12000814 Serrano, Jumer

Question 4
1. Fall
It is defined as an individuals move toward to place on the floor or
other lower level; occasionally a body part hits against an object that
stops them from falling. People do not fall because they become older
and falls do not just happen without any reason. Frequently, there are risk
factors or primary cause involved in it. Some incident of falls is related to
individuals medical problem or health condition, such as chronic diseases.
Other reasons may be due to safety hazards in the facility or community
environment.(Merck Manual, 2015)
The Kindly Residential Care Rest Home focuses on reducing or
preventing the incident of possible falls and other injuries that related to
fall and its complications while keeping the patients independence and
function as much as possible.
Effects
Many people especially elderly adult have had an incident of fall
that resulting in an injury. However, some of the elderly encounter severe
injury from falls causes them hospitalisation and sometimes death. Even if
there is no injury happened physically, a fall can cause loss of confidence
and independence, unwillingness to perform task and be afraid of falls to
happen again.

Management
1. Kindly Residential Care Rest home will evaluate patient after the
incident of fall to address and recognize risk factors and to deal with
the primary health conditions.
2. Staff training about risk factors of fall and preventive measures in
Kindly Residential Care Rest home.
3. Making modifications in the Kindly Residential Care Rest home
environment to provide residents move safely and comfortably. Such
modification include placing handrails in the hallways, putting down
the height of the bed, installing grab bars and adding elevated toilet
seats.
4. Supplying Kindly Residential Care Rest home patients with hip pads
to avoid hip fracture if a fall happens.
5. Kindly Residential Care Rest home will implement programs that can
enhance walking ability, strength and balance among residents.
6. Studying the effects of prescribed medicines to evaluate their
possible benefits and risks to all the patients of Kindly Residential
Care Rest home.

2. Skin tears
These are wounds caused by friction or direct force and shear
causing the skin layers to separate, first defined by Payne and Martin in
1993. Skin tears are painful injury which can result in partial thickness
(separation of the epidermis from the dermis) or full thickness (separation
of the epidermis and dermis together from underlying structures).(Wounds
international, 2011)
Elderly are prone for suffering skin tears, along with those people
with a previous history of skin tears, lack of independence or bed ridden,
limitation in mobility, bruised skin, swelling of the skin, fluid volume deficit
and compromised nutrition that is why quality care should be provided to
all.
Effects
Most of the elderly are affected by this injury but it can be
prevented. Friction, direct force, shearing is the reason resulting to
separation of the skin layers. These skin damages are not serious enough
but are unappealing injuries, painful for the patient.
Management
1. Kindly Residential Care rest Home will implement an organized
protocol to prevent skin tear
2. Kindly Residential Care rest Home will make sure that those patient
at risk wear long trousers, long sleeves or high knee socks

3. Kindly Residential Care rest Home will ensure safe environment and
techniques in handling patient.
4. Kindly Residential Care rest Home will make sure that the patients
and their families are involve in prevention strategies
5. Kindly Residential Care rest Home will educate caregivers, nursing
staff and all healthcare worker to guarantee proper handling of
patients without causing skin tears in providing care
6. Kindly Residential Care rest Home consult a dietician to make sure
that the hydration and nutrition of all the patients are adequate
7. All staffs of Kindly Residential Care rest Home will make sure that
they apply hypoallergenic moisturizer to patients skin at least twice
a day to keep it well lubricated.
References
Centres for Disease Control and prevention. (2014). Falls in nursing
homes. Retrieved from
http://www.cdc.gov/HomeandRecreationalSafety/Falls/nursing.html
Merck Manual. (2015). Falls in the elderly. Retrieved from
http://www.merckmanuals.com/professional/geriatrics/falls_in_the_el
derly/falls_in_the_elderly.html
Wounds International. (2011). Skin tears made easy. Retrieved from
http://www.woundsinternational.com/pdf/content_10142.pdf