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Falls in Geriatric Patients at the Follow-up Care Department
CARDOVÁ, Lenka
This diploma thesis is dedicated to falls in geriatric patients in the aftercare department. Thesis Objectives: To carry out a complex analysis of multifactorial causes in chosen cases of geriatric patients that occured during hospitalization in a chosen aftercare workplace from 2020 through 2021 in Nemocnice České Budějovice, a.s. To carry out SWOT analysis of a chosen aftercare workplace in Nemocnice České Budějovice, a.s. with the objective to evaluate interventions used in preventing falls of patients hospitalized in the given workplace. Suggestion of recommendation to improve current practice of the chosen aftercare workplace in Nemocnice České Budějovice, a.s. in preventing falls in hospitalized patients. Methodology and Research File: To reach the objectives, three research questions were chosen. What are multifactorial causes of chosen cases of falls in geriatric patients in the chosen aftercare workplace? What interventions are used to prevent falls in geriatric patients in the chosen aftercare workplace? What interventions might improve current practice in preventing falls in hospitalized geriatric patients in the chosen aftercare workplace? To implement a survey, a qualitative research strategy was chosen. For case study purposes, the following data collection techniques were used - medical documentation content analysis, reporting adverse events, controlled documentation etc., semi-structured interviews with doctors in specific fall cases. In the following part of the survey, where we were finding out about the intervention used and intervention meant for improving the current practice in fall prevention, semi-structured interviews were carried out with doctors and nurses. Interviews with the nurses were completed by participant observations. Based on the survey results, a SWOT analysis was processed. The research file consisted of 14 chosen falls that happened in hospitalized geriatric patients in the aftercare department from 2020 through 2021, of 12 nurses working in the aftercare department, of 9 doctors that were informed of a fall. A deliberate choice of both nurses and doctros was used, the criterium for being included in the research file was the minimum of a year-long practice in the aftercare deparment. The obtained data was processed using the pen-and-paper method, open coding, and data was subsequently categorized and noted down into tables and schemes. Results: Complex analysis of multifactorial causes of chosen fall cases proved that falls happened due to internal as well as external factors. The risk of a fall was increased by the pateints´ age, morbidity, polypharmacotherapy, cognitive deficit, sarcopenia, fragility syndrome, instability, bed siderails lifted, and human resource failure. Based on the results, we carried out SWOT analysis and we suggested a recommendation to improve the current practice in the chosen aftercare workplace. Practice Recommendations: Based on the survey, we would recommend for a repetitive evaluation of the risk of patients falling to be carrried out. Another recommendation would be educating the nursing staff in the area of fall prevention, in the area of communicating with geriatric patients and patients suffering from dementia. Further on, we would recommend ensuring the use of suitable positioning aids and securing a movement-detection system inside the bed. Last but not least, we would recommend increasing numbers of nursing staff.
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