Assuntos
Doença Crônica/enfermagem , Assistência de Longa Duração/organização & administração , Cuidados de Enfermagem/organização & administração , Assistência Centrada no Paciente/organização & administração , Qualidade de Vida , Adulto , Idoso , Idoso de 80 Anos ou mais , Canadá , Comunicação , Comportamento Cooperativo , Feminino , Gastrostomia/reabilitação , Necessidades e Demandas de Serviços de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Relações Enfermeiro-Paciente , Reabilitação do Acidente Vascular Cerebral , Traqueostomia/reabilitação , Resultado do TratamentoRESUMO
Fall-related injuries are a particular concern within the elderly population, and trends toward an aging demographic will keep this issue at the forefront in health care. We are challenged to develop creative strategies to significantly reduce harm and fall rates among the elderly. This article describes the process of establishing an hourly rounding initiative in a health care facility. Hourly rounding is supported by the literature as an effective strategy for falls prevention and patient safety. When the initiative was not successfully adopted initially, the implementation process was critically examined and an innovative sustainability plan was developed to ensure that the change would be embedded in the organization's culture. Through this opportunity, nurses and allied health members from all levels were able to collaborate on strategies for this patient safety initiative.
Assuntos
Acidentes por Quedas/prevenção & controle , Recursos Humanos de Enfermagem Hospitalar , Segurança do Paciente , Acidentes por Quedas/estatística & dados numéricos , Protocolos Clínicos , Humanos , Avaliação em Enfermagem , Gestão da Segurança/organização & administraçãoRESUMO
At Deer Lodge Centre, oral care practice for adult dependent patients often included the use of sponge swabs and liquid mouth rinse, but the facility had no formal policy outlining best practice. The authors sought to develop such a policy by answering two main questions: Are sponge swabs effective in cleaning the oral cavity? What oral care is required for individuals with dysphagia and those who depend on others for oral care? After a review of the literature for pertinent guidance, a new protocol for oral care, based on tooth brushing and use of antibacterial gel, was implemented for one care unit. Patients showed improvements in oral health, specifically reductions in tartar, swollen and bleeding gums, ulcerations, debris and severe halitosis. Staff members were initially resistant to change, but resistance declined as they witnessed the benefits of tooth brushing. The use of sponge swabs also declined. This intervention confirmed that tooth brushing is appropriate as the gold standard of good oral care and showed that sponge swabs are ineffective for removing plaque. These principles have become the foundation of oral care policies and care plans at this facility.