NURS2006: Safety & Quality in Health Care - Nursing Issues Assessment Answers

Introduction

Nursing, which is often considered as a glorifying job in providing care for everyone is also facing some issues that are not entirely familiar. For example, nurses who are working in many countries including Australia have to clear a set of health checking procedures before they start their service. Fall prevention with the help of nurses is the issue that is taken in this study. The study was based on the three articles that were cited below. Fall is the primary reason for creating severe injuries to old aged people. The consequences of falls are the bone fracture, hip breakage, head wounds, leg fracture and much more. The regular falls create fear for old age people, and they feel difficulties in their daily routines.Fall prevention consists of several activities that can be used to minimise the fall rate of the older people.

Background

Fall prevention is regarded as one of the national quality and safety priority. There are several steps and measures taken by the Australian Commission on Quality and Safety for the health care of people. Their assistance has reduced figure of some falls and thus have reduced the harm for patients. Most of the initiatives therefore conducted in Australia on a national basis. As a part of the efforts taken by the government, there was a set of revised guidelines developed in 2009 for improving the nursing standards in the country. (Serena SL Koh†Email author, Hutchinson, Donath, & Johnston, 2008)

Clinical governance

Clinical governance is an approach to improve the quality of care and services provided to the patients in health care institution. The clinical governance is done to ensure that the patients receive a high standard of care, to know the precise responsibility and to evaluate the constant dynamics of improvement. The approach is evaluated based on different areas of classifications such as Risk management, clinical effectiveness, clinical information, education and training, staffing and management and clinical audit (Robert McSherry, 2011).

Fall Prevention relates to Risk management which is one of the areas of clinical governance. Risk management is the process undertaken to minimise the risk involved to patients during health care by understanding the conditions and the factors which lead to the situation, by ensuring that necessary steps are taken to prevent further occurrence of the issue and identifying the conditions that might go wrong during the care process and take preventive measures. This helps them in providing the highest quality of care and services to the patients and prevent fall.

Critique of Literature

On critically analysing the articles mentioned above, it was found that there are several methods through which nursing can help improve the prevention of the falls. According to the article provided by Mirjam Pijnapples, the falls prevention that happened during the study are mainly by the women of 70 years and older. The methods used were including the monitoring of exercise programming. For the qualitative analysis, there was a review of the author's thoughts, and data were pooled whenever required. The critical analysis of the facts provided in the article can bring down to a conclusion that multifactorial interventions can reduce the risks of falls.

Strength and limitations of fall prevention

Based on the study conducted it is sure that there are some benefits and also the limitation in fall prevention activities. Provide attention to avoiding falls is an easy method than recovering from injuries of a fall. Fall prevention focused on the safety of patients. Hospitals should provide a safe environment for patients. Fall prevention can be implemented by adopting any balance training program and using some methods home to reduce the fall of older people. Fall prevention helps the people to reduce the risk of injuries from a fall. It contains specific actions which enhance the body balance and strength of older people.

A limitation related to this fall prevention is the lack of cooperation of patients. To implement these fall prevention activities it requires the proper understanding and cooperation of patients. Another limitation is sometimes the fall prevention action is difficult to achieve the people whose health condition is not much good. It is difficult to convince the fall prevention actions to patients, and also it takes more times for execution. (Unga, et al., 2013)

Most rigorous study

The most rigorous research to be conducted was the quantitative study performed to understand the effects of falls prevention and the role of nursing in preventing it. The main reason for considering the quantitative analysis to be one of the most rigorous studies is the understanding of the clear picture of how many are affected. The precise observation of daily exercise programmes have provided a statistics data about the number of that are occurring each year. The study was conducted from over 17 general practices held in New Zealand. The responses were obtained of which the fall rate has been reduced drastically in the exercise group where nursing is provided. (Pijnappels, Burg, Reeves, & Dieën, 2008)

CASP: Critical Appraisal Skills Program

As a part of the clinical decision-making process, health care professionals need to practice evidence-based medicine and applies their research findings to patients.The appraisal tools are designed to assess and review the validity of the study in clinical practice using the flaws in literature and make available use of the research evidence and make a final decision about the research. The appraisal tools can be used to know which treatments and approach benefited the patient and to know which treatments are worth financing.

With the critical appraisal skills programs and its tools, medical professionals can analyse the treatment procedures and the methods adopted in fall prevention of patients. This helps in knowing whether the ways chosen will be successful or not and know if the patient would get the best health care services and care (Geri LoBiondo-Wood, 2017).

Comparison and choosing of the study

Hierarchies of this evidence are an important and strongly related method for the study of fall prevention with the help of nursing. In this comparison and critical review of the study, the aim is to evaluate the particular evidence obtained from the randomised controlled studies that are related to the falls prevention strategies obtained with the help of nursing. The best practice is identified with the exercise group that are conducted at the hospitals and other nursing facilities. The quantitative study was considered the best option since the results generated should be based on the evidence and it reduces the staff time and resources. The effects can be seen after the implementation of balance retaining programme with the help of nurses.

Findings

The qualitative study was done for people over the age of 65 years based on meta-ethnographic approach. The research aimed to find the factors that lead to successful implementation of fall prevention programs. The factors that affect the successful implementation of fall prevention are related to older people, families and health care system. The study shows us that the older people should be consulted first to know what changes they are expecting after the implementation of the fall prevention steps. If this consulting does not happen then the fall prevention methods will not be useful, and the people won't be benefited (Child, Goodwin, Garside, Jones-Hughes, Boddy, & Stein, 2012).

A systematic review was also considered into account for the analysis of success rate of fall prevention methods. Risk ratios and 95% intervals were estimated, and random Meta-analysis was taken where a total of 21 were taken into account. The study shows that there is a 25% reduction in the fall rate (Oliver, Hopper, & Seed, 2000).

The key findings of the quantitative analysis of the study include that, the injuries caused by the falls can be prevented by a programme called "balance and strength retraining exercise" with the help of nurses at the hospital or homes. The effectiveness of the study was sustained, and the continuation of the programme was formulated to further reduce the risk of the falls. The Qualitative analysis of the study provides findings that on conducting the post hoc analysis, the rate of falls will be reduced by including a multidisciplinary team of nurses. The article also confronts that the results were found out using study conducted with 17 participants (Pijnappels, Burg, Reeves, & Dieën, 2008).