Risk assessment and fall prevention: Practice Development in action
Jennifer Dempsey
School of Nursing and Midwifery, University of Newcastle, Ourimbah NSW
PP: 123
Abstract
Amongst the health disciplines, nurses spend the most time with patients providing most of the supervision in care. Therefore, nurses have a primary role to play in contributing to knowledge surrounding the best methods of assessment of risk and prevention of adverse events.
According to the Australian Incident Monitoring System (AIMS), the adverse event (38%) most frequently reported in acute hospital settings is patient falls (Evans et al 1998). The continuing rise in reported rates of falls in the acute medical wards of a tertiary hospital, on the Central Coast of New South Wales (NSW), Australia was the impetus for an action research project aimed at increasing nurses' sense of ownership of their fall prevention practice.
This paper specifically reports the findings of a pilot project related to development of a fall risk assessment chart that was one of the cycles of the action research.
Keywords
fall prevention, risk assessment, practice development
References
Antrobus S and Kitson A (1999) Nursing leadership: Influencing and shaping health policy and nursing practice, Journal of Advanced Nursing 29(3): 746-753.
Brandis S, Lewis S, Simpson T and Tuite A (2001) Falls prevention: Best practice guidelines for public hospital and state government residential aged care facilities, Queensland Health: Quality Improvement & Enhancement Program, Brisbanes.
Chang JT, Morton SC, Rubenstein LZ, Mojica WA, Maglione M, Suttorp MJ, Roth EA and Shekelle PG (2004) Interventions for the prevention of falls in older adults: systematic review and meta-analysis of randomised controlled trials, BMJ: 328-680.
Dempsey J (2004) Falls prevention revisited: A call for a new approach, Journal of Clinical Nursing 13: 479-485.
Donoghue J, Graham J, Gibbs J, Mitten-Lewis S and Blay N (2003) Validating components of a fall risk assessment instrument, International Journal of Health Care Quality Assurance 16(1): 21-28.
Evans D, Hodgkinson B, Lambert L, Wood J and Kowanko I (1998) Falls in acute hospitals: a systematic review, The Joanna Briggs Institute for Evidenced Based Nursing and Midwifery, Adelaide.
French B (2005) The process of research use in nursing, Journal of Advanced Nursing 49(2): 125-134.
Grbich C (ed) (1996) Health in Australia. Sociological concepts and issues, Prentice Hall Australia, Sydney.
Hart E and Bond M (1995) Action research for health and social care: A guide to practice, Open University Press, Buckingham.
Hathaway J, Walsh J and Saenger H (2001) Insights obtained from an evaluation of a falls prevention program set in a rural hospital, Australian Journal of Rural Health 9(4): 172-177.
Hendrich A, Nyhuis A, Kippenbrock T and Soja M E (1995) Hospital falls: Development of a predictive model for clinical practice, Applied Nursing Research 8: 129-139.
Hill K, Smith R, Murray K, Sims J, Gouph J, Darzins P and Vrantsidis F (2000) An analysis of research on preventing falls and falls injury in older people: community, residential aged care and acute settings, Commonwealth of Australia: The National Ageing Research Institute, Canberra.
Ingersoll GL (2000) Evidence based nursing: What it and what it isn't, Nursing Outlook 48: 151-152.
Kitson A (1997) Using evidence to demonstrate the value of nursing, Nursing Standard 11: 34-39.
McCormack B, Manley K and Garbett R (eds) (2004) Practice development in nursing, Blackwell Publishing, Oxford.
Meyer JE (1995) Stages in the process: A personal account, Nurse Researcher 2(3): 24-37.
Mitchell A and Jones N (1996) Striving to prevent falls in an acute setting - action to enhance quality, Journal of Clinical Nursing 5(4): 213-220.
Moller J (2000) 'Changing resource demands related to falls injury in an ageing population', unpublished paper, NSW Health, Injury Prevention Policy Unit, Sydney.
Mooney G and Scotton R (eds) (1999) Economics and Australian health policy, Allen & Unwin, St Leonards.
Morse JM (1993) Nursing research on patient falls in health care institutions, Annual Review of Nursing Research 11: 299-316.
Myers H (2003) Hospital fall risk assessment tools: A critique of the literature, International Journal of Nursing Practice 9: 223-235.
Myers H and Nikoletti S (2003) Fall risk assessment: A prospective investigation of nurses' clinical judgement and risk assessment tools in predicting patient falls, International Journal of Nursing Practice 9(3): 158-165.
NSW Health (2000) A Framework for Managing the Quality of Health Services in New South Wales, NSW Health, Sydney.
NSW Health (2001) Preventing Injuries From Falls in Older People, NSW Health Department, Sydney.
NSW Health (2002) Easy guide to clinical practice improvement, NSW Health Department, Sydney.
NSW Health (2003) Management policy to reduce fall injury among older people, NSW Health Department, Sydney.
O'Connell B and Myers H (2001) A failed fall prevention study in an acute care setting: Lessons from the swamp, International Journal of Nursing Practice 7(2): 126-130.
Oliver D, Hopper A H and Seed P (2000) Do hospital falls prevention programs work? A systematic review, Journal of the American Geriatric Society 48(12): 1679-1689.
Oliver D, Britton M, Seed P, Martin FC and Hopper AH (1997) Development and evaluation of evidence based risk assessment tool (STATIFY) to predict which elderly inpatients will fall: case-control and cohort studies, British Medical Journal 315: 1049-1053.
Oliver D, Daly F, Martin FC and McMurdo MET (2004) Risk factors and risk assessment tools for falls in hospital in-patients: a systematic review, Age and Ageing 32(2): 122-130.
Pearson A (2003) Key performance indicators for nursing, International Journal of Nursing Practice 9: 337.
Schneider Z, Elliott D, LoBiondo-Wood G and Haber J (2003) Nursing research: Methods, critical appraisal and utilisation 2nd edn, Mosby, Sydney.
Stetler CB, Morsi D and Burns M (2000) Physical and emotional patient safety: A different look at nursing-sensitive outcomes, Outcomes Management for Nursing Practice 4(4): 159-166.
Turkoski B, Pierce LL, Schreck S, Salter J, Radziewicz R, Guhde J and Brady R (1997) Clinical nursing judgment related to reducing the incidence of falls by elderly patients, Rehabilitation Nursing 22(3): 124-130.
Wood J, Wallace J, Zeffane RM, Schermerhorn JR, Hunt JG and Osborn RN (1998) Organisational behaviour: An Asia-Pacific perspective, John Wiley & Sons, Brisbane.
Uden G, Ehnfors M and Sjostrom K (1999) Use of initial risk assessment and recording as the main nursing intervention in identifying risk of falls, Journal of Advanced Nursing 29(1): 145-152.
Winch S, Creedy D and Chaboyer W (2002) Governing nursing conduct: the rise of evidence-based practice, Nursing Inquiry 9: 156-161.
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