Evidence-based Practice and Applied Nursing Research A1. Healthcare Problem grade A+

The healthcare problem I chose was the lack of fall risk education in the older adult population. “An event which results in a person coming to rest inadvertently on the ground or floor or other lower level” was define ...

The healthcare problem I chose was the lack of fall risk education in the older adult population. “An event which results in a person coming to rest inadvertently on the ground or floor or other lower level” was defined by the World Health Organization (WHO, 2018). Falls are the leading cause of death in Americans over sixty-five years old. Falls, and even the fear of falling, have an enormous impact on the quality of life for those over 65. Mobility decreases with aging, and even more so through the fear of falling or injuries from past falls. Numerous older adults are not aware of the many hazards in their immediate environment or their own fallrisk level related to mentation and/or medications. A2. Significance of Problem The healthcare problem is significant because statistics show numerous people die yearly from preventable falls. Long-term care for fall injuries include increased length of hospital stay, increased pain, secondary infections, and prolonged healing. Many older adults perceive falling as losing their independence and way of life. Some injuries from falling require long hospitalizations and rehab while many are fearful they will never return home. Besides the physical injury, the emotional strain can cause depression and, in some, social isolation. With Americans living longer, the older population carries an increased number of falls and a dire need for fall prevention education and awareness. A3. Current Practice The current practice to prevent falls is targeted at hospitalized patients while several adults in the community have zero education on fall prevention. Many hospitals have their patients watch a video or receive information about fall prevention with their admission packet. A fall risk assessment is performed by a nurse with each admission followed by measures based 2 Evidence-based Practice and Applied Nursing Research on a patient’s scoring in risk factors. Patients with a high risk for falls may have to wear bright yellow socks with a matching yellow wristband along with a sign over their bed that reads, “FALL RISK”. For added patient safety, some hospitals equip their beds and wheelchairs with loud alarms. Patients are consistently reminded of what they cannot do instead of what they can do causing some to feel isolated or imprisoned when restricted to a bed or chair. A4. Impact of the Problem How the problem affects the patient: The first research study found many problems directly affecting patients’ perceptions of fall risk. Staff response to call bells and chair or bed alarms affected patients greatly. It was determined that chair and bed alarms may create a false sense of security, whereby patients could still fall prior to staff response (Radecki, Reynolds, & Kara, 2018). Another negative impact affecting patients was waiting on assistance for toileting. Despite patients understanding their fall risk, adhering to fall prevention measures proved increasingly difficult and ultimately lead to risk taking. These problems increase stress for patients by not feeling empowered in mobility, increased fears of falling, as well as the pain and trauma associated with falls. How the problem affects the organization: Patient falls in acute-care settings directly affects the organization. Patient falls have multiple negative outcomes such as injuries that may require surgery or cause death, prolonged hospitalization, as well as the legal liabilities that follow. Fractures from falls on in-patients are reportable to the state, and if frequent, puts healthcare institutions at risk for investigation and/or closure. Then there is the Center for Medicare and Medicaid (CMS) mandate; CMS has engaged in heavy pressure on hospitals by recognizing falls as a "never event", creating a zero-falls goal for many institutions and stopped