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After discussion with your preceptor, name one financial aspect, one quality aspect, and one clinical aspect that need to be taken into account for developing the evidence-based change proposal. Explain how your proposal will directly and indirectly impact each of the aspects.


(Eliz ID 5/16)

To provide high-quality healthcare service to Elderly patients at risk of Fall, health professionals need to be equipped with the knowledge and skills that will help them undertake this challenging task. With the current economic constraints on healthcare budgets, care providers face an important challenge to ensure their practices are cost-effective and, in particular, that they use clinically efficient products. Advanced technology devices, such as video monitors, have been proven cost-effective. Hourly rounding and bed/chair alarms can reduce the risk of falls. The higher costs of video monitors are offset by a faster detection of falls, resulting in a shortened hospital stay and a reduction of the expenses associated with nurse time. Briggs and Steele (2007) concluded that video monitoring would improve outcomes, lower legal costs, improve patient satisfaction, and save direct money. Side rails, using skid socks, and adequate lighting could reduce the expenses associated with Falls. 

When I discussed with my mentor one financial aspect is about purchasing the devices, Video monitoring, they were thinking about how many to buy and the durability. My mentor went in search of the device, learned more about it, and weighed the advantages and the disadvantages of this device, and she was convinced and able to convince the board of directors. Since there are not many patients and the time usage of the device at a time is not long, they consider buying a few numbers of the device since all the patients may not be susceptible to falls at the same time. Other treatment methods suggested that are not expensive are also getting a sitter. There is some sitter who sleeps or press phones instead of watching the patient. Falls in the acute care setting gives rise to additional morbidities related to psychosocial trauma and increase mortality risk for older adults (Tideiksaar 2010). I remember one of my shifts that an 85-year-old female patient fell even when there was a sitter. Eventually, we got to know that the sitter was fast asleep while in patient room, and the patient stood up to use the bathroom; then she slipped and fell, hitting her head and eventually having surgery done for broken bones. Over 300,000 elderly individuals suffer hip bone fractures annually due to frequent falls (Vaishya & Vaish, 2020). Women are more prone to falling than men (Lorentzon et al., 2022). Educating all sitters on patient care is very important and also being vigilant because some patients are just so fast in action.

One quality aspect is that it gives the patient back their quality of life, which gives joy to the patient and the family and increases their self-esteem and satisfaction. At least it serves as a solution to their pending problems. Improving patient outcomes and satisfaction will also redeem the image of the health care setting, and build confidence in their customers, thereby increasing the number of patients and boosting the ego and finances of the organization. Falls that happen in hospitals are associated with an increased length of stay and the use of health resources (Morello et al., 2015), (Hill et al., 2007).




Morello RT, Barker AL, Watts JJ, Haines T, Zavarsek SS, Hill KD, et al. The extra resource burden of in-hospital falls: a cost of falls study. Med J Aust. 2015; 203(9): 367e1-e8. Available from: 


Hill KD, Vu M, Walsh W. Falls in the acute hospital setting –impact on resource utilization. Aust Health Rev. 2007; 31(3):471–77