DNP 805 Case Report: Health Care Informatics

DNP 805 Case Report: Health Care Informatics

DNP 805 Case Report: Health Care Informatics

The current health care system is characterized by massive utilization of technology to help in improving the quality of life by lessening recovery time in patient and help them to enjoy a healthy life. Consequently, in the recent years, several technology-based applications have been extensively used to help in preventing the fall incidences among the older adults in acute care settings. Essentially, falls among the older adults are associated with primary sources of disability and deaths. Falls have adversely affected many patients aged 65 years and above who are admitted in acute care inpatients (Matarese et al., 2015). Besides, falls in these settings are attributed to other factors such as medication side effects, polypharmacy, and acute diseases. Therefore, the aim of this paper is to explore how technology can be used to prevent the issue of falls among the elderly inpatients in acute care settings. In particular, the paper will delve into the virtual monitoring technology which comprises fall detection devices, in particular alarms.

Literature Review

A fall refers to accidental descent to the ground with or no injury to the patient (Toren & Lipschuetz, 2017). With the growing ageing population, the incidences of fall among the elderly people aged 65 years and above is increasing rapidly, causing a great public health problem not only in the US but also globally. The NCOA (2020) claim that falls are the major reasons for both fatal and non-fatal injuries in the older adults in the United States, which has compromised their independence and safety, including being associated with considerable personal and economic burdens. A similar argument is also advanced by Toren and Lipschuetz (2017) who claim that falls are primary causes of injuries that lead to pain, emotional distress, reduced quality of life, increased hospitalization days, loss of independence, and high morbidity and mortality rates. According to NCOA (2020), one in four elderly Americans fall annually. Besides, in every 11 seconds, at least one older person is admitted at the emergency room because of fall. Moreover, in every 19 minutes, an elderly person dies due to fall related issues. Generally, around 2.8 million fall related injuries are treated annually, with estimated 800,000 hospitalizations and 27,000 fatalities (NCOA, 2020).  Besides, Toren and Lipschuetz (2017) project that by the year 2015, falls in older adults will reach 1.2 billion globally.

Falls in elderly persons in acute care settings are caused by various factors such as surgery, diagnostic testing conditions, and medications conditions which results in confusion or body weakness in patients (Galet, Zhou, Ten Eyck & Romanowski, 2018). These factors hamper functional autonomy leading to falls. As a result, older adults suffer poor functional outcomes and low quality of life. Owing to the adverse consequences, nursing interventions such as installation of bed alarms have been used to help in preventing the incidences of fall.

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Case Description

The identified case is a situation where a 76-year-old male patient was admitted at the acute care setting for spinal surgery. Although the surgery was successful, the patient seemed disoriented and confused. The circumstance of the fall was elimination related since the patient slipped while trying to get out of the bed. Since the patient was disoriented, he could not tell what he wanted making it difficult for health care providers to provide the right intervention.

Proposed Technology

Although falls are likely to occur in older adults, it is imperative to put measures in place to prevent falls and

DNP 805 Case Report Health Care Informatics
DNP 805 Case Report Health Care Informatics

related injuries. Today, technologies are increasingly being used to prevent fall and reassure individuals who face possible falls, their family, and care givers.  Besides, these technologies are also critical for clinicians to understand when a patient experiences a fall, circumstances of the fall, and offer enabling opportunity for better treatment. One of the ways to prevent falls include use of personal emergency response systems (PERS) (Chaudhuri, Thompson & Demiris, 2014). PERS connote clinical alarm systems that are used to contact the emergency center. This fall detection technology is crucial in enabling quick detection and intervention for patients who experiences fall.

How to Use Technology in the Present Case

In the above illustrated case scenario, the use of bedside alarm connotes a smart technology that can detect fall in real time. The clinical alarm systems work by offering the patient an opportunity to contact the emergency center by pressing the button located within the reach of the patient, mostly on the bedside. Besides, the alarm system tends to be activated in cases where the patient changes position, moves, or getting out of the bed. Therefore, in the present case, the fall would have been prevented if the alarm system was installed on the patient’s bed to notify the nurses on duty possible movement or changing of position of the patient to enable them attend to the patient promptly before falling (Chaudhuri, Thompson & Demiris, 2014).

Summary of The Case Integrating Christian Worldview

However, despite the effectiveness of alarm system in fall prevention, the system may not be suitable where the patient cannot reach the button or is unconscious. Therefore, as a Christian who intends to do everything for positive patient outcomes, it is imperative to include other solutions. These solutions may include passive monitoring solutions such as wristwatch to be worn by patient, having cameras or microphones to help in further detection of fall.

Conclusion

Falls among the older adults in acute care settings are associated with significant dire impacts on health and economic burden. However, despite the massive effort by the health care industry players to prevent the incidence, the success has been minimal. Therefore, it is vital to change the approach of tackling falls in the current society. It is against this backdrop that a customized approach of using alarm system to prevent falls was proposed. However, it has been established that alarms are not effective when used independently, especially where the patient is unconscious or the device is out of reach. Therefore, other options should be used alongside the alarm systems.

 

 

References

Chaudhuri, S., Thompson, H., & Demiris, G. (2014). Fall detection devices and their use with older adults: a systematic review. Journal of geriatric physical therapy (2001), 37(4), 178.

Galet, C., Zhou, Y., Ten Eyck, P., & Romanowski, K. S. (2018). Fall injuries, associated deaths, and 30-day readmission for subsequent falls are increasing in the elderly US population: a query of the WHO mortality database and National Readmission Database from 2010 to 2014. Clinical epidemiology, 10, 1627.

Matarese, M., Ivziku, D., Bartolozzi, F., Piredda, M., & De Marinis, M. G. (2015). Systematic review of fall risk screening tools for older patients in acute hospitals. Journal of advanced nursing, 71(6), 1198-1209.

National Council on aging (NCOA). (2020). Falls Prevention Facts. NCOA. Retrieved 30 March 2020, from https://www.ncoa.org/news/resources-for-reporters/get-the-facts/falls-prevention-facts/.

Toren, O., & Lipschuetz, M. (2017). Falls prevention in hospitals-the need for a new approach an integrative article. Nurse Care Open Acces J, 2(3), 93-96.