded that the ones that are suggested for low risk categories are actually proper fundamental nursing care. As supported by Beasley (2009) strategies in the plan of care will involve:

  • Documentation of the score of risk assessment

  • Communication to various significant health professionals

  • Ensure bed is on the lowest setting unless when care is being given

  • Ensure clients have required items in their reach

  • Check footwear and clothing of the client

  • Assess the environment for hazards of safety

  • Refer to suitable agencies in case further assessments are required

  • Bed rails’ assessment

  • Educate carer/client in practices that are safe

  • Consider the use of sensor alarm

  • Consider nursing practice with respect to one-to-one basis

  • Communicate with the whole team concerning management of the client.

A comprehensive risk assessment of the environment will be developed as the project’s element. This assessment will be done after every six months by the healthcare providers in charge of the facility and offer a comprehensive account of whichever external factors that might influence the rates of fall within a specific area of the facility. A summary sheet will be completed after the assessment is done which may then be applied to establish where resources of the area shall be directed or where extra funding will require to be sought.

The national policy has provided approved guidelines on the bed rails’ use. With this perspective, this project will also implement the same measures whereby the 120 beds in the aged care facility will have side rails. It is important that clients have a comprehensive assessment of need before using bed rails and every benefit as well as risk will be considered before use. Care givers will also be educated on the same issue so that they can provide effective care. Indiscriminate bed rails’ use has been indicated to raise the falling risk (Andrews et al, 2012). In terms of visual cues, it will be important to communicate the risk level to every healthcare provider as well as other personnel within the facility so that every staff would be able to adhere to strategies of reducing risks of falls. For instance, traffic lighting system for visual cues will be introduced throughout the facility in order to establish the risk level of the patient.

There will be provision of some chairs that are bucket type throughout the facility to prevent clients mobilizing or trying to transfer out of their chairs with no help. This kind of approach will be needed for a few clients but will just be applied after entire multidisciplinary appraisal, consideration of every other strategy of fall prevention and in discussion with the family and patient. This approach shall be regarded a restraint once the patient is limited from mobilizing in case he or she wishes to and hence the care givers will have to be fully informed of their responsibility in terms of care in case they use the bucket chairs to prevent mobilization of the patient.

Sensor alarms will be purchased and put in a chair or bed so that the client can notify the care giver in case he or she requires assistance. Older people are prone to hip fractures caused by falls (Dyer et al, 2005). One of the approaches to decrease the effect of falls within the facility will be hip protectors’ use. Different kinds of hip protector have actually been developed. This is why the aged care facility will implement this strategy because most of them are shielded with plastic, which are positioned by pockets in particularly designed underwear.

Research shows that education of staff is among the leading significant factors when it comes to the success of the reduction programme of falls (Dyer et al, 2005). The project manager will provide a number of sessions for staff education. Liaison nurses and those in charge will have enough time in staff education so that they will be able to pass on the right information as well as encourage staff to finish the forms of assessment. Posters will be produced to emphasize the significance of completing the assessment on falls and to uphold staff awareness once the project’s first interest has abated. Special attention will be given to the physiotherapists as well as occupational therapists so that they would be able to appreciate the need for managing the residents at the facility. Since the fifty participants are of varying mobility, allocation of time and number of the physiotherapist will be important because most of the residents might require aid in terms of physiotherapy. The work plan of the above objectives will be completed within the first year of funding.

Evaluation Plan

At the end of the first 9 months, evaluation will be carried out to in order to assess the reduction of falls in the facility. With proper implementation of the strategies enable by proper funding, a great number of falls will be seen. A reporting system will be piloted throughout the facility so as to enhance availability of appropriate statistics on a basis that is more regular as a means of informing workers of the way their participation towards falls prevention is as compared to the past months or even years. Feedback from the staff will also assist in the evaluation process. Documentation audit will also be used to influence the project’s sustainability and this will be an effective tool because healthcare givers as well as other staff within the facility will be encouraged to embed strategies regularly into practice (Church et al, 2011).

Appendixes

£571.05: Visual Cues

£200.00: bed rails and resource files

£ 11.75: Education posters

£750 will cater for other services.

Total: 1532.8 dollars

Reference

Neyens, J., Dijcks, B., Twisk, J., Schols, J., van Haastregt, J., van den Heuvel, W. & de Witte, L. (2009). A multifactorial intervention for the prevention of falls in psychogeriatric nursing home patients, a randomised controlled trial (RCT). Age and Ageing 38(2):194–199.

Hartikainen, S., Lönnroos, E. & Louhivuori, K. (2007). Medication as a risk factor for falls: critically stematic review. Journal of Gerontology 62A(10):1172–1181.

Gibson, R. E., Harden, M., Byles, J., & Ward, J. (2008). Incidence of falls and fall-related outcomes among people in aged-care facilities in the Lower Hunter region, NSW. New South Wales Public Health Bulletin, 19.

Andrews, S., Lea, E., Haines, T., Nitz, J., Haralambous, B., Moore, K., Hill, K. & Robinson, A. (2012). Reducing staff isolation and developing evidence-informed practice in the aged care environment through an action research approach to falls prevention. Ans. Advances in Nursing Science, 35, 1.)

Dyer, C., Taylor, G., & Reed, M. (2005). Falls prevention in residential care homes: A randomised controlled trial. Abstracts in Social Gerontology, 48, 2.)

Bourke, M., Vardon, P., & Brandis, S. (2005). Engaging consumers in falls prevention: experiences and outcomes from the Australian Falls Prevention Project for Hospitals and Residential Aged Care Facilities. Australian Health Consumer, 1, 17-8.

Beasley, K. (2009). Evidence Utilization: Benefits of implementing an interdisciplinary and multifactorial strategy to falls prevention in a rural, residential aged-care facility. International Journal of Evidence-Based Healthcare, 7, 3, 187-192.

Church, J., Goodall, S., Norman, R., & Haas, M. (2011). An economic evaluation of community and residential aged care falls prevention strategies in NSW. New South Wales Public Health Bulletin, 22, 3-4.

Lea, E., Andrews, S., Hill, K., Haines, T., Nitz, J., Haralambous, B., Moore, K. & Robinson, A. (2012). Beyond the ‘tick and flick’: facilitating best practice falls prevention through an action research approach. Journal of Clinical Nursing, 21, 13-14.

WHO Commission on Social Determinants of Health., & World Health Organization. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health : Commission on Social Determinants of Health final report. Geneva, Switzerland: World Health Organization, Commission on Social Determinants of Health.