Development of Clinical Nursing Practice Guideline for Fall Prevention and Fall Management in Older Patients with Visual Impairment, Eye Unit, Khon Kaen Hospital

Abstract

Falls among hospitalized older patients with visual impaired were important problem, lead to injury, delayed recovery, increased morbidity & mortality and implicated to quality of nursing service. This independent study aimed to develop CNPG for fall prevention and fall management in older patients with visual impairment based on The Center for Advanced Nursing Practice Evidence-Based Practice Model (Soukup, 2000)  which consisted of  1) Evidence-trigger phase  2) Evidenced-supported phase   3) Evidence-observed phase and   4) Evidence-based phase. From 13 evidences to developed CNPG  there  were 5 CPGs, 2 systematic reviews,  3 RCTs, 1 quasi-experimental design, 1 operational study and 1 article, which included fall risk assessment and identified risk, education, safety environment, review medication, foot wear, targeted risk factor prevention, fall management and communication & documentation. Validation and quality evaluated by 5 experts and 7 nurses in Eye unit that was feasibility and appropriated implementation. The result of pilot study in 30 older patients and 7 nurses in Eye unit were no incident of falls, older patients and families and staffs were satisfied and all staff can provide for effective to reduce fall. CNPG was the standard for fall prevention in Eye unit. Further  suggestion that utilize and study outcome of CNPG in other conditions and long LOS.