2.50
Hdl Handle:
http://hdl.handle.net/10755/182927
Category:
Abstract
Type:
Presentation
Title:
Designing a Proactive Post-Fall Care Policy
Author(s):
Hook, Mary; Winchell, Shana; Zweig, Faye
Author Details:
Mary Hook, MS, APRN, BC, Aurora Health Care, West Allis, Wisconsin, USA, email: mary.hook@aurora.org; Shana Winchell, BSN, RN, BC; Faye Zwieg, MBA, RN
Abstract:
Poster Presentation: Background/Significance: Prevention of falls for hospitalized patients is critical; however, some patients fall despite intensive efforts. Serious consequences may result. Purpose of the Project: A shared-governance workgroup was convened to review current evidence on post-fall care and create tools to support nursing practice. Method: Workgroup members reviewed incident case reports over the past year from a large, tertiary care facility. The group determined that standards were needed to guide the direct care staff in conducting post-fall assessments and implementing immediate and ongoing interventions to reduce adverse outcomes. Method: Multidisciplinary evidence was reviewed, summarized and used to create and implement a new policy and procedure to enhance collaboration between nurses, physicians, radiology, and quality management. Findings: Key policy and procedure steps include: Conducting a comprehensive post-fall assessment; Applying cervical spine immobilization for symptomatic patients prior to moving; Reviewing patient history for presence of factors that increase the risk for injury including osteoporosis, bleeding disorders or the use of anticoagulation or anti-platelet medication; Reporting events, assessments and injury risk factors to physicians to facilitate urgent diagnostic testing and treatment; Conducting ongoing post-fall assessment based on level of risk for injury; Embedding forms in the computerized medical record to support decision-making and documentation; and Implementing individualized patient plans to prevent recurrent falls. Conclusion: An evidence-based policy can support nurses in developing the skills and knowledge to partner with medical staff in aggressively assessing and intervening after a fall to minimize complications and prevent recurrence. References: Bond, A. J., Molnar, F. J., Li, M., Mackey, M., & Man-Son-Hing, M. (2005). The risk of hemorrhagic complications in hospital in-patients who fall while receiving antithrombotic therapy. Thrombosis Journal, 3(1), 1. Bub, L. D., Blackmore, C. C., Mann, F. A., & Lomoschitz, F. M. (2005). Cervical spine fractures in patients 65yrs & older: a clinical prediction rule for blunt trauma. Radiology, 234(1), 143-149.Center for Disease Control (CDC). (2004). Traumatic Brain Injury Fact Sheet. Retrieved May 29, 2005, from http://www.cdc.gov/Migrated_Content/Fact_Sheet/Freeform_Fact_Sheet_(General)/Traumatic_Brain_Injury_updated_May_2004.pdf Eastern Association for the Surgery of Trauma (EAST). (2000). Determination of cervical spine stability in trauma patients (Update of 1997 EAST cervical spine clearance document). Retrieved May 15, 2005, from http://www.guideline.gov/summary/summary.aspx?doc_id=2623&nbr=1849Fabbri, A., Vandelli, A., Servadei, F., & Marchesini, G. (2004). Coagulopathy and NICE recommendations for patients with mild head injury. Journal of Neurology, Neurosurgery & Psychiatry, 75(12), 1787-1788.Kwan, I., Bunn, F., & Roberts, I. (2005). Spinal immobilization: a systematic review of randomized trials on healthy subjects. Cochrane Database of Systematic Reviews, 2.Lomoschitz, F. M., Blackmore, C. C., Mirza, S. K., & Mann, F. A. (2002). Cervical Spine Injuries in Patients 65 Years Old and Older: Epidemiologic Analysis Regarding the Effects of Age and Injury Mechanism on Distribution, Type, and Stability of Injuries. American. Journal of Roentgenlogy, 178(3), 573-577.Madigan,K., & Proehl, J.A.( 2004). Procedure 115: Spinal immobilization. In. J.A. Proehl, Emergency Nursing Procedures. (3rd Ed). pp.528-533. St. Louis, Missouri: Saunders. Mina, A. A., Bair, H. A., Howells, G. A., & Bendick, P. J. (2003). Complications of preinjury warfarin use in the trauma patient. Journal of Trauma, Injury, Infection & Critical Care 54(5), 842-847. National Quality Forum. (2004). National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set. Washington, D.C, Author. p. A-3National Institute for Clinical Excellence (NICE). (2003, June 2003). Head Injury: triage, assessment, investigation and early management of head injury in infants, children and adults. Retrieved May 20, 2005, from http://www.nice.org.uk/page.aspx?o=56817.Ohm, C., Mina, A., Howells, G., Bair, H., & Bendick, P. (2005). Effects of antiplatelet agents on outcomes for elderly patients with traumatic intracranial hemorrhage. Journal of Trauma, Injury, Infection & Critical Care. 58(3), 518-522.Perry, A.G. & Potter, P.A. (2004) Clinical Nursing Skills & Techniques. 5th Ed. (p. 1096). St. Louis: Mosby. Rechtine, G. R., Del Rossi, G., Conrad, B. P., & Horodyski, M. (2004). Motion generated in the unstable spine during hospital bed transfers. J Trauma, Injury, Infection and Critical Care. 57(3), 609-611; discussion 611-602.Reynolds, F. D., Dietz, P. A., Higgins, D., & Whitaker, T. S. (2003). Time to deterioration of the elderly, anticoagulated, minor head injury patient who presents without evidence of neurologic abnormality. Journal of Trauma, Injury, Infection and Critical Care. 54(3), 492-496.Spektor, S., Agus, S., Merkin, V., & Constantini, S. (2003). Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study. Journal of Neurosurgery, 99(4), 661-665.Tideiksaar, R. (1998). Falls in Older Persons: Prevention & Management. 2nd Ed. Baltimore, MD: Health Professions Press. Walters, B. C., & Hadley, M. N. (2003). Development of evidence-based guidelines for the management of acute spine and spinal cord injuries. Clinical Neurosurgery, 50, 239-248.
Repository Posting Date:
28-Oct-2011
Date of Publication:
28-Oct-2011
Conference Date:
2006
Conference Name:
ANCC National Magnet Conference
Conference Host:
American Nurses Credentialing Center
Conference Location:
Denver, Colorado, USA
Description:
10th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 4-6 October, 2006 at the Colorado Convention Center in Denver, Colorado, USA.
Note:
This is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.

Full metadata record

DC FieldValue Language
dc.type.categoryAbstracten_US
dc.typePresentationen_GB
dc.titleDesigning a Proactive Post-Fall Care Policyen_GB
dc.contributor.authorHook, Maryen_US
dc.contributor.authorWinchell, Shanaen_US
dc.contributor.authorZweig, Fayeen_US
dc.author.detailsMary Hook, MS, APRN, BC, Aurora Health Care, West Allis, Wisconsin, USA, email: mary.hook@aurora.org; Shana Winchell, BSN, RN, BC; Faye Zwieg, MBA, RNen_US
dc.identifier.urihttp://hdl.handle.net/10755/182927-
dc.description.abstractPoster Presentation: Background/Significance: Prevention of falls for hospitalized patients is critical; however, some patients fall despite intensive efforts. Serious consequences may result. Purpose of the Project: A shared-governance workgroup was convened to review current evidence on post-fall care and create tools to support nursing practice. Method: Workgroup members reviewed incident case reports over the past year from a large, tertiary care facility. The group determined that standards were needed to guide the direct care staff in conducting post-fall assessments and implementing immediate and ongoing interventions to reduce adverse outcomes. Method: Multidisciplinary evidence was reviewed, summarized and used to create and implement a new policy and procedure to enhance collaboration between nurses, physicians, radiology, and quality management. Findings: Key policy and procedure steps include: Conducting a comprehensive post-fall assessment; Applying cervical spine immobilization for symptomatic patients prior to moving; Reviewing patient history for presence of factors that increase the risk for injury including osteoporosis, bleeding disorders or the use of anticoagulation or anti-platelet medication; Reporting events, assessments and injury risk factors to physicians to facilitate urgent diagnostic testing and treatment; Conducting ongoing post-fall assessment based on level of risk for injury; Embedding forms in the computerized medical record to support decision-making and documentation; and Implementing individualized patient plans to prevent recurrent falls. Conclusion: An evidence-based policy can support nurses in developing the skills and knowledge to partner with medical staff in aggressively assessing and intervening after a fall to minimize complications and prevent recurrence. References: Bond, A. J., Molnar, F. J., Li, M., Mackey, M., & Man-Son-Hing, M. (2005). The risk of hemorrhagic complications in hospital in-patients who fall while receiving antithrombotic therapy. Thrombosis Journal, 3(1), 1. Bub, L. D., Blackmore, C. C., Mann, F. A., & Lomoschitz, F. M. (2005). Cervical spine fractures in patients 65yrs & older: a clinical prediction rule for blunt trauma. Radiology, 234(1), 143-149.Center for Disease Control (CDC). (2004). Traumatic Brain Injury Fact Sheet. Retrieved May 29, 2005, from http://www.cdc.gov/Migrated_Content/Fact_Sheet/Freeform_Fact_Sheet_(General)/Traumatic_Brain_Injury_updated_May_2004.pdf Eastern Association for the Surgery of Trauma (EAST). (2000). Determination of cervical spine stability in trauma patients (Update of 1997 EAST cervical spine clearance document). Retrieved May 15, 2005, from http://www.guideline.gov/summary/summary.aspx?doc_id=2623&nbr=1849Fabbri, A., Vandelli, A., Servadei, F., & Marchesini, G. (2004). Coagulopathy and NICE recommendations for patients with mild head injury. Journal of Neurology, Neurosurgery & Psychiatry, 75(12), 1787-1788.Kwan, I., Bunn, F., & Roberts, I. (2005). Spinal immobilization: a systematic review of randomized trials on healthy subjects. Cochrane Database of Systematic Reviews, 2.Lomoschitz, F. M., Blackmore, C. C., Mirza, S. K., & Mann, F. A. (2002). Cervical Spine Injuries in Patients 65 Years Old and Older: Epidemiologic Analysis Regarding the Effects of Age and Injury Mechanism on Distribution, Type, and Stability of Injuries. American. Journal of Roentgenlogy, 178(3), 573-577.Madigan,K., & Proehl, J.A.( 2004). Procedure 115: Spinal immobilization. In. J.A. Proehl, Emergency Nursing Procedures. (3rd Ed). pp.528-533. St. Louis, Missouri: Saunders. Mina, A. A., Bair, H. A., Howells, G. A., & Bendick, P. J. (2003). Complications of preinjury warfarin use in the trauma patient. Journal of Trauma, Injury, Infection & Critical Care 54(5), 842-847. National Quality Forum. (2004). National Voluntary Consensus Standards for Nursing-Sensitive Care: An Initial Performance Measure Set. Washington, D.C, Author. p. A-3National Institute for Clinical Excellence (NICE). (2003, June 2003). Head Injury: triage, assessment, investigation and early management of head injury in infants, children and adults. Retrieved May 20, 2005, from http://www.nice.org.uk/page.aspx?o=56817.Ohm, C., Mina, A., Howells, G., Bair, H., & Bendick, P. (2005). Effects of antiplatelet agents on outcomes for elderly patients with traumatic intracranial hemorrhage. Journal of Trauma, Injury, Infection & Critical Care. 58(3), 518-522.Perry, A.G. & Potter, P.A. (2004) Clinical Nursing Skills & Techniques. 5th Ed. (p. 1096). St. Louis: Mosby. Rechtine, G. R., Del Rossi, G., Conrad, B. P., & Horodyski, M. (2004). Motion generated in the unstable spine during hospital bed transfers. J Trauma, Injury, Infection and Critical Care. 57(3), 609-611; discussion 611-602.Reynolds, F. D., Dietz, P. A., Higgins, D., & Whitaker, T. S. (2003). Time to deterioration of the elderly, anticoagulated, minor head injury patient who presents without evidence of neurologic abnormality. Journal of Trauma, Injury, Infection and Critical Care. 54(3), 492-496.Spektor, S., Agus, S., Merkin, V., & Constantini, S. (2003). Low-dose aspirin prophylaxis and risk of intracranial hemorrhage in patients older than 60 years of age with mild or moderate head injury: a prospective study. Journal of Neurosurgery, 99(4), 661-665.Tideiksaar, R. (1998). Falls in Older Persons: Prevention & Management. 2nd Ed. Baltimore, MD: Health Professions Press. Walters, B. C., & Hadley, M. N. (2003). Development of evidence-based guidelines for the management of acute spine and spinal cord injuries. Clinical Neurosurgery, 50, 239-248.en_GB
dc.date.available2011-10-28T15:46:23Z-
dc.date.issued2011-10-28en_GB
dc.date.accessioned2011-10-28T15:46:23Z-
dc.conference.date2006en_US
dc.conference.nameANCC National Magnet Conferenceen_US
dc.conference.hostAmerican Nurses Credentialing Centeren_US
dc.conference.locationDenver, Colorado, USAen_US
dc.description10th American Nurses Credentialing Center (ANCC) National Magnet Conference, held 4-6 October, 2006 at the Colorado Convention Center in Denver, Colorado, USA.en_US
dc.description.noteThis is an abstract-only submission. If the author has submitted a full-text item based on this abstract, you may find it by browsing the Virginia Henderson Global Nursing e-Repository by author. If author contact information is available in this abstract, please feel free to contact him or her with your queries regarding this submission. Alternatively, please contact the conference host, journal, or publisher (according to the circumstance) for further details regarding this item. If a citation is listed in this record, the item has been published and is available via open-access avenues or a journal/database subscription. Contact your library for assistance in obtaining the as-published article.-
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