Among various health hazards threatening the elderly, falls are very common. Leininger and McFarland (2002) noted that it is generally estimated that about 30-40% community-dwellers above 65 years suffer from falls each year. Most of these falls result in serious injuries. In the light of the above observation, development of effective fall prevention strategies becomes extremely important.
Plan
The main intention of undertaking this particular project is to suggest measures that will reduce the occurrence of falls among the elderly as well as introduce assisted devices that will be of help to the elderly after a fall. To begin with, 10 clinical nurse specialists will be made to undergo training over a period of 1 month. They will initially be provided learning materials regarding the factors resulting in elderly fall and the measures to be adopted to arrest it. The fundamental nursing theory in this context will be “Betty Neuman’s Systems Model” (Nursing Theory, 2011) as the inpatients would be treated as unique cases because a fundamental issue of prevention will be to make them understand their responsibility as patients. Classroom teaching will be imparted side-by-side. Education being the cornerstone, weekly group discussions on various aspects of the topic will take place. The implementation process will involve sharing their knowledge with the elderly inpatients and studying the effectiveness of the assisted devices on them. They will then undergo an evaluation process to assess whether the project has been effective in imparting necessary information regarding this field. The entire project will be supervised by the consultants who will reserve their comments for the final outcome.
Name of the agency
The decision to implement this project has been taken only after consultation with Dr. Casey (phone no. 646-211-4567), an expert in this field. This particular project will be carried out in an agency, which boasts of a special service designed for fall and osteoporosis patients. The name of this agency is………..Prior approval for carrying out this particular project in the agency has already been obtained from Dr. Conal Walsh who is in-charge of this special facility. He, along with Dr. Cunningham, renowned Geriatrician and the person primarily responsible for setting up this specialized service are responsible for giving advice on the progress of this project and evaluating its outcome.
Motivation for the project
According to Andin (2006), elderly persons are usually prone to two types of falls – injurious falls and recurrent falls, what can prove devastating for them. In addition to affecting the lives of the individuals concerned, falls also prove expensive for the healthcare industry. Therefore, effective fall prevention strategies will not only help the individual, but also prove beneficial for the health care industry at large.
Objectives
The project concerned aims at achieving the following objectives:
- a. To reduce the occurrence of falls and resulting injuries among the elderly.
- b. To create awareness among the healthcare professionals and the community at large regarding the risk factors associated with falls. Risk factor assessment reduces falls to a greater extent.
- c. To educate healthcare professionals regarding effective fall prevention strategies are also cost-effective.
- d. To increase compliance with effective fall prevention strategies among the elderly.
Timeline for meeting the objectives
The timeline for meeting the above-mentioned objectives is April 2- May 2, 2012. The details of the timeline have been provided in Appendix A.
Rationale for the Project
Both empirical and non-empirical studies support the development of effective elderly fall reduction strategies. According to the Fall Prevention Program manual of the Temple University, mentioned by Arnold and Boggs (2007), the causes of falls are multi-factorial involving both individual and environmental. Naturally, if the elderly are aware of the factors that are responsible for falls and risks associated with it, falls can be arrested to a greater extent, in accordance to “Virginia Henderson’s Need Theory” the patients must be aware of their situation and thus be more responsible (AIPPG, 2012). Moreover, the assisted devices are found to be highly beneficial for elderly fall patients and are also cost-effective. This will naturally ease the burden of the healthcare industry, because the cost of this specific issue relating to rehabilitation and fall amount up to 72 billion per year on an average.
Anticipated benefits: according to Aud and Rantz (2005), it is anticipated that this particular project will prove beneficial in the following ways:
- a. It will create awareness among healthcare professionals and the elderly community regarding the ways in which to arrest fall.
- b. It will also inform the target group regarding the usefulness of the assisted devices for those who have experienced a fall.
- c. By reducing the occurrence of falls, the healthcare industry at large will also be benefited as the cost for treatment and rehabilitation of elderly fall patients is huge.
- d. Through this project, the number of healthcare professionals trained in this field will increase which in turn; will be beneficial for the society.
1. Anticipated problems:
Like every project, this particular project may also have some problem areas, some of which are listed below:
- a. The effectiveness of the assisted devices for inpatients with serious injuries may remain questionable, especially for those who suffer from hearing or vision problems.
- b. There is no single reason for a fall to occur; the causes are multi-factorial, which also include environmental factors. These environmental factors may not get proper emphasis in the present setting.
- c. Any awareness program cannot be totally successful without any tie with a local organization at the community level. Thus, the proper implementation and sustainability of the project may emerge as bigger challenges.
Resources
Resources include the number of personnel involved, the materials required, the number of hours of training involved as well as the financial resources available.
1. Materials required
The materials required for undertaking this project include a number of things. Primarily, a 50 page learning package will be provided to the nurses. Risk assessment forms will also be required. Computer assisted aids like power point presentations, speakers and visual aids will also be required. Computer software programs will be necessary in this context. Moreover, evaluation tools like questionnaire and fall lists will be required.
2. Budget allocation
The budget allocation for the specified project has been tabulated below in accordance to the estimated cost of Arnold and Boggs (2007).
Resources used
Budget allocation
10 trained nurses @ $40/hr * 6 hours initial training =
$2400
3 Consultants(including the person implementing the project) @ $300/hour*40 hours training per week plus food and lodging=
$17000
50 page learning material @ $1 per page * 10 + cover of the material @ 0.50 per cover *10=
$550
Computer software programs=
$1500
Miscellaneous materials required for educational sessions, discussions and hospital orientations like posters, power point presentations etc. =
$2000
Assisted devices to be used in the project like bed alarms, hip protectors etc. =
$20000
Evaluation tools like questionnaires, fall lists etc.=
$1200
Total expected expenditure= $44650
Evaluation
1. Evaluation criteria to be used
In order to judge whether the project has been successful in achieving its objectives, an outcome evaluation of the program will be carried out at the end of the project using baseline measurement methods as well as project measurement methods.
2. Evaluation methods to be used
The baseline measurement method as well as the project measurement method will be used in this context. Questionnaires will be given out to the target group in order to judge their knowledge, skills and ability. Surveys with open-ended questions will be conducted to get an idea regarding how far the project succeeds in generating information to the elderly inpatients. The fall checklist will determine how many falls have occurred after the completion of the project. Consultants will be provided recommendation forms to enlist their observations regarding the entire process. The focus group method of evaluation will also be employed.
3. Ways to measure the outcome of the project
In accordance to Burns and Grove (2002), the outcome of the project will be measured on the basis of the data collected from the questionnaire, the surveys conducted, the views aired in the open-ended group discussions and the recommendations of the consultants. The questions should be such that the outcomes can be measured. If 8 out of 10 nurses score above 90%, it will suggest that the project has been successful in creating the necessary awareness. If the falls list shows 1-2 or no falls during the stipulated period, it suggests that the inpatients have been able to attain almost 100% compliance with the fall prevention strategies.
4. Ways to inform the agency personnel regarding the completion of the project
The agency personnel will be aware of the time period. After the completion of the project, the personnel would be officially informed. An independent survey will be conducted by the agency and if the agency is satisfied with the outcome, they will declare the project complete and successful.
5. Professional goals to be attained by completing this project The following professional objectives may be realized after successful completion of this project:
- a. It will help mobilize funds for the sustainability of the project in an independent way.
- b. The results, if favorable, can be published in a Science journal.
- c. It will be helpful in establishing credentials as a healthcare provider specializing in the field of elderly fall prevention.
