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<p> Falls are a serious issue for the elderly living in long-term care facilities, as falls contribute to significant health problems such as increased dependence, loss of autonomy, confusion, immobilization, depression, restriction in daily activities, and, in some cases, death. An estimated 424,000 fatal falls in elderly patients residing in long-term facilities occur annually in the United States costing $34 billion in direct medical costs. One way to reduce falls among elderly patients in long-term care is to assess for fall risk frequently and implement evidence-based strategies to prevent falls. Patients in this project site facility had been assessed for fall risk via the Briggs Fall Risk Assessment Tool with implementation of fall risk iinterventions only upon admission or when there was a fall. The purpose of this project was to assess whether changing to weekly use of the Briggs Fall Risk Assessment Tool with implementation of fall risk interventions by nursing staff could decrease fall rates in the elderly in long-term care in Harris County, Texas. The model of prevention served as the conceptual framework for this project. Thirty participants (20 females and 10 males) between the ages of 65-115 participated in the program. Pre-implementation data were collected for 1 month and post-implementation data were collected for 1 month. The total number of falls reported weekly was counted before and after the weekly implementation of the Briggs Fall Risk Assessment Tool. The number of falls decreased from 12(70.6%) before the implementation of the assessment tool to 5(29.4%) falls afterwards. A fall prevention program in long-term care may affect social change positively by reducing fall risk in long term care by reinforcing the importance of increased awareness of risk of falls to implement fall prevention strategies</p>

<p> The goal of the project was to implement best-practice guidelines for adults with heart failure (HF) receiving home care. Heart failure is incurable, but can be managed when healthcare providers use evidence-based treatment guidelines and patients comply with routine follow-up and practice a healthy lifestyle. Providing access to care for the elderly in the form of a structured telephone call program to monitor self-care efficacy related to adherence to medication and other treatments and therapies is associated with reduced HF symptoms and improved quality of life. This project implemented a phone call follow-up program to evaluate and improve self-care efficacy in adults with heart failure by monitoring compliance, providing education, and focusing on key indicators of HF symptom exacerbation. The Self-Care of Heart Failure Index (SCHFI) was used in weekly phone calls for a total of 10 weeks. Using the SCHFI tool provided structure and included key best practice content areas with scripting to enhance consistency. The project participants were adults age > 65 year old patients receiving care through a home health care team in central Louisiana who had an established diagnosis of heart failure. </p>

<p>Abstract The aim of this quality improvement (QI) project was to explore whether the implementation of an enhanced telephone reminder system improved the rate of attendance at initial follow-up appointment and medication adherence. A total of 86 patients, discharged from inpatient psychiatric units with a follow-up within 7 days of discharge, were eligible to receive the enhanced telephone contact reminder and follow-up text. A preliminary retrospective chart review was conducted to collect historical data on medication and attendance adherence. A prospective interventional design was used to implement the QI project. Patients received telephone contact within 24-72 hours of discharge and text message reminder strategies. A medication adherence assessment was completed at telephone contact and at initial follow-up appointment. An analysis of the data examined the impact of the TCM strategy on patient?s rate of adherence to medication and initial follow-up appointments. Descriptive analysis assessed the frequency of medication adherence in retrospective and implementation data. Inferential statistics analyzed factors of association such as prior clinic services and rate of attendance at follow-up appointment. In the retrospective chart review (n=57), data revealed a 28% attendance rate and an 81% medication adherence at the follow-up appointment, with no statistical difference in a 145 history of prior series on attendance. Implementation data on medication adherence at telephone contact and at first follow-up appointment revealed a 61.5% medication adherence rate at telephone contact and 80% adherence rate at first follow-up appointment. The predictor value of a prior history of service on attendance at first follow-up appointment revealed no statistically significant difference. The project, however, resulted in clinically significant benefits that promoted individual patients? medication-taking behaviors and decisions to attend follow-up appointments, and improved clinical practices at the BHC.

<p> <b>Rationale/Background:</b> Fall prevention is a paramount and lifesaving healthcare initiative. The investigation of interventions for the prevention of falls may lead to a decrease in injuries and promotion of superlative care for patients hospitalized in an acute healthcare environment. </p><p> <b>Purpose: </b>The purpose of this quantitative correlational direct practice improvement (DPI) project is to determine the relationship between the implementation of a fall prevention training program and changes in fall rates over a period over three months. </p><p> <b>Theoretical Framework:</b> The Neuman system model served as the theoretical foundation for this project. The model presents a holistic approach to patient at-risk for falling and guides bedside nursing care, assess stressors, safety needs, and environmental factors suggest potential indicators linked to fall-risk patients. </p><p> <b>Project Method and Design:</b> A quantitative method and correlational design was used to investigate the impact of the intervention. The intervention involved training for a total 28 nurses (N = 28) on two wards. The final data collection included fall rates for 56-patients (N = 56). </p><p> <b>Data Results:</b> The control ward had a fall rate of nearly twice as high than the ward who received the intervention. There is a statistically significant reduction in fall rates on the intervention ward (p = 0.04). </p><p> <b>Implications:</b> Based on the findings of this project, a fall education training program supported safety through a reduction of falls. The training program was adopted as a part of standard education for the site. </p><p>

<p> A nursing shortage has resulted in hospitals seeking ways to meet their staffing needs. One strategy is the use of travel nurses (travelers) employed by staffing agencies. Hospitals are challenged with providing travelers an adequate orientation to assure their patients receive safe care while placing the travelers where they are urgently needed&mdash;at the bedside. The goals of this project are to identify best practices to provide a quality orientation and to propose an orientation program. To address these goals, pertinent literature has been reviewed, and input from travelers has been examined. As a result, an orientation program has been developed with a module for travelers to review prior to their assignments. An onsite orientation program follows with one day of didactic training and two shifts with a preceptor at the bedside. The recommendation is that organizations use the proposed program as a template when developing their orientation programs.</p>

Thesis (MHSc--Health Science) -- Auckland University of Technology, 2005. / Also held in print (145 leaves, 30 cm.) in Akoranga Theses Collection (T 616.0250231 GAB)

Thesis (Ph. D.)--University of Washington, 1990. / Vita. Includes bibliographical references (leaves [206]-218).

Thesis (M.S.)--University of Michigan, 1982. / "A research report submitted in partial fulfillment of the requirements for the degree ..."

Thesis (Ph. D.)--University of Wisconsin--Madison, 1980. / Typescript. Vita. eContent provider-neutral record in process. Description based on print version record. Includes bibliographical references (leaves 257-265).