Nursing Risk for Falls

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 consistent compliance by healthcare professionals in the later phase. 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 not only cause temporary trauma but also has a long-term impact on the career of healthcare professionals. However, the research has also indicated that fear of legal outcomes also forces the health care professionals to exercise unnecessary CPGs for non-risk patients.

The resultant is time taking and unnecessary practice of CPGs which results in demotivation. Lack of time has been identified as one of the substantial barriers for successful implementation of CPGs and unnecessary compliance would make the healthcare professionals to face this barrier indirectly. On the other hand, there is also a negative consequence of this fear. The demotivated staff may show reluctance to report the incidence of falls (Semin-Goossens et al., 2003).

Cumulative outcomes of these researches have indicated that fear of legal actions and the long-term impacts associated to them have a substantial impact on compliance of CPGs. Clarity of leader's role and ability to set suitable priorities is another factor which facilitates successful implementation of CPGs. Efficient leadership and conducive workplace environment are of fundamental importance for gaining compliance from the staff. Therefore, it is important that the leaders have defined but limited priorities as vast set of priorities will create confusion and stress in the workforce.

Too many priorities will enhance the probability of healthcare staff to follow CPGs as per their own preferences instead of effectiveness level. Therefore, conflicts may also arise as a result of different priorities. Another critical factor was the support of someone knowledgeable. The research showed that healthcare staff provided with the support of skilled and knowledgeable figure that is aware of CPGs and the mode of implementation, are more motivated to adhere to CPGs.

Furthermore, ethical compliance, being dutiful and responsible were also mentioned as attributes mandatory for this knowledgeable figure. This key role of CPG implementation and implementing evidence into practice can be described as facilitator. Facilitation is a multi-faceted process and can vary from being task-focused to a more complex holistic process enabling teams and individuals to change attitudes, behaviors, and ways of working (Stenberg & Wann-Hansson, 2011). There are researches which have shown that presence of staff having varied skills and knowledge can also have considerable impact on successful implementation of CPGs.

Presence of different skills and competences allow the analysis of falls, and outcomes of CPGs implementation in relation to prevention of falls, from different aspects. Presence of professionals from multiple disciplines facilitates.