Clinical guideline and plan clinical guideline based

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Clinical Guideline and Implementation/Evaluation Plan Clinical Guideline Based on the meta-analysis and synthesis of 10 primary source research articles the authors of this study created a set of clinical guidelines detailed in Appendix B to reduce the incidence of in-patient falls and the severity of injuries sustained from falling. A one-page algorithm was created for use of staff involved in direct patient care (see Appendix D). A facility-wide approach is suggested involving all staff who through the orientation process and continuing education will be alerted to what contribution each can make to prevent patient falls. Simply accompanying an at-risk patient to a chair and informing an appropriate staff member supports this systematic effort. This set of fall prevention and management guidelines is intended to prompt clinical staff (nurses, physicians, rehabilitation therapists and others) to consider a systematic assessment for determining a patient’s risk for falling and to recommend interventions. The fall risk assessment involves a determination of both extrinsic (environment specific) and intrinsic (patient specific) fall factors. The Morse Fall Scale (see Appendix C), a tested and reliable tool for assessing a patient’s fall risk is recommended on admission and when specific changes occur. Additionally, each patient’s medical history, medications, physical and cognitive functioning level are taken into account when determining a patient’s fall risk status. Post fall management guidelines are also provided that includes post fall assessment, fall risk level, interventions and documentation. If a patient is not at risk for falling, based on the fall risk assessment, interventions should still be implemented to protect the patient from extrinsic fall risk factors such as the presence of clutter,
EVIDENCE-BASED PRACTICE 12 spills, and electric cords. On admission universal fall precautions are to be initiated on all patients and a thorough fall risk assessment needs to be conducted, which will determine what additional precautions and interventions need to be instigated. Implementation/Evaluation Plan In order to implement fall risk and prevention strategies, an action plan is generated. Polit and Beck (2008) provide guidance for implementation of a fall prevention program in a hospital setting. First, outcomes need to be identified for evaluation of the plan such as the fall rate, injuries sustained, and the sensitivity and reliability of the screening process. The clinical settings need to be identified, in this case, acute care hospitals, nursing homes, and rehabilitation facilities. It is essential to have a committed individual such as an advanced practice nurse or clinical nurse educator to provide guidance, clinical proficiency, and support throughout the implementation and evaluation process. A steering committee comprised of stakeholders and members needs to be established with a timeline and responsibilities for each individual planned in detail (Registered Nurses’ Association of Ontario, 2005).

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