ASSIGNMENT 4: Investigate clinical governance/practice issue (1200) words You are required to choose a nursing issue that is related to one of the key safety and quality in health care areas from the...

Fall prevention and Harm from falls in aged care/ nursing homes
Introduction
A major cause of injury and sometimes even death among the aged undergoing care in Australia is accidental falls (NSW Department of Health, 2011). It is known that loss of balance, weakness and trips among other reasons may result in easy falls in the elderly, especially elder women who are greatly prone to osteoporosis (Swanenburg, de Bruin, Uebelhart and Mulder, 2010). Falls can easily cause much damage from simple fractures to complex bone breaks like spine fractures or hip fractures (Prince et al, 2008). Falls are not only an object of concern when it comes to health care instead they are also a great financial burden to the health system according to the NSW Department of Health (2011).
The statistics related to falls is alarming with 32,000 cases of hospitalizations in 2009-2010 alone with cases on the increase with every passing year (NSW Department of Health, 2011). Various studies have undertaken to observe the incidence, cause and prevention measures of falls in the elderly due to the vitality of this issue. In order to analyse and conclude some relevant practices for clinical governance, this paper focuses on three studies that detail some observation and measures relating to falls in the aged under care.
The studies include one qualitative study that uses observational methods like video footage and observational data to draw conclusions about the circumstances of falls (Robinovitch et al., 2013). Only when the cause of falls is known can falls be prevented. The second study which is a literature review of the risk factors of falls among the elderly validates the findings of the first study (Ambrose, Paul and Hausdorff, 2013). The third study is a randomized controlled trial that studies the role of exercise in preventing falls providing a possible solution to reducing falls in the aged (Iwamoto et al., 2009).
Critical Appraisal
In order to evaluate the validity and quality of the three studies and their relevance to clinical governance, a CASP checklist based on 10 questions was employed. (Critical Appraisal Skills Programme, 2018)
The qualitative study (Robinovitch et al., 2013) identified a clear aim for itself and also listed the major cause of falls in the aged. A qualitative assessment is appropriate here since observation forms the basis of such determination. A video observation is one of the best methods since it allows direct observation. Thus this method can be considered fairly rigorous. The setting...