Please provide a meanifull respond to the current post:
State which tool you are reviewing. Include what contributing/risk factors are assessed by the assessment tool/
Johns Hopkins Fall Risk Assessment Tool
Falls are a common and serious issue affecting patients in hospitals, homes, and nursing homes. Understanding the factors that increase the chances of falls is crucial in order to prevent them and improve patient safety (Johns Hopkins Medicine, n.d.). One of the primary factors that increase the risk of falls for patients in hospitals, homes, and nursing homes is the presence of physical impairments. One of the assessments nurses do is the patient’s history of falls. Patients who have a history of falls are at a higher risk of experiencing future falls, making it crucial for nurses to identify this risk factor early on. Additionally, nurses also assess the patient’s mobility status, including their ability to walk independently, use assistive devices, and navigate their environment safely (Johns Hopkins Medicine, n.d.).
How does utilization of evidence-based tools relate to root cause analysis of a nursing concern/problem? How does understanding the root cause of the nursing concern/problem guide the development of goals and interventions? The use of an example may be helpful.
Patient safety is a top priority in healthcare, especially in nursing care where the risk of falls can have serious consequences for patients. Utilizing evidence-based tools such as the John Hopkins fall risk assessment tool can help nurses identify patients at risk and implement preventive measures which are crucial for improving patient outcomes and ensuring high-quality care (Strini, Schiavolin, & Prendin, 2021).
Evidence-based tools like the John Hopkins fall risk assessment tool provide nurses with a systematic approach to identifying patients who are at risk of falling. By utilizing this tool, nurses can gather data on factors such as mobility, balance, and medication use, which are known to contribute to fall risk (Strini et al., 2021). This information allows nurses to tailor interventions to each patient’s specific needs, ultimately reducing the likelihood of falls occurring such as reinforcing use of bed alarms or frequent monitoring.
Root cause analysis is a systematic approach to identifying the underlying causes of a problem or concern in healthcare (American Society for Quality, 2023). It involves analyzing the chain of events leading to an incident, identifying contributing factors, and developing strategies to prevent recurrence (American Society for Quality, 2023). In the American Society of Quality (ASQ), RCA is a key methodology used to drive continuous improvement and enhance organizational performance (American Society for Quality, 2023).
In the healthcare setting, fall risk patients are a vulnerable population requiring special attention to prevent adverse events. Implementing evidence-based practices is crucial in reducing fall-related injuries and improving patient outcomes. RCA can help healthcare providers identify the root causes of falls in high-risk patients and develop targeted interventions to address these underlying factors (American Society for Quality, 2023). This may involve examining environmental factors, medication errors, or communication breakdowns that contributed to the fall.
Examples
Patients who have mobility issues, muscle weakness, or balance problems are more prone to falling. Additionally, older adults are at a higher risk of falls due to age-related changes in vision, hearing, and coordination (Johns Hopkins Medicine, n.d.).
At home, falls are often caused by hazards within the living environment. Loose rugs, uneven flooring, lack of handrails, and poor lighting are all examples of environmental factors that can contribute to falls at home. For instance, a loose rug in the living room can easily trip an individual walking by, leading to a fall and potential injuries. If RCA identifies one of these as issues, some of interventions would include installing handrails, securing rugs, and improving lighting can help reduce the risk of falls at home and promote a safer living environment for individuals, especially the elderly. Also encouraging these individuals to continue exercising and doing range of motion to maintain stronger muscles rather than sitting and sleeping all the time. When patient is discharged from hospitals community paramedics and home health services that offer occupation therapy (OT) and physical therapy (PT) can be included in the discharge planning to ensure patients are assessed of their ability to continue caring for themselves otherwise would go to a transition care unit, assisted living, or group homes.
In hospitals, environmental factors are also a risk factor for falls. Inadequate lighting, cluttered walkways, IV pole cords and infusing medications, if patients have draining outlets like chest tubes and wound vacs, and poorly maintained equipment can all contribute to falls among patients and staff. Addressing these environmental factors through regular maintenance, proper lighting, clear pathways, have bed alarms on if patients have equipment that need more than individual assist, and promoting increased activities like range of motion, and ambulation to prevent deconditioning during hospitalization are some of the interventions that can be implemented to address these issues. This can be done by nurses, PT, OT, family, and individual patients if they are independent.
Another common cause of falls in health care settings is medication-related factors. Certain medications can cause dizziness, drowsiness, or loss of balance, increasing the risk of falls among patients. For instance, sedatives, antihypertensives, and psychotropic drugs can all have side effects that affect a patient’s ability to maintain stability and coordination. Healthcare providers must be aware of the potential side effects of medications and monitor patients closely to prevent falls associated with medication use. Patients must also be educated on the effects of the medications they are taking and request them to seek assistance with ambulation as needed.
Furthermore, cognitive impairments, such as dementia or delirium, can impact a patient’s ability to recognize and respond to fall risks. Patients with cognitive issues may be disoriented or have difficulty following instructions, making them more susceptible to falls. Bed alarms, close observation and continuous reminder can be implemented to reduce fall.
Part Two
One purpose of care planning is to promote continuity of care and as nurses it is important to remember that those who live with chronic illness typically receive care from a number of professionals, unlicensed staff, and family members. It is not uncommon that important information is lost during transitions from one caregiver and/or one healthcare setting to another. Omitting significant information can impact outcomes quickly thus effective communication and follow ups are important.
Explain in a minimum of 250 words how you would develop three specific strategies to facilitate continuity of care while adhering to principles of person and family centered care. Hint: The assigned readings by Ljungholm, Edin-Liljegren, Ekstedt, & Klinga (linked into the module guide) and the article by Hirschman, et al. (linked into the module – table 1 is a nice summary) will be valuable as you compose your response.
Continuity of care refers to the coordination and consistency of healthcare services provided to an individual over time. It involves a seamless flow of information, communication, and collaboration among healthcare professionals to ensure that the patient’s needs are met effectively (Ljungholm, Klinga, Edin, and Ekstedt, 2022). In the chronic care trajectory, where patients often require long-term management and support, continuity of care plays a vital role in promoting better health outcomes and quality of life (Ljungholm et al., 2022). To ensure continuity of care for individuals with chronic illnesses, it is important to develop specific strategies that focus on person and family-centered care (Ljungholm et al., 2022). Here are three strategies that can help facilitate continuity of care:
1. Communication and Information Sharing: Communication is key in ensuring that all caregivers, both professional and family members, are on the same page regarding the individual’s care plan (Ljungholm et al., 2022). Implementing a system where all relevant information is documented and easily accessible to all parties involved can help prevent important details from being lost during transitions of care (Ljungholm et al., 2022). Regular meetings or check-ins can also help facilitate open communication and ensure that everyone is up to date on the individual’s condition and needs (Ljungholm et al., 2022).
2. Care Coordination: Assigning a care coordinator who is responsible for overseeing the individual’s care across different settings can help streamline the care process and prevent gaps in care (Ljungholm et al., 2022). The care coordinator can work with all caregivers to ensure that everyone is working towards the same goals and that there is a cohesive plan in place. This can help prevent duplication of services, medication errors, and other issues that can arise when care is fragmented.
3. Empowering the Individual and Family: Involving the individual and their family in the care planning process can help ensure that their preferences and values are taken into consideration (Ljungholm et al., 2022). Providing education and resources to help them self-manage their condition can also help promote continuity of care, as they will be better equipped to navigate transitions between different caregivers and settings. Encouraging open communication and collaboration between all parties involved can help foster a sense of empowerment and ownership over the individual’s care (Welch, Hodgson, & Didericksen, 2021). By implementing these strategies, we can help promote continuity of care for individuals with chronic illnesses while adhering to the principles of person and family-centered care (Welch et al., 2021). Involving patients in decision-making, setting goals, and developing care plans, healthcare professionals can ensure that the care provided is tailored to the individual needs and preferences of the patient (Ljungholm et al., 2022). This patient empowerment not only improves adherence to treatment but also enhances patient satisfaction and engagement in their own care. It is important to remember that each individual is unique, and care plans should be tailored to their specific needs and preferences to ensure the best outcomes.
References
American Society of Quality (2023). What is Root Cause Analysis (RCA)? ASQ
https://asq.org/quality-resources/root-cause-analysis
Johns Hopkins Medicine. (n.d.). Fall Risk Assessment | Johns Hopkins Health Care Solutions. Johns Hopkins HealthCare Solutions. https://www.johnshopkinssolutions.com/solution/johns-hopkins-fall-risk-assessment-tool-jhfrat/
Ljungholm, L., Klinga, C., Edin, L. A., & Ekstedt, M. (2022). What matters in care continuity on the chronic care trajectory for patients and family carers? —A conceptual model. Journal of Clinical Nursing (John Wiley & Sons, Inc.), 31(9/10), 1327–1338. https://doiorg.ssuproxy.mnpals.net/10.1111/jocn.15989
Strini, V., Schiavolin, R., & Prendin, A. (2021). Fall Risk Assessment Scales: A Systematic Literature Review. Nursing Reports, 11(2), 430–443. https://doi.org/10.3390/nursrep11020041
Welch, Melissa L., et al. “Family-Centered Primary Care for Older Adults with Cognitive Impairment.” Contemporary Family Therapy, vol. 44, no. 1, 15 Nov. 2021, https://doi.org/10.1007/s10591-021-09617-2.
