Nursing and ancillary support staff of a primary care clinic

PICOT: For the nursing and ancillary support staff of a primary care clinic (P), how does the fall risk management protocol (I) compare to current practice (C) affect fall rate (O) over 12 weeks (T)?
Brief Summary: Falls among older adults are a health concern that can have profound physical, psychological, and social implications. As the global population ages, addressing this issue becomes imperative to ensure the well-being and independence of older individuals (Arkkukangas et al., 2021). Fall rates have emerged as a concern within the primary care clinic. The present fall rate of our clinic is noted to be elevated at around 3 to 5 falls per month, the national rate is estimated at 700,000 to 1 million annual falls each year, contributing to a considerable proportion of adverse events and injuries. The healthcare expenses associated with falls impose a potentially financially burdensome amount on the clinic and patients, Medicare, for instance, expended approximately $28.9 billion in 2015 on medical expenses linked to nonfatal falls in the elderly. Falls can potentially undermine the reputation and diminish patient satisfaction with a healthcare facility (Elrod et al., 2023). In response to this matter, a proposed intervention involving the implementation of an evidence-based protocol for managing fall risks will be undertaken to effectively mitigate fall rates within the primary care context.
Primary Objective: To reduce to zero the incidence of falls within the primary care setting.
Secondary Objective:

Enhance staff compliance with falls assessment and reassessment.

Improve communication and reporting among healthcare professionals.

Actively engage the patient in the fall prevention protocol, fostering their awareness and commitment to reducing the risk of falls and thereby enhancing their safety and overall well-being.
Proposed Evidence-based Intervention(s):

Implementation of fall risk management protocol based on findings from Abd et al. (2022).

Development of interprofessional communication strategies informed by Brach et al. (2021).

Patient and family education on fall prevention strategies inspired by Choi et al. (2019).

Sample Answer

The fall risk management protocol (I) compared to current practice (C) can affect the fall rate (O) over 12 weeks (T) in a primary care clinic (P) in the following ways:

Improved fall risk assessment and identification: The fall risk management protocol includes a more comprehensive fall risk assessment tool that identifies patients who are at high risk of falling. This tool considers factors such as age, medical history, medications, and functional status. As a result, more patients who are at risk of falling are identified and can be targeted for interventions.

Full Answer Section

Increased staff compliance with fall prevention measures: The fall risk management protocol includes clear and concise instructions for staff on how to prevent falls. This includes measures such as providing assistive devices, ensuring that the environment is safe, and monitoring patients for signs of falls. As a result, staff are more likely to comply with fall prevention measures, which can reduce the number of falls.
Improved communication and reporting: The fall risk management protocol includes a system for communicating and reporting falls. This system ensures that all falls are reported to the appropriate staff, and that steps are taken to prevent future falls. As a result, falls are more likely to be prevented from happening again.
Active patient engagement: The fall risk management protocol includes measures to actively engage patients in fall prevention. This includes educating patients about fall risks and prevention measures, and providing them with opportunities to participate in fall prevention activities. As a result, patients are more likely to take steps to prevent falls.

Overall, the fall risk management protocol can be effective in reducing the fall rate in a primary care clinic. However, it is important to note that the effectiveness of the protocol will depend on the specific implementation of the protocol and the commitment of staff and patients to fall prevention.

Here are some additional details about each of the points above:

Improved fall risk assessment and identification: The fall risk assessment tool used in the fall risk management protocol is more comprehensive than the tool used in current practice. This tool considers a wider range of factors that can increase the risk of falls, such as age, medical history, medications, and functional status. As a result, more patients who are at risk of falling are identified and can be targeted for interventions.
Increased staff compliance with fall prevention measures: The fall risk management protocol includes clear and concise instructions for staff on how to prevent falls. This includes measures such as providing assistive devices, ensuring that the environment is safe, and monitoring patients for signs of falls. These instructions are easy to understand and follow, which makes it more likely that staff will comply with them.
Improved communication and reporting: The fall risk management protocol includes a system for communicating and reporting falls. This system ensures that all falls are reported to the appropriate staff, and that steps are taken to prevent future falls. This system is easy to use and efficient, which makes it more likely that falls will be reported and prevented.
Active patient engagement: The fall risk management protocol includes measures to actively engage patients in fall prevention. This includes educating patients about fall risks and prevention measures, and providing them with opportunities to participate in fall prevention activities. These measures help to ensure that patients are aware of the risks of falling and are taking steps to prevent them.

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