Patient safety is a primary concern in the health field, including the risk for falls. Falls are one of the most commonly reported safety concerns, especially when it comes to the elderly population. There are many factors that contribute to the risk for falls, one being age, and the degenerative nature that comes with increasing age. Loss of sight, motor function, and elasticity effects a person’s ability to see any objects in their path, and ability to perform activities with ease. It is important to corelate patient safety, including fall risk, with patient centered care and the nursing process.
The first step in the nursing process is assessment. Assessment is when you are gathering information on the patient to make an informed decision about their health and well-being. When discussing the topic about patient safety and the concern for fall risks, it is especially important to continually assess the older population, whether they still live on their own home or they are in a nursing home. When assessing a patient’s risk for falls, there are several factors that can contribute to this risk; age, medications, vision or balance loss, and diseases or accidents that affect motor functions; dementia, stroke, arthritis and Parkinson’s disease (American Speech-Language-Hearing Association, 2018). As a nurse it is important to look for these factors when assessing a patient. Patients who are currently in the nursing home may be there because they cannot live on their own for reasons like disease, immobility, impaired mental status, and inability to perform their activities of daily living. This population is already at increased risk for falls and should consistently be monitored and reassessed. For patients who still live at home but me succumb to the effects of aging, it is important for the nurse to remind the patient, that it may be necessary to take extra precautions. Some may include, getting their eyes checked frequently, knowing if their medications could affect their motor skills, and be extra careful when in the bathroom (American Speech-Language-Hearing Association, 2018). After gathering the data, the nurse should have enough information to make a diagnosis regarding the patients fall risk.
A patient who has multiple factors that could lead to falls, could be diagnosed as a fall risk and precautions should immediately be implemented, but it is important for the nurse to individualize these plans of care for the patient. Looking at each patient individually will help to plan the best care for that person in order to maximize their chances of reducing their fall risk. There is controversy on some forms of fall precautions, and there are some that are used widely in the healthcare field. Knowing your patient will help determine which precaution is the best for that specific situation. With the knowledge you have regarding your patient, you are able to start planning and then implementing.
Planning interventions for a patient consists of many factors. Do they live at home? If they do, do they live alone? Do they have family support? Are they in the nursing home? If so, why? How does that disease/factor affect their fall risk? A patient who lives at home with a spouse and family support, may not need the types of precautions needed for someone in a nursing home. A patient who lives at home may just need to be educated on their fall risk and be cautious when it comes to using the shower or going up or down stairs. Placing nonslip mats in the bathroom, and handles on the side of the shower are ways to implement these plans given by the nurse. It is important for the nurse to make sure they educate the patient as much as possible regarding their risk and what they can do to drastically reduce that risk.
When planning interventions for a patient who is in the nursing home, who may have dementia, there are some precautions that can be taken, like providing non-slip socks, having them use a cane, walker, or even wheelchair, and making sure there is nothing on the floor that they could possibly trip on (American Speech-Language-Hearing Association, 2018). Providing the non-slip socks is just one extra precaution that can be taken. Non-slip socks won’t necessarily prevent all falls, but it will help the older adults who may “shuffle” so they don’t fall due to slippery surfaces (Hartung and Lalonde, 2017). Bed alarms a very controversial precaution when it comes to mobilization. Bed alarms are something that should only be used in a very specific situation, in which you had no other option. They should be used in order to keep the patient from unknowingly harming themselves. Some patients who have dementia may be the type of people who just don’t like to sit still even though they are a very high fall risk, and could harm themselves. On the other hand, bed alarms are seen as a restriction on patients that may diminish their mobility further and could lead to incontinence (HCPro, 2018). Bed alarms tend to be loud and could potentially scare patients and other residents as well. These implementations take careful planning and could be a trial and error event. It is important for the nurse to evaluate how the plan worked once it was implemented and see of the patient responded to the implementations. Did it work? Was the patient happy? Does the plan need to be revised? There are many factors that need to be assessed, and questions that should be asked when considering the outcome of these implementations.
Evaluation is the final step in the nursing process where you assess what worked and what didn’t. The nurse should ask themselves did the non-slip socks help? Did the bed alarm work? Was it helpful to the patient? Was there anything that could have been done differently to create an even better outcome? What about the patient who is at home? Have they installed handrails and non-slip mats? Do they like these implementations? Do they feel safe walking around the house? There are many things the nurse has to ask not only themselves, but also the patient when evaluating the interventions. Sometimes the interventions work, but sometimes it is necessary to go back, reassess, and start with a new plan. Nurses play a key role in how a patient will react and embraces these changes. Proper education is very important when it comes to changing a person’s lifestyle and a nurse has to provide that information.
It is clear to see that the nurse plays a large role in the patient’s life when providing patient centered care and helping to reduce risks like falls. Patient safety is a large concern in the health field especially for nursing homes. The nurse has a huge impact on the patient, that is why a strong nurse-patient relationship is important from the start. It is also important for the nurse to educate and plan the best outcome possible for the patient, taking their opinions into consideration as well. The patients current and future well-being are the nurses main concern and should always be a primary concern when addressing safety and fall risks.