Discuss About The Journal Of The American Geriatrics Societ?
Individualised balance exercises would be achieved through the collaboration of the specific patient and physical therapist or nurse assistants. Hence, the pillar of consumer and community participation is relevant to the project. Based on consumer and community participation pillar, an intervention is developed on the principles of consent, autonomy and professional ethics. The patient at the aged care home should offer consent before the therapist initiates therapy session. On the other hand, the healthcare professional should practice autonomy and observe professional ethics when treating the patient. Besides, needs assessment, information provision and privacy are fundamental aspects of the consumer and community participation pillar (Department of Health, 2012). These principles are all pertinent to the proposed project. Another clinical governance pillar that is pertinent to the project is service evaluation, quality improvement and innovation. The structure of the project requires constant evaluation and improvement based on the client’s outcomes and efficiency. The pillar of service evaluation and quality improvement suggests that treatment should be monitored progressively and updated to meet the envisioned or desired results (Department of Health, 2012). In this project, the individualised balance exercises will be continuously monitored, and deficiencies in relation to the predetermined standards of care will be remedied. This analysis indicates that clinical governance is relevant and indispensable to the proposed project.
Falls in nursing homes is a significant problem that results in adverse health outcomes and is a common occurrence in Australian aged care facilities. Empirical evidence suggests that there is a high number of falls in nursing homes. Ibrahim and colleagues, in their study conducted between 2000 and 2013, found that most deaths in accredited Australian nursing homes occur due to falls. Specifically, they revealed that out of 21672 deaths 81.5 percent (2679) are associated with falls. They concluded that falls cause premature deaths in aged care facilities, which are preventable (Ibrahim et al., 2017).
One study conducted in New South Wales (NSW), shows that there is a high number of falls in residential aged care that require medical treatment. The study shows that between 2006 and 2007 5756 falls were requiring medical attention in NSW. The number of falls that needed emergency department attendance in nursing homes was about 6988. Lastly, the number of falls in residential aged care that required non-hospital treatments was 29790 (Watson et al., 2010).
Another justification for implementing a fall prevention strategy in nursing homes is the incidence report of Queensland health facilities. Between 2007 and 2008, 11928 fall-associated clinical incidents in Queensland. 22 percent of these incidences occurred in nursing homes. Some of these incidents led to mortality or severe and permanent patient harm. Other incidents led to temporary loss of function, while a few did not cause any harm (Black & Ferrar, 2011).
Chen and colleagues did a study to determine the prevalence of falls in nursing homes in Australia. In this study, there were 1342 older males and females with a mean age of 86 years. Over a period of 1.97 years, approximately 6646 led to 308 fractures. Some fractures resulted in long hospitalisation and disability. This study shows that falls in nursing homes should be prevented to enhance the quality of life for the residents (Chen et al., 2008).
Fall-associated ambulance attendances for Queensland also reveal the prevailing problem of falls in aged care facilities. From 2007 to 2008, there was an average of 1895 fall-linked attendances. About 24 percent of all the falls occurred in aged care facilities around Queensland. The report indicates that most of these falls needed treatment at the scene (Black & Quinn, 2010).
Nicholas and colleagues did a study in nursing homes in Sydney to investigate the prevalence of falls linked to Drug Burden Index. The study found that there are many falls in the aged care homes associated with the medication. In one year, there were 998 falls in 330 clients. The analysis insinuates that the average falls per person in a year is 1.74 (Wilson et al., 2011).
In a study conducted in Australia between 2009 and 2010, it was found that one in five injurious falls involving an individual aged 65 years and older occurred in nursing homes and led to hospitalisation. Within the same period, the prevalence of fall injury cases in nursing homes was six times higher than in homes (Bradley, 2013).
Finally, this project is supported by the AIHW report of 2005-2006. Based on this report, the largest number of fall injury incidences happened in nursing homes, which was 21.8 percent. The falls in women were 23.6 percent, while in men the falls were 17.5 percent. The report notes that in the number of falls in aged care facilities was five times higher compared to the home environment (Bradley & Pointer, 2008).
Recent literature suggests that individualised balance exercise is effective in reducing falls in nursing homes. One review article asserts that balance training using mechanical apparatus reduces falls in intermediate level nursing homes (Cameron et al., 2012). Besides, research found that high-intensity exercise reduces falls in older people living in aged care facilities if they enhance their balance. This study involved 191 older people living in nursing homes (Rosendahl et al., 2008). A meta-regression study found that interventions that entail balance training, excluding walking training have a significant impact in reducing falls in older adults. The meta-analysis recommends the balance exercise to be performed for about two hours per week (Sherrington et al., 2011). Raimunda and colleagues did a meta-analysis of 12 studies involving 1292 candidates to determine the effectiveness of exercise in fall and fracture prevention. Their analysis notes that balance exercises have a preventive impact on falls (Silva et al., 2013).
The problem: A fall is an act of collapsing without control. In nursing homes, falls can be sudden and can happen at any place within the aged care facility. Exercises are designed, structure and repetitive movements to enhance or sustain certain components of physical fitness (Tiedemann et al., 2013).
Nurse assistants – Nurse assistants, will act as the primary caregivers for the patients in nursing homes. They will identify residents within nursing homes who should be included in the program.
Registered nurses (RNs) - RNs will be required to monitor residents who are undertaking balance exercises. They will ensure the patients maintain appropriate hygiene and receive proper nutrition.
Physiotherapists – These specialists will examine and treat residents who can benefit from balance exercises. Their role will be restoring and maintaining physical function within musculoskeletal systems.
Orthopaedic surgeon – This medical professional will be involved in examining musculoskeletal system disease among the patients. They will determine patients who are the risk of experiencing osteoporosis.
Patient representatives - The patient advocates will be responsible for maintaining communication with the patients and healthcare providers in the course of the program.
The CPI tool that will be used for this project is PDSA (Plan, Do, Study, Act). PDSA is an iterative tool appropriate for performing change or improving a process.
Plan: The initial step is to plan the change that will be trailed. The process that needs improving is identified and a mission statement drafted. Additionally, the evidence is collected at this stage as well as the formation of an appropriate team (NSW Health Department, 2002). The planning stage relates to the four parts of this project which are project title, project aim, evidence that the issue is worth solving and key stakeholder analysis.
Do: The trail of the proposed change is performed. In this stage, the plan is executed or set in motion. An understanding of the event is required for accurate investigation. Observations on the performance of the interventions are made in the Do stage. This stage relates to the summary and proposed intervention part of the project.
Study: This stage entails the evaluation of the trail impact. The observations and data collected in the DO stage are used to determine whether the plan led to an improvement (NSW Health Department, 2002). The main aim of the Study stage is to measure whether the project aim is achieved. This stage relates to the evaluation part of the project.
Act: The last stage involves the implementation of the changes that have proven to be effective. The conclusions of the project are made at this stage. If the plan led to success, the improvements are standardised and constantly used to solve the problem. This stage relates to the “barriers to implement and sustain change” part of the project.
The PDSA could be used to address the aim and implement the intervention in the following ways. It could be used to identify and diagnose the fall problem and measure the extent of the problem. Then an appropriate intervention could be identified, implemented and re-measured to ascertain whether it has been effective.
Balance control is the foundation of an individual’s capacity to move, walk and function independently. The individualised balance exercises would include dual as well as multi-task exercises. These exercises have been proposed based on the understanding and principles that, balance control depends on the coordination of physiological systems, interaction with the task performed and environmental factors (Halvarsson et al., 2015).
Nurse assistants conduct risk assessment will identify and refer the older adults at the aged care facilities who are the risk of falls. The nurse assistants will be required to use Physical Mobility Scale to determine the individuals who are the risk of falling.
The residents of nursing homes who have been referred by nurse assistants will be examined by the RNs and orthopaedic surgeon to determine their eligibility for the balance exercises. Eligible clients will be enrolled.
The physiotherapist will develop an individualised treatment for patients based on their health condition. The balance exercises will be categorised into basic, moderate and advanced levels. Basic level will include dynamic balance as well as sensory orientations. Advanced level will include stability limits, dynamic balance and sensory orientation. The advanced level will include multi-task exercises.
Individualised exercises will be performed for at least 3 hours per week for 12 months. The effectiveness of the project will be evaluated in the first six months and the second at the end of the 12 months.
Staff education will be one of the barriers to the implementation of the project. The aged care facility staff requires training on how to utilise risk assessment tools and should be in a position to delineate the pragmatic for conducting a fall assessment on admission. They should also be trained about predisposing and factors that might trigger falls, which can be prevented through balance exercises. This barrier can be addressed through ongoing training.
Obtaining baseline data before the execution of the project is another challenge. Before the project is executed, there is a need for the current baseline for cases of falls in aged care facilities. The data would be used to determine whether previous interventions have been successful and whether the individualised balance exercise would be successful. This barrier would be addressed by conducting an initial study of the falls in nursing homes to gather the required baseline data.
The cost of implementation is also a barrier. The costs would be incurred in risk management, documentation, acquisition of supplies and equipment. This barrier would be solved by involving state and territory governments to fund the project.
The evaluation of the project would be based on outcomes to determine the advantages to the patients. Data on the number of falls in aged care facilities would be the foundation of the evaluation. A poised mixed model will be used to analyse the number of falls. This model has been used by Hewitt and colleagues to evaluate the number of falls in nursing homes (Hewitt et al., 2014). During the evaluation, data would be recorded based on the time of day, the circumstance of fall, location and activity. The data would help to determine the type of fall like accidental, predicted physiological and unpredicted physiological fall. A decline in the number of accidental falls will suggest that the project is successful.
Black, A. & Ferrar, K., 2011. Fall-related clinical incidents reported in Queensland Health facilities, 2007- 08. Brisbane: Queensland Health. Retrived from https://www.health.qld.gov.au/__data/assets/pdf_file/0018/435024/0708-clinicalincid.pdf
Black, A. & Quinn, J., 2010. Falls-related ambulance attendances for Queenslanders aged 65 years and over, 2007-08. Brisbane: Queensland Health. Retrieved from https://www.health.qld.gov.au/__data/assets/pdf_file/0033/434877/0708-ambulance-data.pdf
Bradley, C., 2013. Hospitalisations due to falls by older people, Australia 2009–10.. Injury research and statistics series no. 70. Cat. no. INJCAT 146. Canberra: AIHW. Retrieved from https://emsas.com.au/blog/wp-content/uploads/2014/11/14820.pdf
Bradley, C. & Pointer, S., 2008. Hospitalisation due to falls by older people, Australia 2005–06. Injury research and statistics series number 50. Cat. no. INJCAT 122. AIHW. Retrieved from https://188.8.131.52/WorkArea/DownloadAsset.aspx?id=6442458827
Cameron, I. et al., 2012. Interventions for preventing falls in older people in care facilities and hospitals. The Cochrane Library, (12), p. CD005465.
Chen, J. et al., 2008. Risk factors for fracture following a fall among older people in residential care facilities in Australia. Journal of the American Geriatrics Society, 56(11), pp.2020-26. Retrieved from https://onlinelibrary.wiley.com/doi/10.1111/j.1532-5415.2008.01954.x/abstract
Department of Health, 2012. Appendix C: comparison of with ATAPS clinical governance framework. [Online] (https://www.health.gov.au/internet/publications/publishing.nsf/Content/mental-pubs-e-evalnurs-toc~mental-pubs-e-evalnurs-app~mental-pubs-e-evalnurs-app-c#t8-4) [Accessed 2 October 2017].
Halvarsson, A., Dohm, I.-M. & Stahle, A., 2015. Taking balance training for older adults one step further: the rationale for and a description of a proven balance training programme. Clinical Rehabilitation, 29(5), pp.417-25.
Hewitt, J. et al., 2014. Does progressive resistance and balance exercise reduce falls in residential aged care? Randomized controlled trial protocol for the SUNBEAM program. Clin Interv Aging, 9(1), pp.369-76.
Ibrahim, J.E. et al., 2017. Premature deaths of nursing home residents: an epidemiological analysis. Medical Journal of Australia, 206(10), pp.442-47. Retrieved from https://www.mja.com.au/journal/2017/206/10/premature-deaths-nursing-home-residents-epidemiological-analysis?inline=true
NSW Health Department, 2002. Easy guide to clinical practice improvement: A guide for healthcare professionals. [Online] Available at: https://www.cec.health.nsw.gov.au/__data/assets/pdf_file/0005/286052/cpi-Easyguide.pdf [Accessed 2 October 2017].
Rosendahl, E. et al., 2008. A randomized controlled trial of fall prevention by a high-intensity functional exercise program for older people living in residential care facilities. Aging Clinical Exp Res, 20(1), pp.67-75.
Sherrington, C. et al., 2011. Exercise to prevent falls in order adults: an update meta-analysis and best practice recommendations. NSW Public Health Bulletin, 22(3-4), pp.78-83.
Silva, R.B., Eslick, G.D. & Duque, G., 2013. Exercise for falls and fracture prevention in long term care facilities: A systemic review and meta-analysis. JAMDA, 14, pp.685-89.
Tiedemann, A., Sherrington, C. & Lord, S., 2013. The role of exercise for fall prevention in older age. Motriz: Revista de Educação Física, 19(3), pp.541-47.
Watson, W., Clapperton, A. & R, M., 2010. The incidence and cost of falls injury among older people in New South Wales 2006/07. Sydney: NSW Department of Health. Retrieved from https://www.health.nsw.gov.au/falls/Publications/incidence-cost-of-falls.pdf
Wilson, N. et al., 2011. Associations Between Drug Burden Index and Falls in Older People in Residential Aged Care. Journal of the American Geriatrics Society, 59(5), pp.875-80. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21539525
To export a reference to this article please select a referencing stye below:
My Assignment Help. (2019). Journal Of The American Geriatrics Societ. Retrieved from https://myassignmenthelp.com/free-samples/journal-of-the-american-geriatrics-societ.
"Journal Of The American Geriatrics Societ." My Assignment Help, 2019, https://myassignmenthelp.com/free-samples/journal-of-the-american-geriatrics-societ.
My Assignment Help (2019) Journal Of The American Geriatrics Societ [Online]. Available from: https://myassignmenthelp.com/free-samples/journal-of-the-american-geriatrics-societ
[Accessed 25 May 2020].
My Assignment Help. 'Journal Of The American Geriatrics Societ' (My Assignment Help, 2019) <https://myassignmenthelp.com/free-samples/journal-of-the-american-geriatrics-societ> accessed 25 May 2020.
My Assignment Help. Journal Of The American Geriatrics Societ [Internet]. My Assignment Help. 2019 [cited 25 May 2020]. Available from: https://myassignmenthelp.com/free-samples/journal-of-the-american-geriatrics-societ.
At MyAssignmenthelp.com, we are committed to deliver quality assignment assistance in the fastest way possible. To make our service delivery fast, we have hired subject matter experts to work on different subject specific assignments. We have hired experts who owe in-depth knowledge in their respective subjects. As per their expertise, they provide geography assignment help, Physics assignment help, Strategic assignment help, history assignment help, art architecture assignment help and assistance with other subjects as well.
Answer: Nursing E-portfolio Legal issues and frameworks in competent nursing In my academic course of nursing I have faced with many ethical dilemmas and am looking forward to many such ethical dilemmas. I believe that as a nurse I should be aware of my legal and the ethical duties as a nurse. One of the legal aspects is the responsibility and the accountability of the registered nurses. A nurse is committed to provide a safe care to t...Read More
Answer: Area Awareness New practice approaches I have realized that evidence based medicine encompasses a systematic approach that helps to solve a clinical problem. For this purpose we are required to integrate best available research evidences with our clinical expertise. We should also give due respect to the preferences and individual needs of a patient before implementing any such intervention (Melnyk et...Read More
Answer: Introduction: Accident prevention is the single most important operation. To ensure that this succeeds, the policy advocates for a substance free environment. The use of alcohol or narcotics is strictly forbidden in the workplace. In the event that an employee is injured in the line of work, the institution will cater for medical expenses and rehabilitation so that the employee can return to work as soon as possible. To maintain safet...Read More
Answer: Introduction: Evidence based practice (EBP) is one of the necessary professional standards for registered nurse. The NMBA registered nurse standards for practice values EBP and encourages nurse to use best available evidence in taking health care decisions and providing safe and quality care to patient (Nursing and Midwifery Board of Australia, 2016). The necessity for competencies in EBP has been realized for its potential to enhance...Read More
Answer: Introduction A master's degree in nursing under the certification of American Association of Colleges of Nursing (AACN) is core nursing education that enables advanced practice nurses to work as register nurse practitioners, certified clinical nurse specialists, certified nurse midwives, and certified nurse anesthetists. I have selected nurse practitioner as a career option of my interviewee. This is because; nurse practitioner i...Read More
Just share Requriment and get customize Solution.
Our writers make sure that all orders are submitted, prior to the deadline.
Using reliable plagiarism detection software, Turnitin.com.We only provide customized 100 percent original papers.
Feel free to contact our assignment writing services any time via phone, email or live chat.
Our writers can provide you professional writing assistance on any subject at any level.
Our best price guarantee ensures that the features we offer cannot be matched by any of the competitors.
Get all your documents checked for plagiarism or duplicacy with us.
Get different kinds of essays typed in minutes with clicks.
Calculate your semester grades and cumulative GPa with our GPA Calculator.
Balance any chemical equation in minutes just by entering the formula.
Calculate the number of words and number of pages of all your academic documents.
Our Mission Client Satisfaction
The finished product of my assignment was impressive! No stone was left unturned from the required rubric. Easy to follow, original material, and thorough, not to mention, completed more than 24hrs before the requested time. THANKS TO MY MAH EXPERT! ...
THANKS Very timely completion. The attitude of the experts is very good, and it is found that the job requirements are different at different times. The experts completed the new requirements in a short time.
thanks for helpingto get good marks in all the work. i have got good marks. i hope u will provide good work in future
Met the requirements for the assignment. I would definitely recommend this website.