A Comprehensive Fall Prevention Change Initiative: Promoting Patient Safety Among Old Geriatric Orthopedic Patients

Introduction:

Falls among elderly patients, especially those who have orthopedic problems a, core challenge that results in increased cost of care, prolonged hospitalization time, pressure on unlimited resources, long periods of recovery, complications such as secondary structures and head injuries, and caregiver role strain where aged people are highly dependent on an individuals support. This change project is a significant way to develop a comprehensive intervention plan to promote the overall needs of old orthopedic patients. The paper discusses areas such as the population and stakeholders, among other perceived challenges and benefits of the program in promoting patients’ health and well-being.

Problem:

This change project aims to promote falls among aged orthopedic patients, a vulnerable population with several healthcare needs and associated risk factors. Among this demographic population, the problem of falls is a significant issue that leads to severe orthopedic complications such as morbidity, delayed recovery, and declined overall health and well-being of the patients. Despite the current fall prevention measures, falls remain a significant crisis, especially among the aged population, with a 30 to 40% prevalence rate among old individuals. This care makes it an emergency concern for root cause and safety promotion measures that promote healthcare quality and patients’ well-being (Kobayashi et al., 2019). In various hospitals, falls have become a significant safety concern that needs to be reduced with impeccable change management protocols, which could engage the use of programs, policies, and practice changes in the facility (Dykes et al., 2020). This change project could improve the culture of patient safety and well-being; hence, nursing managers, clinical leaders, and administration should take the proper measures to appreciate evidence-based interventions to alleviate falls.

Stakeholders:

Internal: 

Some of the critical practitioners in the promotion of the change project here include the following:-

1. Orthopedic department nurses who are equipped with significant skills and work to monitor and implement the proposed elderly patient fall prevention interventions like the use of bedside alarms and fall detection tools and assessing patients’ stability, which are essential tools to promote the overall health and well-being of the population (Siv Linnerud et al., 2023).
2. Hospital administration: The hospital administration must set the required resources that prioritize patient care, hence promoting a culture of patient well-being in the orthopedic department where, with the right resources, they can effectively manage their patients.
3. Orthopedic clinical leaders and surgeons: Their role is to offer leadership and guide the care process among old orthopedic patients, where the inclusion of the fall prevention plan is a critical imperative.
4. Partnering with health professionals like pharmacists, occupational therapists, and physical therapists: These care professionals are essential to offer insights on issues such as the effects of various medications on patient stability and balance, engagement in physical activity, and occupational support where they link the patients with their work areas ensuring they are supported to be safer while out in the community (Baris & Seren Interpeler, 2019).

External:

1. Insurance companies: Their insurance coverage companies enhance access to care and reduce the cost of care for the patients, whereas fewer fall cases mean reduced expenses for the management of the population.
2. Rehabilitation center or department: In rehabilitation centers, there is a need to collaborate with the orthopedic departments to promote an effective care transition process that promotes safety and continuity of care for patients who adhere to fall prevention initiatives.
3. The patients, caregivers, and family members: The family, caregivers, and patients are often directly affected by fall cases; hence, their engagement is vital to promote the overall health and well-being of the patients. This suggests involving them offers a critical aspect of change and the program’s success.
4. Information technology department: Due to the involvement of technology measures in the fall prevention protocol, it is essential to realize the need for such professionals who ensure that the technological imperatives engaged are working successfully. This includes fall detection machines, bed alarms, and electronic health records.
5. Policymakers. Policymakers must make necessary policies that promote the health and well-being of elderly patients during management.
6. Community partners: This includes the area agency on aging, which offers the required support for aged patients who need to support the prevention of falls.

Benefits and challenges associated with the engagement of stakeholders: 

Some of the importance of stakeholder engagement is the promotion of patient safety and outcomes where there is a positive outcome of reduced fall cases, translating to less workload pressure for the professionals. Also, there is a potential for improved patient satisfaction and recovery rates, which occur with minimal post-operative problems such as secondary fractures. The engagement of facility administration is essential since this promotes positive facility performance metrics for patients’ safety and recovery. This is crucial to advancing the reputation and support of the orthopedic department. Policymakers must offer well-equipped fall prevention standards, which must be adhered to to promote the overall care for the patients. Patients, families, and their caregivers are essential to boost confidence in the safety plan, increase confidence in the patient’s well-being, and effectively transition care to primary care support. A streamlined transition plan is essential, as it reduces fall risk during physiotherapy and rehabilitation processes. There is less cost incurred in care when insurance coverage comes in a place where easy access to care and financing for different needs are provided when management is effectively met, hence promoting the quality of care for the patients.

Some associated challenges include increased demand for resources by the facility to offer additional staff who handle the patients and provide training programs to equip the caregivers with skills and knowledge on fall prevention measures. The facility needs to provide additional resources that help promote staff training and education while investing in technological-based solutions. The family and the patient need to adapt to the new roles where they are engaged in changed care routines, and some could even resist the protocols adopted.

Summary

developing a fall prevention intervention among aged orthopedic patients is essential to promote safety and overall well-being. The engagement of stakeholders such as nurses, surgeons, administrators, family, patients, caregivers, policymakers, and information technology experts is essential to ensure a collaborative approach to care. In this case, this helps reduce falls, promote patient safety and recovery processes, and optimize patient care, making it an overall tool for performance metric promotion.

References

Baris, V. K., & Seren Intepeler, S. (2019). Views of key stakeholders on the causes of patient falls and prevention interventions: A qualitative study using the international classification of functioning, disability, and health. Journal of Clinical Nursing, 28(3-4), 615–628. https://doi.org/10.1111/jocn.14656

Dykes, P. C., Burns, Z., Adelman, J., Benneyan, J., Bogaisky, M., Carter, E., … & Bates, D. W. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: a nonrandomized controlled trial. JAMA network open, 3(11), e2025889-e2025889.

Kobayashi, K., Ando, K., Inagaki, Y., Suzuki, Y., Nagao, Y., Ishiguro, N., & Imagama, S. (2019). Characteristics of falls in orthopedic patients during hospitalization. Nagoya Journal of Medical Science, 80(3), 341–349. https://doi.org/10.18999/nagjms.80.3.341

Siv Linnerud, Aimée, L., Birgitte Graverholt, Idland, G., Taraldsen, K., & Brovold, T. (2023). Stakeholder development of an implementation strategy for fall prevention in Norwegian home care – a qualitative co-creation approach. BMC Health Services Research, 23(1). https://doi.org/10.1186/s12913-023-10394-x