Falls Amongst Elderly People Aged 65 or Older Living in Long-term Care Facilities

Falls Prevention
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Abstract
This study recognizes that elderly patients living in long-term care facilities are still likely to endure challenges related to falls. The study aims at pointing out the likelihood of falls amongst elderly people aged 65 or older living in long-term care facilities, and the likely outcome of the implementation of the Agency for Healthcare Research and Quality (AHRQ) Morse Fall Risk scale compared to current practices on the fall rate over an eight-week period. The nursing model theory identified for the project is King’s Theory of Goal Attainment. The study identified elderly adults of 65 years or older living in long-term care facilities. The intervention strategy is the independent variable and the number of falls is the dependent variable. The data analysis will be conducted using regression analyses. The study will also offer recommendations based on the positive outcome of implementing the Agency for Healthcare Research and Quality (AHRQ) Morse Fall Risk scale in accordance with the Theory of Goal Attainment.
Case Report Background
Conflicting definitions of functional status provided by various professions make it difficult to establish a coherent definition. The lens through which one examines functional status has a significant impact on how it is characterized and assessed. Differentiating which aspects of functional ability are essential to nursing practice and proving the ways in which nurses may impact clients' functional statuses are two of nursing's problems. A party's capacity to partake in activities of daily life, for instance, feeding, showering, going to the toilet, mobility, and dressing, is the measure of functionality in several disciplines. With this perspective, physical capacities are directly related to functional status, as mediated by a disease's impacts on sensory processes like vision and touch. The social, cognitive, psychological, and spiritual aspects are often included in more complete interpretations of functional status.
Problem Statement
Patients unable to live independently because of chronic sickness, accident, or age advancement are cared for in long-term care institutions. Due to a variety of medical illnesses, generalized weakness, and a lack of awareness of their physical limitations, this population is already at a high risk of falling. According to estimates by The National Center for Patient Safety (2020), long-term care facilities have a national average fall rate of 2.74 to 5.48 falls in every 1000 patient days. In about 30 to 50 percent of inpatient falls, there is an injury that need care (The Joint Commission, 2019). A fall that causes an injury might have a negative impact on a patient's recovery. Lacerations, abrasions, fractures, and cerebral bleeding are some of the injuries caused by falls. (Burnett et al., 2018). The costs of treating falls-related injuries total $31 billion dollars each year. A hospitalization for a fall-related injury costs around $30,000 on average (CDC, 2019). According to The Joint Commission, mortality rates following a fall injury might be as high as 20-30 percent (2015). According to the CDC (2019), 20 percent of fatal falls occur in long-term care facilities. To address this problem, evidence-based approaches must be applied at this level of care.
The primary goal of nursing is to achieve positive patient outcomes. Nursing mission and vision are usually aligned with this primary objective (McEwan & Wills, 2021). King defines the patient as a social being with three basic needs: the need for health education (primary or preventive care), the need for continuing care (secondary or curative care), and the need for management care (tertiary care), especially when the patients can no longer help themselves. She describes health as being a part of a patient's life experiences, which include responding to external and internal demands by employing available resources (Kruglanski et al., 2018). The environment serves as a backdrop for human interaction. It encompasses both the internal environment, which converts energy to enable humans to adapt to changes in the external environment, and the external environment, which includes both informal and formal organizations. A nurse is considered to be a part of the patient's environment.
Nurses utilize their knowledge to examine patients and make diagnoses in the nurse-patient relationship. The nurse then designs an intervention plan to address the difficulties discovered during the exam and diagnosis. Following the development of a care plan, steps are made to assist the patient in achieving his or her health objectives. Finally, the nurse evaluates the patient to see if the goals were achieved (McEwan & Wills, 2021). In the healthcare business, the ultimate goal of the nurse-patient relationship is to support the patient in accomplishing his or her health goals. When using the nursing strategy indicated in Imogene King's Theory of Goal Attainment, a nurse can boost his or her efficacy when working with a client to attain the key nursing goals and eventually aid them.
It is critical to align the organizational goals to King's Theory of Goal Attainment if the nurses are to achieve positive outcomes in the long-term care facilities if they intend to prevent falls amongst patients aged 65 or older. The theory spells out the best approach to take when working towards a goal. The primary goal of the PICOT in this case is reducing or eliminating the challenges experienced by the identified group of patients (McEwan & Wills, 2021). The implementation of the Agency for Healthcare Research and Quality (AHRQ) Morse Fall Risk scale requires a strategy that must begin from the conception of the intervention strategy to the evaluation of the outcomes it may yield.
Purpose of the Project
The project aims at ascertaining the application of King's Theory of Goal Attainment in managing falls amongst patients aged 65 or older by applying the Agency for Healthcare Research and Quality (AHRQ) Morse Fall Risk scale over an eight-week period within a long-term care facility.
Literature Review
Background
To comprehend King's Theory of Goal Attainment, one must first comprehend her intellectual framework. In a 1968 study, King initially outlined her conceptual approach. In 1971, she published a book that was entitled "Toward a Theory of Nursing," which elaborated on the Theory of Goal Attainment (Swann et al., 2021). King's conceptual system was known by numerous names before she publicly described it in 1997, including the interactive systems approach, the open systems model, and the general systems framework. King's views on nursing theory were shaped by what she saw as a scarcity of theory within the profession (Swann et al., 2021). Nurse leaders, in her opinion, were more preoccupied with how the profession was performed rather than why it was conducted in that manner. Theory, according to King, may bridge this divide and reveal previously unknown aspects of the profession.
Review of the Literature
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