Currently I am on my gerontology prac and treating a lady with parkinsons who was admitted to the ward from a nursing home due to reduced mobility and frequent falls. She came to the ward with a four wheeled walker (4WW) which she has been using at the nursing home. Her gait pattern is very shuffling steps, forward lean posture and pushes the 4WW a long way in front so it is easy to see when observing her ambulate why she has been having frequent falls. She responds very well to verbal cues while ambulating telling her to take long steps and counting 1,2 but she requires continuous verbal cues. Despite writing in her notes and on her mobility chart she needs verbal cuing when ever i saw her ambulating with another staff member she reverted to her poor gait pattern and they were not using these cues. I realised it was unrealistic to expect the other staff members to use the cuing when she was ambulating with them so i decided to give her a wheeled zimmer frame (WZF) instead of the 4WW. I thought this would prevent the frame from being so far in front of her and therefore hopefully help prevent falls. I gave her the WZF and had a practice with it and she seemed to be able to control the WZF much easier and prevent it from getting so far in front of her. After i saw how much safer she was ambulating with the WZF i wrote on her mobility chart and in her notes that she should ambulate with the WZF instead of the 4WW, told her this and put her 4WW in a corner in her room as i couldn’t remove it as it belonged to her. Despite this whenever i saw her ambulating around she was using the 4WW. I realised that it wasn’t enough to just write in the notes as the other staff members would see the 4WW in her room and get her to use that possibly because they do not have the knowledge that we do about different types of walking aids. I decided to fold the 4WW up and put it somewhere out of site so the only option of walking aid in her room was the WZF. In the future i will realise that just because i write something in someone’s notes does not mean it will be read or taken notice of so sometimes we need to take other steps to ensure something happens.
1 comment:
I agree with you especially in a hospital setting where the staff members are constantly changing. Writing a handover in pts notes is not adequate. In my cardio placement, I have found that giving a verbal handover to the RN and getting the RN to note it down in the nurses handover notes helps alot.
Post a Comment