A. What are the implication/significance of this study to:

1. Nursing research
2. Nursing education
3. Nursing Practice

B. In what ways is this study relevant to a professional nurse and a student nurse?

 

Answer:

Nurses' documentation of falls prevention in a patient centred care plan in a medical ward
A. What are the implication/significance of this study to:

1. Nursing research

The research found out that  multiple factors are responsible for falls and several factors also contribute to implementation the prevention strategy. These factors may include the knowledge of nursing staff, their knowledge, belief, attitudes, workloads and staff culture on the ward, environmental factors and access to required resources. Falls assessment tools have been documented to be effective in reducing the rate of falls and injuries amongst inpatients. The research developed a falls assessment tools to help identify patients that are at risk of falls, so that timely interventions can be put in place. 

2. Nursing education

• As part of the implementation of the tool, the new nursing staff are educated on falls prevention and the risk assessment tool as part of the orientation to the hospital. 
• Ward-based training was delivered by the injury prevention champions of the designated wards, so as to prepare and engage nursing staff in providing falls prevention assessment and interventions. 
• The injury prevention champions of the ward conducted monthly audits of the falls prevention assessment tool, and in response to the audit results feedback was provided to the nursing staff team each shift. 
• The nursing staff were encouraged to instil the education provided to the next shift to improve the assessment, documentation and implementation of the documented falls prevention strategies. 
• Also, during ward handover/huddles, the location of the high falls risk patients is reinforced by the nurse in charge to increase nursing staff awareness.

3. Nursing Practice

Th research also showed that falls were due to environmental factors, intrinsic physiologic factors and attempts to get up in the patient room. Also,  the patient's bedside was the hotspot for fall injuries. It was also discovered that the rate of tall among men  (55%) was higher than in women (45%). Falls in men may be due to their penchant to engage in risky behaviors. For example, men are less likely to call for assistance when getting up to use the bathroom even after being instructed to do so by the nurse.

Understanding the current practices of falls prevention and raising nursing staff awareness of variance in the implementation of falls prevention strategies will improve the quality, efficiency of healthcare delivery and patient safety.

The following were also noted in the research:

• Nurses' do not always document patient assessment of falls and related nursing care.
• There are multiple factors which affect nurses' documentation of the assessment of risk of falls and implementation of nursing care.
• Patients are not educated or engaged in their falls prevention plan, even when they are at risk of falls.
• Patients are not aware of the implemented falls prevention strategies which are part of their care.  

B. In what ways is this study relevant to a professional nurse and a student nurse?

The awareness of the risk for falls, prevention and proper documentation is very important for professional nurses and student nurses for effective patient care. The hospital in this study implemented a tool called the nurse led 6-PACK falls prevention tool, as part of the Patient Centred Care Plan (PCCP). The PCCP is a patient's daily plan of care which is completed by nursing staff and updated for each shift. PCCP is usually located in the patient's medical record. The falls prevention strategies documented on the falls prevention tool are: 

• The placement of falls alert signs above the patients' bed
• Use of high low beds
• Establishment of a toileting regime
• Supervision of patients whilst in the bathroom
• Use of bed/chair alarms, ensuring walking aid is within reach
• Patient engagement/education in falls prevention plan. 

The implementation of the 'Alert Sign' with one or more falls prevention strategies specified in the PCCP were deemed as correct implementation of the falls prevention plan. As part of the implementation of the tool, the nursing staff are provided training on their falls prevention risk.

Reference

https://www.ajan.com.au/index.php/AJAN/article/view/103/23