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Risks for Falls
Critical Analysis
'Risks for falls' have been an area of concern for medical professionals especially nurses. Statistics have shown that an increasing number of falls in hospitals and hospice settings not only raises question marks on the services provided to the patients along with negative consequences for the healthcare professionals and patients but also increases the overall costs of providing healthcare services. There are various researches which have shown that following clinical practice guidelines (CPGs) has found to reduce the number of falls substantially however the effectiveness of these CPGs is mainly dependent on the experiences of the healthcare professionals and patients after falls along with the impact of social factors such as community obligation, organizational resources, and individual resources.
Research by Stenberg and Wann-Hansson (2011) has shown that the in order to comply with the provided CPGs, personal experience after the event of falls plays a decisive role. This attitude related to fall prevention and compliance with CPGs is dependent on two variables: experiences of falls and related injuries leading to negative consequences for the related professional and the patient. Through this research, it was found that negative consequences increased the acceptance level in the nurses and other healthcare professionals regarding compliance of CPGs. However, this compliance was also driven by another element: visible positive outcomes of the compliance of CPG. Where negative consequences provoked the nurses and other healthcare professionals to comply with the CPGs, positive outcomes resulting in fall prevention motivated them to use CPGs with consistency.
The findings of the research emphasized on the importance of experiencing the course of events for compliance of clinical practice guidelines. The implementation of CPGs is dependent on three factors: the level of evidence, (2) the context into which the evidence is being implemented, and (3) the method of facilitating the change (Rycroft-Malone et al., 2002). The research of Stenberg and Wann-Hansson (2011) has shown that where there are evidences that implementation of CPG is effective in preventing falls, difficulties are faced while implementing them and acquiring...
This research is consistent with the findings of PARHIS which has shown that CPGs will be successfully implanted only if they reflect the clinical experience and expertise are relevant and match the research-based evidence.
Stenberg and Wann-Hansson (2011) also asserted that the social factors also played a decisive role in successful implementation of CPGs. During the research, it was found that unified leadership and change sponsorship related to implementation of CPG played an important role. For CPGs to be accepted and implemented, it is important that they are clear, concise and relevant to the healthcare hazard. Too much information would not only reduce the motivation for using CPGs but will further increase the confusion and stress in the nurses. For the purpose of successful implementation of CPGs, it is important that are evaluated and re-evaluated in the context of organizational settings as well as inherent risks related to falls.
Another social factors which played important role in successful implementation of CPG is community related variables such legislative restriction. However, where the healthcare professionals face multiple community obligations such as compliance of preventive measures and ethical obligations, reluctance to follow CPGs may appear. Therefore, it is important that the direct directions must be clear in order to avoid any conflict. Situations where emergence of conflict is inevitable, leadership needs to play its role. Organizational resources like effective leadership and individual resources like ethics, motivation and knowledge are considered to be of primary value for successful implementation of CPGs. All the factors have tendency of directing the behavior of nurses and other healthcare professionals towards falls.
The research of Stenberg and Wann-Hansson (2011) has showed that the healthcare professionals have shown their adherence and motivation to practice CPGs since they have experienced the negative consequences of the falls. This finding is also supported by the work of Semin-Goossens et al. (2003). Studies have also shown that the fear of legal consequences also plays a vital role in triggering and enhancing compliance of CPGs. Legal consequences…
References
Rycroft-Malone J. (2004). The PARiHS framework -- A framework for guiding the implementation of evidencebased practise. Journal of Nursing Care Quality, 19(4), 297 -- 304.
Rycroft-Malone J., Harvey G., Seers K., Kitson A., Mc- Cormack B. & Titchen A. (2004). An exploration of the factors that influence the implementation of evidence into practise. Journal of Clinical Nursing, 13, 913 -- 924.
Rycroft-Malone J., Kitson A., Harvey G., McCormack B., Seers K., Titchen A. & Estabrooks C. (2002). Ingredients for change: Revisiting a conceptual framework. Quality Safe Health Care, 11, 174 -- 180.
Semin-Goossens A., Van Der Helmi J.M.J. & Bossuyt P.M.M. (2003). A failed model-based attempt to implement an evidence-based nursing guideline for fall prevention. Journal of Nursing Care Quality, 18(3), 317 -- 325.
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