...Falls do not just occur as a result of people aging. Often, numerous risk factors and underlying causes are involved in patient falls. “A risk factor is something that increases a person's risk or susceptibility to a medical problem or disease” (cdc.org, 2013). The higher the number of risk factors the higher the risk of falls. Falls are usually related to medical conditions or physical disabilities. “Falls are the leading cause of injury-related visits to emergency departments in the United States and the primary etiology of accidental deaths in persons over the age of 65 years” (cdc.org, 2013). Increase in age, cognitive impairment medication use and sensory are all risk factors for falls. Management is focused on these underlying causes...
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...Dykes PC1, Carroll DL, Hurley A, Lipsitz S, Benoit A, Chang F, Meltzer S, Tsurikova R, Zuyov L, Middleton B. Fall prevention in acute care hospitals: a randomized trial PubMed.gov 2010 Quantitative Cluster randomized study 4 urban United States hospitals in units that received typical care (4 units and 5104 patients) or the intervention of a fall prevention tool kit (4 units and 5160 patients). Patient fall rates in US hospitals was the focus of study. The primary outcome was patient falls per 1000 patient-days, adjusted for site and patient care unit. A secondary outcome was fall-related injuries to patients in these units. Number of patients that experienced a fall differed between the control (n = 87) and the intervention (n = 67) with...
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...Prevention and the Child Protection System Jane Waldfogel The Future of Children, Volume 19, Number 2, Fall 2009, pp. 195-210 (Article) Published by Princeton University DOI: 10.1353/foc.0.0037 For additional information about this article http://muse.jhu.edu/journals/foc/summary/v019/19.2.waldfogel.html Access Provided by Columbia University at 09/11/12 2:47PM GMT Prevention and the Child Protection System Prevention and the Child Protection System Jane Waldfogel Summary The nation’s child protection system (CPS) has historically focused on preventing maltreatment in high-risk families, whose children have already been maltreated. But, as Jane Waldfogel explains, it has also begun developing prevention procedures for children at lower risk—those who are referred to CPS but whose cases do not meet the criteria for ongoing services. Preventive services delivered by CPS to high-risk families, says Waldfogel, typically include case management and supervision. The families may also receive one or more other preventive services, including individual and family counseling, respite care, parenting education, housing assistance, substance abuse treatment, child care, and home visits. Researchers generally find little evidence, however, that these services reduce the risk of subsequent maltreatment, although there is some promising evidence on the role of child care. Many families receive few services beyond periodic visits by usually overburdened caseworkers, and...
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...Vol. 27, No. 1, pp. 6–12 Copyright c 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Missed Nursing Care, Staffing, and Patient Falls Beatrice J. Kalisch, PhD, RN, FAAN; Dana Tschannen, PhD, RN; Kyung Hee Lee, MPH, RN Patient falls in hospitals continue to be a major and costly problem. This study tested the mediating effect of missed nursing care on the relationship of staffing levels (hours per patient day [HPPD]) and patient falls. The sample was 124 patient units in 11 hospitals. The HPPD was negatively associated with patient falls (r = − 0.36, P < .01), and missed nursing care was found to mediate the relationship between HPPD and patient falls. Key words: falls, missed nursing care, staffing P to 12% of hospitalized patients experience at least 1 fall during their hospital stay.1 A fall is defined as any event in which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors.2 In 2008, and 2010, falls were identified as one of the top 10 sentinel event categories by the Joint Commission.3 Fall rates in hospitals range from 4 to 14 falls per 1000 patient days.4 With the adoption of the Centers of Medicare and Medicaid rule, which no longer reimburses hospitals at the higher diagnosis related group for the care and treatment associated with patient falls that occur during hospitalization, a clearer understanding of what factors U Author Affiliations: School of Nursing, University of Michigan...
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...REDUCING FALLS IN THE HOSPITAL SETTING Abstract “Falls and fall related injuries are the most commonly reported adverse event among adults admitted to inpatient setting. Up to twenty percentages of patients admitted, reported falling of at least once during an inpatient hospital stay period” (Oliver, Healey, & Haines, 2010). The author works at a city hospital located in Gilbert, Arizona and encounters a great amount of orthopedic patients along with other general surgery patients. All patients that are on that floor are at a risk of falls during the first 48 hours after surgery due to anesthesia that is still in the system and pain medication that is scheduled to help ease the patient during the post-surgical time frame. One of the side effects of anesthesia exiting the body is nausea and vomiting which can make the patient feel dizzy and lightheaded, thus making them a great risk for falls. This has been the reason that the topic was chosen; to attempt to improve this issue in the hospital setting and to provide a system in which all hospital staff collaborate to help increase the quality of patient care. The location that is being observed is the post-surgical/orthopedic floor where the author is currently working. A description of risks and concerns are provided and patient outcomes depend on implementing the proposed interventions. The two solutions that are presented are hourly rounding and the importance of an improved nurse call light button and education on proper...
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...universal fall precautions. This ranged from failure to use and untimely response to bed and chair alarms, missing patient fall risk bands, cluttered patient rooms, and missed hourly rounding. Importance of this Issue Patient falls is still a significant issue in healthcare. Around 700,000 to 100,000 people in the U.S. suffer from falls in a hospital setting (Agency for Healthcare Research and Quality, 2013). Obviously, this is problematic because falls can exacerbate the patient’s condition. It can cause unwanted outcomes like pain, fractures, head injuries, or in a worst-case scenario, even death. Preferred Practice Falls in a hospital setting are preventable. Successful implementation of universal precautions is a big part of preventing this issue. It should always be practiced. Universal fall precautions include but are not limited to • Properly identifying patients...
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...research is essential in determining patient safety issues and improving patient outcomes due to the nurse being the closest point of care provider for the patient. It is the nurse’s observations that help direct and manage the path that a patient’s care may take. With the nurse as the closest observer of the patient, it only makes sense that nurses play the intricate role in the research of patient improvements or disparities, alike, especially since we are the implementers of the prescribed treatments. We see firsthand what is working and what is not working, and it is our duty to advocate for what our patients need, and report what is not working or causing harm. Our facility has recently implemented a post fall huddle program which is performed by a pre-educated Fall Intervention Team (FIT) who to try and determine the...
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...According to the Centers for Disease Control, “diabetes affects 25.8 million people, 8.3% of the U.S. population” (Center for Disease control and Prevention, 2012, par 1). Twice as many African Americans are likely to develop diabetes than Caucasian Americans. These statistics represent how serious diabetes has become for the black community. Epidemiology can focus healthcare efforts and interventions to help lower the incidence of diabetes of the African Americans. This paper will focus on the role of epidemiology in the observation of the frequency of diabetes in the morbidity and mortality of American of African decent. This paper will also include the definition and description of epidemiology, epidemiological methods, the epidemiological triangle, types of epidemiology, and prevention that is related with diabetes in the African American community. Definition and Description of Epidemiology Epidemiology is defined as, “the study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems.” (Center for Disease Control and Prevention, 2012, p. 243). Epidemiology has provided an understanding of the factors, which contribute to health and disease, and the development of health promotion and disease prevention measures. The purpose of epidemiology is to find the causes of the disease that affect a population. Epidemiology has influences on both...
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...Abstract As life expectancy increases the number of older adults requiring long-term care of some kind increases. These adults have varying needs, but most adults have problems with skin integrity, muscle weakness, and emotional issues in long-term care facilities. Interventions to meet these needs focus on preventing skin break down, improving muscle strength to prevent falls, and settings that promote usefulness and a feeling of not being alone. Current options available to older adults may not meet all of their needs, and creativity is needed in devising interventions to meet these needs. Structuring long-term care settings to encourage activity in older adults and connecting with other generations can help prevent feelings of loneliness and uselessness, and help older adults live meaningful and productive lives in long-term care settings. Long-Term Healthcare Needs of the Elderly As adults age many will require long-term health care. The evolving needs of the older adult population will require creative and new ways to meet their health care needs. This paper will look at the needs older adults have, and options that are currently available to meet these long-term care needs. This paper will also present new options that have been proposed for long-term health care settings, how these options compare with current interventions, and what outcomes can be expected if these new options are implemented. The Problem As life expectancies increase the older adult population...
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...PROJECT: “LOSS CAUSATION MODEL” HISTORY, THEORY & APPLICATION Fall 2014 Student: Mariana Ifteni INTRODUCTION/ HISTORY Companies suffer a considerable loss due to accidents, and it is reflected in paying insurance cost, repair of the damage machinery, slowing down of production, additional charges on training of new specialists, and so on. Thus, a special system of accident investigation or, in other words, loss causation investigation is widely in practice. Accident investigations are conducted not only to prevent material loss, physical injury or corrective measures – the point is also to assure that the injured worker gets all material compensation necessary, or, instead, to oppose false insurance claims. Thus, inadequate safety program is reflected in the lack of workers training, necessary inspections of the equipment and so on. Inadequate safety program standards are evident when workers do not understand the peculiarity of the safety program and how to apply it, that is why insufficient compliance to standards occurs. Before a loss occurs (Injury, illness, damage, loss in process), there are series of events that take place with a root cause that begins this series of events. The root cause is called a Lack of Control (Inadequate standards, lack of compliance for preparedness, knowledge and skill training, etc). This leads to a basic cause (or personal factor) such as lack of knowledge, stress, inadequate capabilities. This in turn leads to an immediate cause (substandard...
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...promotion and prevention have expanded greatly. The goal is to prevent disease from occurring rather than taking a reactive position of treating the client once disease has already occurred. Health defined by Edelman and Mandle is a state of physical, mental, spiritual, and social functioning that allows a person to reach their individual potential for optimal health (Edelman & Mandle, n.d.). In order to reach these goals, levels of prevention have been defined and nurses take an active role in the implementation of positive changes in clients’ lifestyle. On each level of the health promotion continuum, the nurse has to keep in mind the clients’ cultural and educational background to develop mutually agreed- upon goals. “Primary care providers, including nurse practitioners and other advanced practice nurses, now attempt to involve individuals and their families in the delivery of care, teaching individuals about individual responsibilities and lifestyle choices has become an important part of their job”(Edelman & Mandle, p. 9). These positive changes improve the quality of the clients’ and families lives. The three- levels of health care promotion are primary, secondary, and tertiary prevention. All of these levels fall under the wellness continuum. The purpose of this paper is to compare these three levels of health care promotion and give example of how each can be implemented throughout the continuum of wellness promotion. The main goal of primary prevention is to...
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...Services The needs assessment revealed that 15% of the population will be older than age 65 within the next 5 years. 50% of men and 33% of women are expected to develop cancer during their lifetime. New cases of cancer are expected to grow by 34% in the next 5 years. Current physician practices that serve oncology patients are at their full capacity. Additional facilities and equipment are needed to be able to provide the care that is needed. There is poor coordination of care between the different disciplines that provide care to these patients. There are delays in scheduling care for oncology patients. There are no established programs focused on cancer prevention and control. Educational programs on the risk factors for cancer are limited. Orthopedic Services The needs assessment reveals that there will be anticipated growth in orthopedics. Orthopedic cases are expected to increase by 46%. Inpatient volume is expected to increase by 30% and outpatient procedures by 350%. The community needs additional physicians in order to accommodate this growth. There will need additional imaging equipment, operating rooms and rehab facilities. There needs to be better coordination of care to ensure timeliness of scheduling. Educational programs need to be implemented on accident prevention and promoting health lifestyles. Cardiovascular Services Over the next 5 years, there will be an increased need for cardiovascular services....
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...characteristics of why patients fall in the hospital setting. The article being critiqued defines a fall as an unexpected drop from a sitting, standing, and lying position, which include an assisted fall (where someone helps guide them to the floor), slipping from a chair to the floor, and when a patient is found on the floor (Hitcho et al., 2008). This critique will discuss data collection, data management, analysis, and interpretation of the findings. The Washington University Institutional Review Board gave their approval for this study. Written consent was waived due to the fact that this study was part of a hospital-based project to improve quality. The study did not pose any risks to the patients as the patients were not put in any situation to induce a fall, and no precautions were taken away from patients that prevent falls. Several sources and a comprehensive fall data collection tool was used to collect data on the patients that fell during their hospitalization which included: the database of adverse events, the electronic medical record, the paper chart, and patient/ family interviews, where no objections to being interviewed were noted (Hitcho et al., 2008). The variables that were identified in the study were the patient’s information, details of the fall, contributing factors, injuries sustained, and the actions that were taken as a result of the fall. The patient information included the patient demographics, cognitive status, admitting diagnosis, fall history, medications...
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...Health Program (MHHP)? Please describe the details of this program. During 1980s, the MHHP research conducted for primary prevention of coronary heart disease and stroke. This program was a community trial of prevention methods in three upper Midwestern communities with three matched comparison communities. This intervention program took 5-6 years, and used individual and community-wide health education to decrease population risk. The hypothesis for this program was that after the health promotion program was introduced, the fatal and nonfatal coronary hearth disease for men and women in 30-74 year old would decline differentially. 2. Was the MHHP a randomized or non-randomized study? It was a nonrandomized community trial with three community pairs. Two communities were selected for each pair, and they were similar in structure, size, and distance from Minneapolis. One community from each pair was chosen not randomized for comparison, and the other community for intervention....
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... Research Summary and Ethical Considerations “Nursing Staff’s Awareness of Keeping Beds in the Lowest Position to Prevent Falls and Fall Injuries In an Adult Acute Surgical Inpatient Care Setting” Huey-Ming Tzeng, Chang-Yi Yin, Allison Anderson, and AtuI Prakash Background: In medical care centers and in hospitals a major concern is falling of inpatients from their bed. This problem becomes more serious while dealing with old age patients in care for acute surgical or post op care. Presented study has addressed these issues and suggested that most of these fall related injuries [Anderson, Boshier and Hanna (2012)] could be prevented by examining the factors which could be controlled and applying measures to control them. Also those factors which could not be controlled measures to prevent them according to need of individual and specific medical setting should be applied. This study is very important and significant to nursing practice as according to Quigley and associates (2007) has pointed out that severity of injuries due to fall could be minimized with the help of an interdisciplinary team of which nurses are most important part. It help the nurse to provide the education how to prevent from fall and any serious injury through the falling time. On other hand it helps the nurse to aware the nurse about the proper bed position to prevent from fall and helps to prevent the injury in old age patients, because staff nurse know about the patient’s condition and who patient’s...
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