Skip to content 
NURS FPX 8045 Assessment 7
Conceptualizing a Potential Project
A significant component of the Doctor of Nursing Practice (DNP) program in Cleaveland Clinic is developing a plan to deal with the absence of measures to protect patients from falls and injuries. Its Leapfrog rating is above average in patient harm caused by falls; the existing measures implemented at the hospital are not compatible with the best practices that range the patient’s safety at risk (Leapfrog Group, 2024).
The results of this meta-analysis of the studies provide the basis for the development of a significant, complex, and varied prevention approach to decrease the possibility of falls, which involve both the physical environment and technological elements and the psychological parameters of exercise and balance training and the educational and psychological factors such as fear of falling. Since the DNP curriculum focuses on discovery that aims at enhancing the practice of healthcare and patients’ outcomes, thinking and implementing a project, such as this one at Cleaveland Clinic, is inherent in the curriculum.
Introduction and PICOT Question
Falls and their management is one of the areas of focus when it comes to patient safety risks at Cleaveland Clinic. A systematic review carried out by Greeley et al. (2020) revealed that 30% or more of inpatients were identified to have fall incidences at least once during their hospital stay.
The papers’ analyses reveal that it is necessary to develop an extensive program that will tackle aspects like environment, devices, exercises and balance in the use of video games, information, and fear factors which seem to influence falling. There is the potential to enhance outcomes for patients such as their safety, treatments, and reduce the costs related to falls if the Cleaveland Clinic adapts an evidence-based intervention suitably.
Analysis and Synthesis of Research
Scholarly studies reveal that there exists the relationship between the patient demographic factors and organizational factors and the risk of falls, therefore the need for a large scale fall prevention campaign in Cleaveland Clinic as demonstrated by the five papers. Subscales including the nurse staffing, the use of the fall prevention devices, and the rehabilitation environment predicts the hospital fall risk The patients’ characteristics including their age, comorbidities, functional status, mobility restrictions, and other factors can predict fall risk in addition to the subsystems noted above (Kim et al. , 2022; Kinoshita et al. , 2022; Kobayashi et al. , 2023).
NURS FPX 8045 Assessment 7 Conceptualizing a Potential Project
Satoh et al. (2022) and Trinh et al. (2023) substantiate that, for fall risk factors, interventions should be developed based on the cumulative points’ time to reduce the probability of fall incidences and their ramifications, such as fractures, lengthened hospital stays, and amplified healthcare costs. Altogether, the results of these studies support the statement that Cleaveland Clinic experienced the issue of patients’ self-inflicted injuries as a result of falls and other similar injuries, and calls for the organization of a fall prevention program that entails patients’ risks and environmental obstacles.
Collectively, the aforestated research draws strong evidence in support of the specially designed and integrated comprehensive fall prevention in Cleaveland Clinic. This program will entail self- identification of the risks and their management, changes to the physical surroundings and equipment, exercise and balance, knowledge enhancement and psychological treatment for reduced fall-related phobia.
-
Uncertainties and Gaps
Nevertheless, the above data does support the assertion that Cleaveland Clinic should implement a comprehensive fall prevention plan for aesthetic client facilities, but there are also some issues that need further research. Nevertheless, it is unclear how it is better to intertwine all these factors to strengthen the adoption process, especially in the area of the healthcare where physicians, and patients have different origins (Lan, Neyens, & Chen, 2019).
However, it in one way, one must acknowledge that there are merits that come with the use of multifactorial treatments; it only implies that there could be other ways that has not been explored that could complement the multifactorial approaches such as the technological solutions. g.
Technologies utilizable onto the patients, surveillance systems, community services and supports all have their drawbacks specific of the post-discharge surveillance and the reinforcement of identified fall preventive measures. Hoping to identify measures facilitating IP collaboration, the engagement of the patient’s and families, and compliance with the developed intervention activities while working at the hospital, facing numerous time constraints and other barriers should be an area of the future research.
Recommendations to Stakeholders
The following recommendations are offered to address the practice shortfall with regards to patient falls and injuries within Cleaveland Clinic using the findings of this study in conjunction with prior investigations. Out of all the elderly people, those at ‘high risk’ are those who have had a previous fall, have been hospitalised in the previous 1 year, or depend on others to perform their ADLs as identified by Clemson et al (2023); specific home fallhazard reduction interventions are feasible for these high-risk individuals.
Unfortunately, it would take some Environmental modifications (for example, prophylactic actions that reduce the risk of falling at home or the use of appropriate walking aids), physical activity and balance training (the aspects of virtual reality mentioned by Ren et al. 2023) Along with the staff and patient education; and addressing psychological factors, such as fear of falling, as discussed by Rodrigues et al. 2023. In another study by Dykes et al. (2023) it was identified that a simple decrease in the incidences of inpatient falls and further falls related injuries was realized to reduce the over all health care costs hence proposing that the application of a wide and expansive intervention to prevent falls could be economically effective to implement.
Are you Looking for guidance for NURS FPX 8045 Assessment 7? Our experts are here to assist you. Reach out to us for support today.
As put by Vandervelde et al. (2023), it is for this reason that the methods that should be implemented to enhance the facilitation of targeted adoption and maintained fidelity of the fall prevention program are; Targeting, Learning, and Participation. In addition, an evidence-based fall prevention programme can entice significant economic benefits on its own as revealed through the economic assessment by Dykes et al. (2023) thus, from a hospital perspective, it can be viewed as a worthwhile intervention.
According to the literature analysis, Cleaveland Clinic should implement a multi-faceted fall preventative strategy. The existing literatures of moderate systematic reviews and meta analyses indicate that a multi-component intervention for decreasing falls, the number of patients who fall and consequences linked with falls such as fractures, longer hospital stays and high health costs may be helpful.
-
Uncertainties and Gaps
Summing up, the evidence is on the side of developing a multimodal intervention for the prevention of falls; however, numerous questions remain before the intervention could be introduced at the particular healthcare facility. There is also limited evidence on how to incorporate these factors into implementation, which is a major issue in highly specialized healthcare facilities with different patient and staff cohorts (Dolan et al. , 2021).
To enhance the interprofessional collaboration, the involvement of the patient and the family, and the compliance with the components of the intervention in a hospital setting, it is necessary to consider what barriers may be addressed and what enablers can be applied to the topic in order to conduct the further research.
Regarding the broad fall prevention program, there will be the need to integrate and sustain it in practice as a way of catering for the needs of the particular health-care institution as well as its customers. Studies other than these pilot investigations can shed light on how this goal is to be attained.
Communicating with Stakeholders
For this reason, stakeholders management commensurate with identification of all the stakeholders and how it is possible to manage every stakeholder during implementation of Cleaveland Clinic’s comprehensive fall prevention program. When it comes to multifactorial treatments for the reduction of falls in community settings, processes such as intervention, involvement, and contribution of the learners (Turner et al. , 2020).
So that the message being conveyed is easily understood and also courteous regarding the implementation team and their demands in the hospital, it has to be created with them specifically in mind. To overcome such chances of complications, there is a need to have daily interdisciplinary team meetings, formation of focus group teams, and open communication channels.
Explaining, advising and interviewing might be helpful when including patients and their families in data collection through surveys and/ or structured interviews; while, providing briefings and/ or reports would assure the managers that they have the support and the necessary resources.
Reflecting on Feedback and Writing Improvement
Feedback is an crucial aspect in people’s growth in their careers hence the need for a person to accept and use feedback. Based on the analysis of the findings, the student has been trying to advance in writing and is gradually narrowing the gap with the writing quality indicators provided by the Writing Feedback Tool (Tian & Zhou, 2020).
Structure, clarity, and evidence should be considered as critical factors of the academic writing; the present student has enhanced these factors with the help of criticism. The student intends to initiate the process of seeking criticism from teachers, supervisors, and coworkers actively in the future as it is a crucial step in the process of learning.
Conclusion
Thus, using data presented in the articles containing systematic reviews and meta-analysis in the present study, the effectiveness of complex interventions including environmental modifications, use of assistive devices, exercise, balance retraining, health promotion, as well as psychological interventions for fear of falling was substantiated.
To complete the gaps concerning the implementation of the interventions, the stake holders’ participation and potential sustenance of improvements in a hospital context, more research are required. Both the increased effectiveness and the maintenance of the results of the fall prevention program is essential for enhancing of patients’ safety, outcomes, and decreasing of the costs, which occur as a result of falls. Cleaveland Clinic might do this through continued investigation and small scale tests in these fields.
If you need complete information about class 8045, click below to view a related sample:
NURS FPX 8045 Assessment 6 Synthesis of Evidence Substantiating an Intervention
Reference
Clemson, L., Stark, S., Pighills, A. C., Fairhall, N. J., Lamb, S. E., Ali, J., & Sherrington, C. (2023). Environmental interventions for preventing falls in older people living in the community. Cochrane Database of Systematic Reviews, 2023(3).
https://doi.org/10.1002/14651858.cd013258.pub2
Dolan, H., Slebodnik, M., & Taylor‐Piliae, R. (2021). Older adults’ perceptions of their fall risk in the hospital: An integrative review. Journal of Clinical Nursing, 31(17-18).
https://doi.org/10.1111/jocn.16125
Dykes, P. C., Curtin-Bowen, M., Lipsitz, S., Franz, C., Adelman, J., Adkison, L., Bogaisky, M., Carroll, D., Carter, E., Herlihy, L., Lindros, M. E., Ryan, V., Scanlan, M., Walsh, M.-A., Wien, M., & Bates, D. W. (2023). Cost of inpatient falls and cost-benefit analysis of implementation of an evidence-based fall prevention program. JAMA Health Forum, 4(1).
https://doi.org/10.1001/jamahealthforum.2022.5125
Greeley, A. M., Tanner, E. P., Mak, S., Begashaw, M. M., Miake-Lye, I. M., & Shekelle, P. G. (2020). Sitters as a patient safety strategy to reduce hospital falls. Annals of Internal Medicine, 172(5), 317.
https://doi.org/10.7326/m19-2628
Kim, J., Lee, E., Jung, Y., Kwon, H., & Lee, S. (2022). Patient‐level and organizational‐level factors influencing in‐hospital falls. Journal of Advanced Nursing, 78(11).
https://doi.org/10.1111/jan.15254
Kinoshita, T., Nishimura, Y., Umemoto, Y., Kawasaki, S., Yasuoka, Y., Minami, K., Koike, Y., & Tajima, F. (2022). Characteristics of falls occurring during rehabilitation in an acute care hospital in older and non-older patients: A retrospective cohort study. Frontiers in Medicine, 9(33), 969457.
https://doi.org/10.3389/fmed.2022.969457
Kobayashi, K., Kido, N., Wakabayashi, S., Yamamoto, K., Jun Hihara, Tamura, M., & Sakahara, T. (2023). Association between fall-related serious injury and activity during fall in an acute care hospital. PLoS One, 18(7), e0288320–e0288320.
https://doi.org/10.1371/journal.pone.0288320
Lan, X., Li, H., Wang, Z., & Chen, Y. (2019). Frailty as a predictor of future falls in hospitalized patients: A systematic review and meta-analysis. Geriatric Nursing, 41(2).
https://doi.org/10.1016/j.gerinurse.2019.01.004
Leapfrog Group. (2024). Cleaveland Clinic | Ratings | Leapfrog Group. Ratings.leapfroggroup.org.
Ren, Y., Lin, C., Zhou, Q., Yingyuan, Z., Wang, G., & Lu, A. (2023). Effectiveness of virtual reality games in improving physical function, balance and reducing falls in balance-impaired older adults: A systematic review and meta-analysis. Archives of Gerontology and Geriatrics, 108, 104924.
https://doi.org/10.1016/j.archger.2023.104924
Rodrigues, F., Monteiro, A. M., Forte, P., & Morouço, P. (2023). Effects of muscle strength, agility, and fear of falling on risk of falling in older adults. International Journal of Environmental Research and Public Health, 20(6), 4945.
https://doi.org/10.3390/ijerph20064945
Satoh, M., Miura, T., Shimada, T., & Hamazaki, T. (2022). Risk stratification for early and late falls in acute care settings. Journal of Clinical Nursing, 32(3-4), 494–505.
https://doi.org/10.1111/jocn.16267
Tian, L., & Zhou, Y. (2020). Learner engagement with automated feedback, peer feedback and teacher feedback in an online EFL writing context. System, 91, 102247.
https://doi.org/10.1016/j.system.2020.102247
Trinh, V. Q.-N., Dukelow, T., Thompson, C., & Gilbert, T. (2023). Falls and fractures in the acute care setting: A retrospective cohort study. Australasian Journal on Ageing, 31(8).
https://doi.org/10.1111/ajag.13177
Turner, K., Bjarnadottir, R., Jo, A., Repique, R. J. R., Thomas, J., Green, J. F., & Staggs, V. S. (2020). Patient falls and injuries in U.S. psychiatric care: Incidence and trends. Psychiatric Services, 71(9), 899–905.
https://doi.org/10.1176/appi.ps.202000004
Vandervelde, S., Vlaeyen, E., de Casterlé, B. D., Flamaing, J., Valy, S., Meurrens, J., Poels, J., Himpe, M., Belaen, G., & Milisen, K. (2023). Strategies to implement multifactorial falls prevention interventions in community-dwelling older persons: A systematic review. Implementation Science, 18(1).
