A Care Management Model to Prevent Falls among Patients with Disabilities in a Ward at the Veterans General Hospital
Keywords:
Care Management Model, Fall Prevention, Patients with DisabilitiesAbstract
This research and development aimed: 1) to create a model of care management to prevent falls of patients with disabilities in a ward at the Veterans General Hospital, 2) to study the rate of falls after using the new model, and 3) to study the satisfaction of professional nurses towards new model of care management. Research was divided in two phases. Phase 1 was dedicated to creating a care management model to prevent falls of patients with disabilities in the ward, using the 3C-PDCA concept, including 5 steps: a) 3C analysis, b) planning, c) practice, d) inspection and e) improvement. A multidisciplinary team of doctors and professional nurses were selected as key informants for participating in a focus group. Phase 2 was dedicated to effectively using the care management model. The sample group comprised 12 professional nurses. The instruments for this research and development were: 1) several group discussion topics, 2) a fall-risk assessment form for patient with disabilities, and 3) a satisfaction assessment form for professional nurses. Content validity value of instruments was between 0.6 - 1.00. Data were analyzed by using statistic development, content analysis and Chi-square test. The results revealed as follows.
1. The format of model consisted of: 1) a physical examination and assessment of disable patients' condition, 2) identification of patients and risk-factors assessment for falls for each, 3) the implementation or care as planned, 4) the monitoring and evaluation and, finally, 5) promoting the model in terms of policy.
2. The results showed that: 1) rate of falls after using the model was significantly reduced, at the .001 level, 2) satisfaction of professional nurses after using the model was at the highest level (M = 4.88, SD = 0.18).
Therefore, this model can be used in hospital wards with similar context in order to prevent fall of patient with disabilities.
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