The of side rails, bed alarms, and bed arrangements

The practice among nurses on prevention of adverse
event can be improve by implement the Orlando
Nursing Theory-based practice to achieve
successful in quality of care as well as reduce any advent event such as
patient falls, medication error, pressure injuries and many more. Furthermore,
Orlando’s framework provides a road map for nurses to use when situation like
fall occur. For example, Mrs.J who have difficulties to look clearly because of
cataract disease administer to hospital without any relative with her. She
needs someone to help her in doing self care activities. Now nurse must assess
the patient behavior based on Orlando Theory- based practice. The practice of
nurse in this situation is first, the nurse must assess and determine whether
patient has high or risk of fall. Assessment like do the patient use cane or
walker,  patient have fallen within 6
months before or not, do the patient take medications that cause frequent
urination and other questions. Then, patient with high risk will be review by
the physical therapist for mobility, safety and their activities daily living.
Besides, nurses can assess the environment and examine the accessibility of
call button, walker or wheel chair, nearness to toilet, or equip patient with
bathroom supplies such as bed pan, wipe tissues, water and others. For low risk
patient, general observation and safety precautions such as using side rail,
tagging with morse fall scale to prevent falls. Hourly rounding is the best
ways to prevent falls. Other than that, positioning, toileting  schedule and addressing pain will improve
patient comfort and decrease falls. For confused patients, the use of side
rails, bed alarms, and bed arrangements must be considered for ambulating patients
and this also useful for patient with unsteady gait. Furthermore, the following
interventions are beneficial for a prevention of fall such as family
involvement in care, room closer to nurse station, lower bed, use bed alarm, side
rails up, scheduled assistance to toilet, hourly rounding. Reducing unsafe
behavior may be achieved by moving patient close to nurse station.