As an LTC nurse, I am familiar with the issues associated with residents/patients falling and fracturing bones, especially their hips. Falling is a painful and humiliating experience, especially for elderly patients. After suffering a fall in an LTC setting, patients may experience a decline in their quality of life. Kaasalainen, Papaioannou, Burgess, and Van der Horst (2015) state fractures can be a significant source of pain, anxiety, agitation, depression, disability, and decreased pulmonary function. Also, fracture rates are four to eight times higher in an LTC setting than in any other medical setting (Kaasalainen et al., 2015). In a mixed method study conducted on managing falls in an LTC setting, Kaasalainen et al. (2015), states NPs reported they overly familiar with caring for patients who received a fracture while in an LTC setting. NPs in this study also report, they have participated in multiple fall reduction initiatives (Kaasalainen et al., 2015). I believe NPs set the tone and expectations for nursing staff. NPs can assist nurses with applying learned fall prevention techniques, taking risk assessments, implementing balance and strengthening exercises, and ensuring all patients have taken an adequate amount of calcium and vitamin D.
NPs can also integrate new information and practices that will benefit existing fall prevention practices. Harrison (2017), states two primary reasons the NPs contribution to fall prevention strategies in an LTC setting are necessary: NPs have the clinical knowledge and skills to establish and lead fall prevention programs in community and LTC settings; FNPs are qualified to teach evidence-based education courses on fall risk factors. The stakeholders impacted most by my concern are patients and families, along with FNP nurses and nursing leaders who practice in LTC settings. Additional impacted stakeholders include nursing administrators, scientific and nursing researchers, physicians, nursing instructors, legislative bodies who create LTC laws, nursing professional associations, and nursing accrediting agencies.
Each of these stakeholders are responsible for promoting LTC patient care and ensuring that a high quality of care is provided to patients. The consequences of not utilizing or introducing LTC evidence-based data in an LTC setting is that it hinders or limits the treatment options provided to FNPs nurses. Another negative result is that it delays the advancement of the LTC and causes traditional LTC nursing treatment methods to become outdated instead of expanding upon them. My proposed solution is to advocate for evidence-based practice LTC methods to be implemented in LTC settings and within the classroom.
Purpose Statement
The purpose of this qualitative study is to determine FNPs clinical experiences in providing EBP centered care to patients who have fractured bones in an LTC setting. The goal is to take the information gathered and use it to create fall prevention programs and/or implement fall prevention strategies, which raises patient safety and satisfaction and lessens LTC malpractice and negligence suits.
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