Preventing Falls And Harm From Falls: A Reflection On The Patient Experience And E-Health Records

Topic Focus: ‘Preventing falls and harm from falls’ and ‘My health record’(e-health record).

Reflection is a way of thinking and working for Registered Nurses and is useful in raising our conscious awareness of aspects of care that may or may not be hidden from our view. This raised awareness about these aspects of care improves our understanding as nurses and assist us in directing action strategies that can improve both the patient and their family’s experience and the ‘partnering in care’ strategies that we utilise. Improving the ‘patient care experience and partnering in care’ and using Gibbs Reflective cycle (1988) as a framework in combination with drawing upon relevant theory provides a foundation for nurses to operate from and as such is required for task 2.

Falls lead to injuries in patients and caregivers should suggest effective preventive measures to curb the effects of the accidents (Bennett et al., 2014). The case scenario presents a 75-years-old who has experienced falls twice, leaving him with severe injuries. e-health records are essential as they improve the quality of healthcare for falls patients . This essay will describe feelings and thoughts due to the scenario. Additionally, the write-up will also explore the values and beliefs towards falls and prevention measures. The paper will then analyze the initial stages of Gibb's reflection cycle and draw a conclusion based on the patient's experience with falls.

Description: The patient has had two falls. The first experience left him with injuries on his nose, chin, right shoulder, and left elbow. The client declined to go to the hospital due to his undesirable experience of waiting for eleven hours for care towards kidney stones. The caregivers later gave him Codeine to relieve his pain. He could not drive, so the wife had to drive him to see his GP. His doctor runs an x-ray and instructed him to take it to the surgeon who indicated that the fall caused a muscle tear on his shoulders. The patient later visited a physiotherapist who taught him how to use his left arm and other walking aids. The second fall was due to dizziness. The risk factors for the falls include type two diabetes, hypertension, anemia, and industrial deafness (Mihaljcic, Haines, Ponsford, & Stolwyk, 2015).

Feelings and Thoughts: The patient's experience has made me feel sad about falls and the public hospitals in the country. I feel sad because the falls have left the patient with numerous injuries and pain. The undesirable effects of falls led to the tearing of the muscle on his right arm; hence limiting his activities to one arm (Hoffman, Hays, Shapiro, Wallace, & Ettner, 2017). Additionally, the patient cannot drive himself and has to ask his wife to take him to the GP. I think that public health facilities should adopt strategies like e-health services to improve the quality of care.

Values and Beliefs: I believe that caregivers should provide walking aids to elderly patients who are at risk of falling. Family members should accompany the senior citizens to places like shops to prevent them from falling. The patient was walking alone during his first fall and did not have walking aids making him fall and sustain severe injuries. My beliefs and values originate from my experience when caring for senior patients at a hospital in Melbourne. It is essential to prevent the falls from elderly patients to keep them safe from mechanical injuries (Cockayne et al., 2017). The patient’s family benefit from the prevention strategies as their loved one leads a healthy life.

Feelings and Thoughts

Analysis: Certain aspects of the care in the case study were inadequate and harmful to the patient. An example is when the client visited the hospital for medical attention towards his kidney stones. He waited for eleven hours to get medical attention despite the pain due to the condition. The caregiver ended up giving him codeine to reduce the pain due to his condition. The experience made the client not to visit a public facility after falling for the first time. He had to rely on painkillers until the next day when he visited his GP. The surgeon who received the x-ray results from the GP and proved that the patient had a torn muscle at his shoulder also provided inadequate care to the patient. He did not explain the various treatment options and allow the patient to select his favorite choice. Caregivers should provide adequate information to clients to allow for informed consent (Basic, & Hartwell, 2015).

Apart from the inadequate care by the health specialists in the case scenario, other aspects were adequate and helpful to the patient. The physiotherapist taught the patient how to use his injured and the healthy arm. The health specialist also provided the patient with walking aids like sticks. Additionally, the care provided suggested a range of exercises to aid in the recovery process. The specialist dealing with his anemic condition instructed him to take iron tablets to balance the body structure and prevent the risk of falling. The gastroenterologist also provides quality care by telling the patient to intake the pill camera. The specialist prescribed the telemedicine to monitor the cause of anemia. The diabetes specialists prescribed Metformin which is an efficient remedy for Type Two diabetes (Healy, Winkler, Brakenridge, Reeves, & Eakin, 2015). The careers also prescribed Indocin and amlodipine to manage hypertension.

Conclusion Drawn: The public health facilities are performing dismally in caring for patients. The 75-years-old client in the case study had to wait for eleven hours for care towards kidney stones. The experience of the client indicates that a fall causes severe injuries to the victims. The patient injures his muscles, face, and chin among other body parts. The elderly individuals are at high risk of falling in comparison to different age groups. The risk factors of falls include anemia, industrial deafness, and hypertension. Anemia limits the ability of blood to circulate oxygen into the body systems; therefore, an individual feels dizzy and can fall easily. Industrial deafness prevents an individual from perceiving imposing objects; hence such an individual is at high risk of falling. Hypertension drugs like Indocin and amlodipine cause dizziness to the patients (Park, Satoh, Miki, Urushihara, & Sawada, 2015). Therefore, falls victims should seek alternative remedies for hypertension other than the two medications.

Values and Beliefs

Falls not only affect the patient but also the family of the victim. The wife of the patient in the case study abandons her chores and drives him to the GP for care. The patient admits that the whole exercise is stressful for his wife. The victims should embrace the existing prevention mechanisms for the complication. Caregivers should provide glasses to patients to aid their sights. The patient should use the hearing aids since he has industrial deafness. Additionally, the care providers should ensure that the hospital wards are noise-free to prevent hearing distractions (Mitchell et al., 2018). Australian health facilities should embrace e-health records to improve the quality of care towards patients. In the case scenario, the health specialist instructs the patient to ingest the pill camera to discover the causes of the anemia. Effective exercise regimes also keep the patient's body fit and prevent him from falling.

Action Plan: The severe effects of falls call for effective remedies to prevent the occurrences. Caregivers should provide walking aids to elderly individuals to ease their movement from one place to the other (Wilkinson et al., 2018). The care providers should also request the patient to wear hearing aids since he has industrial deafness. Australian hospitals should also embrace e-health to reduce the time patients take before receiving medical attention (Speyer et al., 2018). The specialists should also encourage the intake of telemedicine like pill camera to improve the quality of care. The family members of the senior citizens should accompany them to various places to prevent the chances of falling. The caregivers should suggest an alternative remedy to hypertension to reduce the dizziness that the medications cause to victims.  Australian hospitals should treat anemia since the complication is a risk factor for falls.

Conclusion

Falls cause injuries to patients and the caregivers should invent preventive measures to manage the accidents. The patient in the case scenario had two falls that led to injuries to his chin, face, and shoulders. Falls impose a sad feeling to the family of the patient due to the resulting pain. Caregivers should provide walking sticks and hearing aids as preventive measures towards the accident. The case scenario showcases both inadequate and adequate care towards the patient. The fact that the patient waited for eleven hours to receive attention is an example of inadequate care. Health facilities should adopt relevant falls prevention strategies.

References

Analysis of Inadequate and Adequate Care

Basic, D., & Hartwell, T. J. (2015). Falls in a hospital and new placement in a nursing home among older people hospitalized with an acute illness. Clinical interventions in aging, 10, 1637.

Bennett, A., Gnjidic, D., Gillett, M., Carroll, P., Matthews, S., Johnell, K., ... & Hilmer, S. (2014). Prevalence and impact of fall-risk-increasing drugs, polypharmacy, and drug-drug interactions in robust versus frail hospitalized fall patients: a prospective cohort study. Drugs & aging, 31(3), 225-232.

Cockayne, S., Adamson, J., Clarke, A., Corbacho, B., Fairhurst, C., Green, L., ... & McIntosh, C. (2017). Cohort randomized controlled trial of a multifaceted podiatry intervention for the prevention of falls in older people (the REFORM trial). PloS one, 12(1), e0168712.

Healy, G. N., Winkler, E. A., Brakenridge, C. L., Reeves, M. M., & Eakin, E. G. (2015). Accelerometer-derived sedentary and physical activity time in overweight/obese adults with type 2 diabetes: cross-sectional associations with cardio-metabolic biomarkers. PloS one, 10(3), e0119140.

Hoffman, G. J., Hays, R. D., Shapiro, M. F., Wallace, S. P., & Ettner, S. L. (2017). The costs of fall?related injuries among older adults: Annual per?faller, service component, and patient out?of?pocket costs. Health services research, 52(5), 1794-1816.

Mihaljcic, T., Haines, T. P., Ponsford, J. L., & Stolwyk, R. J. (2015). Self-awareness of falls risk among elderly patients: characterizing awareness deficits and exploring associated factors. Archives of physical medicine and rehabilitation, 96(12), 2145-2152.

Mitchell, D., Raymond, M., Jellett, J., Webb-St Mart, M., Boyd, L., Botti, M., ... & Haines, T. (2018). Where are falls prevention resources allocated by hospitals and what do they cost? A cross-sectional survey using semi-structured interviews of critical informants at six Australian health services. International Journal of Nursing Studies. 78(3), 234-256

Park, H., Satoh, H., Miki, A., Urushihara, H., & Sawada, Y. (2015). Medications associated with falls in older people: a systematic review of publications from a recent 5-year period. European journal of clinical pharmacology, 71(12), 1429-1440.

Speyer, R., Denman, D., Wilkes-Gillan, S., Chen, Y. W., Bogaardt, H., Kim, J. H., ... & Cordier, R. (2018). Effects of telehealth by allied health professionals and nurses in rural and remote areas: a systematic review and meta-analysis. Journal of rehabilitation medicine, 50(3), 225-235.

Wilkinson, A., Meikle, N., Law, P., Yong, H. J., Butler, P., Kim, J., ... & Hale, L. (2018). How older adults and their informal carers prevent falls An integrative review of the literature. International journal of nursing studies, 82, 13-19.