Scope and Purpose This clinical practice guideline (CPG) provides the principals and regulations to prevent falls and injury from falls in the hospital setting (National Guideline Clearinghouse (NGC), …show more content…
The first step of assessment involves assessing the inherent risk factors of fall in older adults (NGC, 2012). These risk factors include but are not limited to: age 75 and older, history of fall, comorbidities such as dementia, Parkinson’s disease, type 2 diabetes, and arthritis; altered mental status, visual impairment and high risk medications (NGC, 2012). The second step of assessment is reporting external risk factors to fall and establishing a corrective action plan (NGC, 2012). Some of the external risk factors include but are not limited to: assessing the floors for unevenness or spills, making sure there are night lights to help with illumination of the environment, furniture is sturdy and in good repair, grab rails and bars in the bathrooms, and bed rails that do not fall while patient is transitioning or needing support (NGC, 2012). The third step of assessment is what needs to occur in the event of an actual fall. In the event of a fall a post fall assessment should occur. The post fall assessment involves identifying the causes of the fall, assessing the patient for injury and monitoring the patient for forty-eight hours post fall for any complications (NGC, …show more content…
This CPG outlines very well multiple steps to fall prevention in this population, from careful assessment of the patients, to the institution of nursing strategies and monitoring of quality initiatives that are put in place (NGC, 2012). In practice the advanced practice nurse would apply this CPG in several ways. One, making sure staff was adequately educated on the multiple prevention strategies and that they are being applied. Two, ensuring that proper patient and family education is being delivered to every at risk patient and finally monitoring outcomes to ensure that the initiatives put in place are working.
References
Chamberlain College of Nursing. (2016). NR-505 Week 6 Models of Evidence-Based Practice. Downers Grove, IL: DeVry Education Group.
Melnyk, B., Fine-Overholt, E. (2015). Critically appraising quantitative evidence for clinical decision making. In Evidence-Based Practice in Nursing and Healthcare (95). Philadelphia, PA: Wolters Kluwer Health/ Lippincott Williams & Wilkins.
Gray-Miceli, D. Quigley, P. A. (2012). Fall prevention: assessment, diagnoses, and intervention strategies. In: Boltz M, Capezuti E, Fulmer T, Zwicker D, editor(s). Evidence-based geriatric nursing protocols for best practice. 4th ed. New York (NY): Springer Publishing Company; p. 268 -