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High mortality, morbidity and costs associated with falls amongst high care residents across 10 residential facilities with a total of 500 high care places. All of these 10 residential facilities are part of one large aged care organisation (Jurassic Aged Care).

Each year, the 10 facilities have about 1,000 falls. The falls result in:

  • Twenty fractured necks of femur (NoFs), 10 Colles fractures, 30 head injuries. These incidents results in
    • about 50 hospitalisations, and
    • Five residents with #NoFs died within 12 months of the injury;
  • 500 hours of additional nursing and monitoring, total cost of $1 million per year.
  1. Run your assignment through Turnitinbefore you submit to check for possible breaches of academic integrity.
  2. Before submission, run the spelling and grammar check.

“Hip Fracture Prevention” has been designed to reduce the morbidity, mortality and costs associated with falls

To reduce morbidity, mortality and costs associated with falls in 10 residential facilities in Jurassic Aged Care

  • Preparation and implementation of project – 12 months
  • Ongoing phase – from 13thmonth onwards
  1. To increase at risk resident’s balance & strength by 20% within 8 months
  2. To reduce falls incidence by 50% within one year
  3. To reduce fractured necks of femur by 50% within one year
  4. To reduce health care costs for falls by $500,000 within one yea
  1. To implement a falls risk assessment method to all 10 residential facilities within 3 months;
  2. To provide training to all staff to ensure they all have the competence in conducing falls screening and prevention within 6 months;
  3. To introduce a falls monitoring system within 3 months;
  4. To reduce facility physical risk factors for falling within 6 months;
  5. To ensure all high risk residents are allocated hip protectors within 6 months;
  6. To provide regular remedial physiotherapy  and  strengthening programs to all residents throughout the project.
  • Introduction of a Falls Risk Assessment Method (FRAMT) and Falls Register in care plan for each resident;
  • Introduction of a falls monitoring system in all ten facilities;
  • To train all direct care staff in falls prevention including using of FRAMT and a Falls Register;
  • To appoint and train a ‘Falls Guru’ for each residential site who will monitor the implementation of the project and provide support to staff;
  • To provide ongoing support to staff in applying the Fall Risk Assessment Method and Falls Register in care plan for residents;
  • To undertake implementation of FRAMT and subsequent identification of at risk residents and facility environmental risk factors;
  • Purchase and provision of hip protectors to high-risk residents;
  • Design and commence interventions such as Tai Chi and strength classes for residents.
  1. 10 residential facilities to collaborate with appropriate staffing to implement the strategies;
  2. $200,000 for staffing, development and implementation of falls risk assessment method/process & monitoring system;
  3. $300,000 for staff training in falls screening and prevention ($30,000 per institution);
  4. $45,000 for provision of hip protectors (for 300 residents);
  5. Providing regular remedial physiotherapy  and  strengthening programs to all residents $10,000;
  6. $50,000 for a one-off evaluation.
  1. Ongoing monitoring;
  2. Training of new staff on the used galls risk assessment method and risk register in care plan;
  3. Hip protector checkup, maintenance and replacement;
  4. Hip protectors to newly identified high risk residents;
  5. Regular remedial physiotherapy and strengthening programs to all residents throughout the project.
  1. Training of new staff  $30,000/year
  2. Maintaining the assessment system across the organization $50,000
  3. Hip protectors checkup, maintenance and replacement $10,000
  4. Providing regular remedial physiotherapy  and  strengthening programs to all residents $10,000

Requirements

The assignment task is to design an appropriate evaluation for the Preparation and Implementation Project outlined above and ongoing monitoring in the first two years of the Hip Fracture Prevention Program.

The project was carried out with the aim of studying the assessment and management of risks among the residents of a certain place and educating them how to manage and handle risks among the young children. The outcome was tabulated as below:

Strategies

Key Activities/components to be included in process evaluation

Indicators for measurement

Methods for measurement

(How will you collect the data)

When will the information be collected?

Implementation of the falls risks assessment methods to all the 10 residential facilities.

The activities to be included in the evaluation process is the introduction of the Falls Risk Assessment Method (FRAMT) and the Falls register for each household during the process of rolling out the activities as laid down in the order to be followed.

The indicator of measurement here used is the use of the Falls Register and the Falls Register Assessment Method.

The method used to collect data will be the use of the Falls Register and the Falls Register Assessment Method

The required information should be collected within a period of three months at most.

Providing training facilities to the staff to equip them with competence while conducting the falls screening and preventing (Berry Kiel, 2008).

The activity involved in the process is through monitoring the falls system in all the facilities in the residential while evaluating.

Appointing and training of a Falls Guru follows who will be designated to each residential area whose mandate is to monitor the implementation of the projects and providing support to the staffs he or she is leading and working with.

The system of falls monitoring is used as an indicator.

Service delivery and competence of the Falls Guru also serves as indicators of measurement (Manson Hsia, 2003).

Recording the falls monitored system of collect the data from the monitoring system.

Normally collected within a period of six months.

The introduction of the Falls Monitoring system into the residential.

Provision of hip protective gears to residents in areas perceived to be risky.

After the introduction of the system, the direct care staffs are trained in preventing falls using the Falls Register and Falls Risk Assessment Method (FRAMT) methods as they will be using them all through their entire service delivery to the residents.

In places that are risky, hip protectors are purchased and residents are provided with them because they will help much in protecting them and thus giving easy times to staff working in and around their residential (Ayello, 2007).

They also ensure full implementation of the FRAMT programme and subsequent identification of risks to residents and facilitate environmental risk factors (Lindsay Silverman, 2001).

Competence through the skills acquired and service delivery to the residents.

The number of hip protectors provided to the residents by the Falls Team.

Recording the number of successful candidates who have completed the training session.

Recording the number of hip protectors purchased and distributed to the residents.

It should be collected after three months.

It usually takes a period of six months.

Providing regular remedial strengthening and physiotherapy programs to all the residents all throughout the project as part of service delivery to the residents (Kanis Oden, 2002).

The residents are taken through the design and commence interventions such as Tai Chai and strength classes for residents. This is usually done in order to ensure that the residents are well prepared to deal with any sort of risks while with or without the rescue team in case of any emergency cases (Torgerson Bell-syer, 2001).

The number of people who can offer assistance in case of a risk occurring in their environment and people at large.

Recording and observing the number of people who can help deal with the risks and emergency cases.

It usually takes a period of six months.

To reduce healthcare cost by half.

Through the introduction and sensitization of the training and support to the residents, they are able to learn how to deal with risks and other emergency cases because they are aware of the risks, are competent enough to apply the skills they learnt during their training on risk factors (Szule Seeman, 2000).

The amount of resources reserved that could have been used to deal with the risks.

Also the time that could have been consumed while dealing with risks and other related activities.

Recording the data and drawing the charts to see or measure the reduction

It takes one year to cut the costs.

Proper planning for the activities to be done by the team.

Proper planning involves having all that it takes to get the best out of the activities all arranged and given a sequence of what should follow the other in order to avoid future delays, damage to goods or delay of services (Lee Sowa, 2007).

Normally, planning involves having the right flow and all activities given enough time to go till the final bit. This is the most crucial thing because it allows an individual or a group having activities floe in the right way without having collision of activities in the future time.

Firstly, proper planning enables activities to flow smoothly without having others left pending or not done. This enables one to make adjustments and future adjustment for the activities.

Secondly, proper planning helps to avoid collision of activities in the future and thus gives an individual enough corrections before an action is done. Others include saving on time for other things, enables one to prioritize on activities among others.

The data will be collected by recoding the number of activities with time over a given period of time. This will allow an individual to have correct figures and facts so that they may use them for decision making regarding the program rolled out to the residents.

The information will available only after the first or subsequent programs have been brought to an end. Thus, correct information will be available after the program has been completed and therefore the information given will be reliable and entails mush details that can be analysed to give the required information.

Objectives

Indicators of achievements / Success indicators

Methods for Measurements

including details of data collection

When should data collection and analysis take place?

To increase of the resident s risk strength and balance gain.

The indicator for this increase is evident in the figures portrayed by the statistics and savings by the residents. It s indicated by the percentage growth of 20% which is a positive figure.

The growth or increase is indicated by the positive increase i.e. 20% that was measured from the time the residents were educated and taught the risk assessment skills.

The data was collected through the analysis and figures by recording the data.

Data collection should take place in the areas probable of risks of the residents. Analysis is usually done when giving out the final results or outcome of the research to the relevant authority usually after a period of 8 months.

To cut and reduce the costs of healthcare for falls.

Through the risk awareness created by the supporting teams has helped cut down the costs of healthcare by half a million US dollars which has helped relive the heavy burden of bearing the high costs of healthcare and medications (USDHHS, 2000).

The reduction in costs for falls was measured by the cut costs by $500,000 which has shown that the new methods of risk management and handling as indicated by the figures. Data was collected through recording and analysing the stored figures from the disaster management offices (Yaar Gillchrest, 2001).

Data is collected and analysed when comparison is done and when the report on the progress of the programme is required by the office of management. Analysis is done when there is a rise or changes of the trends with reference to a reference figure at the time of recording the data from the field. Its usually done within a period of 12 months.

To minimize the incidences of falling.

Since the introduction of the risks management programme, there has been a tremendous reduction in the cases of falls among the residents because they were able to learn the ways and skills of dealing with the cases through the help of falls prevention staff.

Direct care from the Falls prevention and FRAMT teams has brought a new revolution in dealing with the fall cases.

The ability of the residents was measured through their ability to deal with the risks among them being falls, which has shown a positive figure in treatment.

The data was collected from the case study of how to deal with fall risks through recording and analysing the data collected through observation and recording through writing (Dawson Moonsawmy, 2001).

The time period for collecting the data usually takes 1 year as the time to do the research, collect enough data, write notes and make recommendations from it,

Analysis is usually done after one year so as to pave way for the coming year.

To reduce the fracture of necks of femur.

Since the introduction of the project, the number of cases of neck fracture has been brought down since many residents are educated how to practice healthy living styles and other throwbacks that may pause risks to their well-being.

Neck fractures of femur have been a serious problem and thus the introductions of the FRAMT team the cases have been brought down. This revolution has enhanced better living among the residents (Cuddigan Berlowitz, 2001).

Since the introduction of this revolution in the sector, the measurements were done in accordance to the number of risk cases that were reported to the risk control team.

The data was collected from the statistics of those who reported the cases and thus it was collected from the healthcare service providers.

After the measurements have been according to the frequency or number of cases that were reported, data collection was taken and analysis done after a period of one year.

Thus, after collecting data, the team sits down to tabulate and analyse and come up with a conclusion so as to give a report as required.

Cost and other overhead expenses.

Despite the fact that the program is benefiting the society at large, it has been found to be costly in terms of finances, time among other drawbacks because since the launching of the program, a lot of finance need to be set aside normally to cater for the day to day running of the activities, paying or supporting the working staff, purchase of materials and acquiring new things that help run it smoothly.

This has been a challenge with many organizations something that has led to them being rejected and some being declared as illegal (Cuddigan Berlowitz, 2001).

This issue is measured by using the projects being undertaken by the trainers in the society. If the projects are dragging behind or running slowly, its evident that there are problems going on in the management and running of the activities of the program and should be addressed so that to solve the internal and external wrangles. This wrangles end up affecting those in need of the support and action from the program (Yaar Gillchrest, 2001).

Data is collected by using the day to day service delivery record books if available.

Data collection and analysis should be done from the findings out of the rolled program through recording, taking samples if any and also taking pictures.

Analysis of the collected data should be done after the collected data has been scrutinized to get the outcome that will be used in analysing leading to decision making and development of the report (Cauley-Robbins et al 2003).

Societal decay among the residents.

Since the introduction of the program to the residents, some morals will be left that are in line with the community and adopting the western culture something that will lead to the morals to decay.

Moreover, new things will make people indulge in unlawfully activities that are against the moral standards. Some residents may start claiming to be trained in the rendering of the services that the Falls Register and the FRAMT teams are offering with the name of gaining falsely from the unsuspecting residents.

The societal decay is evident when the society, not whole of it, but a section of it; starts deviating from the line of living of the society and adopt a different way of living.

This can be evident through the changes in the modes of dressing, lifestyle among many more changes.

Data about this changes can be collected when the people start living different ways or deviate from the others in the society. The data is also collected using questionnaires bearing the topic of study (Torgerson Bell-syer, 2001).

Data collection starts just after the behavioural changes is noticed among a large number of people have been noticed.

After data has been collected, its combined, analysed and the findings given out that will be used in decision making that will henceforth lead to giving out the report based on the changes among the residents.

Indicators of achievements / Success indicators

Methods for Measurements

including details of data collection

When should data collection and analysis take place?

Reduction in the number of visits or trips to the healthcare officers. This is as a result of increased and frequent training that was rolled out by the FRAMT and Falls Register team. This team has taken the opportunity of ensuring that residents live well and many infants and young generation not forgetting older people growing up well.

The team paid a visit to the nearby healthcare centre in order to find out the number of people who visit them whether is still high or low. It was found that the figure had significantly dropped and so they used the stored data and also observed that the figure had dropped since the introduction of the FRAMT and Falls Register teams.

Data collection should be done after a period of 6-12 months depending with the eligibility of the residents to practice the skills taught.

After collection, analysis is done after one year mainly because it s meant to give the final results that will be used to make the report.

Saving on resources that could have been used in medication. The teams have been able to train, teach and educate residents how to avoid things that may pause risk to their health and lives by equipping them with skills and the know-how technics something that has resulted in better living and thus saving on resources that could have been given to someone else to do the work or offer the services to them.

The knowledge and skills acquired by the residents and how well they apply them in solving the emerging risks. This tool is an important key because it s an indicator that shows how important the skills are.

It also acts as a catalyst to the teams to increase their support to the residents so as to curb and bring down the cases that may arise as a result of the risks (Taylour, 2002).

Normally, the data collection should be done in a period of 6-12 months depending with the size of the residential population who were trained by the risk training team.

After collecting data from all the centres that were prone to health risks, analysis should be done after six months so that a report may be developed and given out.

Extensive applications of acquired knowledge and skills. The extensive training and use of equipment provided like the protectors has been applied so widely among the residence using the knowledge they acquired from their mentors and trainers (Oury ,Ferron, 2013).

The measurements are to be taken from the residents who practice the skills that they were trained to administer their services to the victims or those who were injured as a result of getting injured. Is therefore through this that will be measured in order to pave way for collecting the data. Data collection is done by checking the number of patients attending the medical services with that of those offering the services. This will help in determining whether to embark on training more residents or doing some adjustments to the existing team.

After the firsthand data has been captured from the residential area where services are administered to the patients, it should be collected, recorded and analysed in order to be used for decision making right from the junior trainers to the senior trainers and back to the residents. This period usually takes 6 months

Regular remedial for physiotherapy and strengthening programs to the residents all through the program. Through the rolled out program to the residents, they are reminded all that they are trained in order to refresh the knowledge and skills they have in order to improve on the service delivery and strengthen on their weak areas. Through this, residents are able to refresh and reload the skills they had to new and updated ones.

Success will be attained only by accepting the new technics when it becomes to training and at the end of it quality service delivery to the patients (Carpenito-Moyet Cooper, 2006).

Service delivery to the clients or the injured is what is measured and adjustments made. Through this, one is able to learn weak areas and work towards achieving the best from their weaknesses.

Moreover, the measurements done depends with the size of the population and their level of risk management skills. It s from this point where data of patients to the clinical person which is done though recording, drawing graphs and pie charts to be used for analyses.

Data collection should be done for a period of six months or so because collecting data should be given enough time for figures to change and new things develop.

Regular supply of protector s especially hip protectors. Through regular supply of protectors to the residents for a certain period of time shows that the residents are practising the skills and experience they have in handling patients or those affected by the risks (Dawson Moonsawmy, 2001).

This is a successful indicator that should be allocated an additional resources to facilitate smooth and better service deliveries to the clients.

The methods used to measure the success of the program are through the supply of facilities like the hip protectors; additional trainers to intensify training to the residents, the supply of medicines and also the increase in the knowledge and skills from the trainers towards the residents. At the end of the day, it s the service delivery that will be rated that was administered to the patients and also the satisfaction of the patients and residents from the region.

Collection of the data is normally done after a program has been rolled out, facts, pictures and figures recorded to be used for future analysis and decision making.

Employment of the residents. Since the program was aimed at giving a helping hand to the residents, it has been able to engage them actively in the delivery of services to the residents. Those who are trained were to be the ambassadors of the community and thus they act as a link between the residents and the community outside in large, hence fostering community development both socially and economically at large (Szule Seeman, 2000).

Basically, the program should be monitored annually because it will give an insight of the reality about the illnesses that affects the residents living in a given place.

It also gives the approximate figure of the risks and also the patients who are the residents of the given place as long as proper planning and strategies and mechanism are put are put in place.

Thus, monitoring of the program is necessary throughout the year so that the helping or aid given to the residents is kept abreast because community upgrading can bear good fruits and give the residents a sense of belonging.

It also gives those who are willing and capable of helping the less privileged that chance to do well and give their aid to the society at large.

Once rolled out, the programme should be welcomed and given a chance to give its support to the less educated people in the society. This will help in developing the lifestyles of the people in the society.

The measurement here was achieved by looking at the development and wellbeing of the community. This measure is to be used while rating the performance of the program to the residents and its contributions towards the wellbeing of the residents. Here, the residents are involved in most of the activities especially those for service delivery to the residents, their development socially and economically and healthcare systems.

Data is collected from the time of commencing the program and should therefore be recorded in the right way without bias nor incorrect figure that may bring confusion and disagreements during decision making or when making references from the data.

Data should be collected using pictures,tables,charts,graphs,among other methods just before, during and after the first phase of the program has been rolled out and an appropriate analysis made so as to get the required information that will be used to make decisions and future plans about the program.

This period should take a period of 6 months or more depending on the prevailing situation on the ground.

References

Ayello, A.,(2007). Predicting pressure ulcer risk. Try this: Best practices in nursing care to older adults. Issue 5 (revised). New York University: Hartford Institute for Generic Nursing. Retrieved from www,hartfordign.org/resources/education/tryThis.html.

Berry S. Kiel D., (2008). Falls as the risk factors for fracture, Osteoporosis, ed. 3, San Diego. Academic press, pp 911-922

Cauley J.,Robbins J., et al (2003). Effects of estrogen plus progestinon risk of fracture and bone mineral density. The Women s Health Initiative randomized trial .JAMA, 290:1729-1738

Carpenito-Moyet, L Cooper, H.,(2006).Save our skin: Initiative cuts pressure ulcer incidence in half. Nursing Management, 37(4), 36-45.

Cuddigan, J ,Berlowitz, D., (2001). Pressure ulcers in America: Prevalence, incidence, and implications for the future. Advances in Skin and Wound Care, 14, 208-215.

Dawson, M., Moonsawmy, C,.(2001). An evaluation of two bathing products in a chronic care setting. Geriatric Nursing, 22, 91.

Hays J. Ockene J., (2003). Effects of estrogen plus progestin on health-related quality of life, N Engl J Med, 348:1839-1854.

Kanis J., Oden A.,(2002). Uncertain future of trials in osteoporosis. Osteoporos Int. 2002;13:443-449.

Lee N., Sowa H.,. (2007). Endocrine regulation of energy metabolism by the skeleton, Cell, 456-469.

Lindsay R. Silverman S.,. (2001). Risk of new vertebral rapture in the year following a fracture. JAMA

17(285);320-323.

Manson, J Hsia J. (2003). Estrogen plus progestin and the risk of coronary heart disease, N Engl J Med, 349:523-534.

Oury F ,Ferron M., (2013). Osteocalcin regulates marine and human fertility through a pancreas-borne-testis axis, J Clin Invest, 123(6):2421-2433.

Szule P., Seeman (2000). Biochemical measurements of bone turnover in children and adolescents. Osteoporos Int, 11:281-294.

Taylour, S.,(2002) .Understanding of skin color. Journal of the American of Dermatology, 46(2 Suppl.), S41-S62.

Torgerson D. Bell-syer, S (2001). Hormone replacement therapy and prevention of vertebral fractures: a meta-analysis of randomized trials. BMC Musculoskel Disord;2:2-7

U.S. Department of Health and Human Services(USDHHS), (2000), Healthy People 2010(2nd ed.). Washington,DC:U.S. Government Printing Office.

Yaar ,M. ,Gillchrest, B., (2001), Skin aging: Postulated mechanisms and consequent changes in structure and function. Clinics in Geriatric Medicine, 17, 617-630.

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