Navigating Transitions 2: Learning Resource –Short Workbook Template

Student Name:

Student Number:

· To incorporate awareness regarding the need for preventing falls and falls based injury amongst elderly citizens

· To be able to adequately assist Registered Nurses in teaching required exercise strategies to the elderly to prevent incidence of falls.

· To be able to impart awareness and supervision in teaching sufficient exercise strategies to elderly patients.

In the field of critical medical treatment and conventional care pertaining to the recovery process of the elderly population, the emerging incidence of falls forms a pressing concern. As opined by the Australian and New Zealand Falls Prevention Society, the incidence of occurrences involving falls amongst the elderly is constantly on the rise, with almost a quarter of the population belonging to the age group of beyond 60 years, being inflicted with falls once, annually (Canning et al. 2015). There is a further need to prevent falls amongst the elderly due to the severe implications of health projected due to occurrences of the same. Apart from being overcome with a fatal threat of succumbing from injuries due to falls, patients involved in aged care also face the susceptibility of additional harmful physiological consequences such the occurrences of fractures in the neck, hip, arms as well as the trunk (Johansson et al. 2017). There is also an increased susceptibility to suffering from damaging facial distortions as well as abrasions and bruises.

The incidence of falls amongst the elderly results in a debilitating condition, resulting in absolute or substantial reductions in mobility, a sense of depression, isolation and aversions from social interactions, in addition to significant weakness, malaise, loss in muscle mass and an increased phobia towards future occurrences of falls (Luk, Chan and Chan 2015). Apart from the adoption of enhanced nursing supervision as well as implementation of sufficient safety protocols aimed at preventing the occurrences of falls amongst patients involved in aged care, the adoption of exercise training programs has emerged as an additional preventive intervention strategy (Sherrington et al. 2017). As stated by the World Health Organization, the implementation and execution of adequate physical activity strategies, are a key solution which may mitigate the harmful effects of ageing. Physical exercise categories which aim to incorporate training in resistance, strength and balance, have been proven to implicate beneficial health outcomes amongst the elderly through the enhancement and improvement of strength of the muscles located in the limbs of the lower sections of the body (Sadeghi et al. 2017). The implementation of adopting adequate teaching principles by nurses in order to aid in the execution of adequate exercises in the elderly is lacking. Hence, the need of the hour is for nurses to adopt novel falls prevention strategies in order to reduce incidences of the same amongst the elderly, and aim for the incorporation of enhanced life outcomes and improved quality of life amongst the elderly (Palvanen et al. 2014). As stated by the Depart of the Health, in the Government of Australia, the functions of an Assistant-in Nursing (AIN), is emerging as a pivotal role involved as a helping hand for the adequate performance of senior nurses involved as an Enrolled or Registered Nurse (Cowan et al. 2015). While AINs are required to perform solely under the supervision an assistance of the Registered Nurse, there is a need to obtain sufficient knowledge regarding the need for teaching exercises as an intervention strategy to prevent falls amongst the elderly (Brett, Traynor and Stapley 2016). The aims of this Learning Resource Workbook is to the highlight the salient features which are required to be covered in teaching AINs the sufficient steps required to implement correct exercise strategies amongst the elderly, and majorly assist their superiors in the patient care and supervision of the same.

The incidence of falls occurring amongst the patients involved in aged care is emerging at an alarming rate, further resulting in the prevalence of injuries associated with the same and the resultant debilitating health condition of the concerned patients. There is hence, a need for nurses in advanced clinical roles, as well as their subordinates to incorporate sufficient novel strategies for the  prevention of falls as well the detrimental health conditions resulting from the injuries pertaining to the same (Hujig et al. 2015). Incorporation of exercise has been documented as an advantageous novel strategy to aid in the prevention of falls. In the light of lack of sufficient teaching principles pertaining to the same, there is hence a need for assistants-in nursing (AINs) involved in aged care of elderly patients, to learn and obtain sufficient knowledge regarding the usage of exercise as an intervention, further utilising the information to efficiently assist registered and enrolled nurses as well as elderly patients, for the implementation of the same for the purpose of prevention of falls occurrences (Chang and Chang 2015). The following learning resource seeks to efficiently educate and train assistants in nursing regarding the implementation of exercise as intervention strategies to prevent falls amongst the elderly.

The aim of the required learning resource is to educate and train assistants in nursing (AINs) on the usage of sufficient exercise strategies for the purpose of prevention of falls amongst the patients in aged care, as well to assist in the activities of Registered Nurses for the purpose of the same.

· Sufficient technological equipment such as the utilisation of advanced audio-visual techniques as well as presentations, for the purpose of imparting extensive knowledge on the health implications resulting from falls, the various safety protocols to be measured and the correct steps pertaining to the various resistance and balance training exercises to be implemented for further supervising patients in aged care.

· Hard copies of the required information in the form of handbooks, notebooks or pamphlets, in which the various steps pertaining to completion of the learning resource and the resultant training will be mentioned extensively and elaborately.

· Sample safety equipment and first aid kits, for further training considering the treatment of injuries, which may result due to occurrences of falls amongst patients in elderly care.

· Lightweight kettle bells, dumb bells or leg weight bands as exercise equipment which will be required to learn the various resistance and balance training exercises for further implementation amongst aged care patients.

For the purpose of completion of the Learning Resource by Assistants-in Nursing (AINs) involved in treatment of patients involved in aged care, the students would be required to undertake an action learning approach. The purpose of an action learning method of training would involve practical demonstrations for enhanced fulfilment of knowledge attaining and learning objectives, followed by continuous review and team interactions with respect to the individual progress exhibited each day (Leggat, Balding and Schiftan 2015). The true purpose of the action learning procedure implemented in this learning resource is the involvement of an individual-centric approach, where the students themselves would take key responsibility in reviewing and discussing their educational outcomes and shortcomings. For the completion of the training pertaining to the learning resource, assistants in nursing would be required to fulfil the following three phases of training.

· First Phase of Learning (1 week): The initial phase of the learning resource training to be undertaken by the students would involve a phase of preparation by the students, to be conducted for over a week. There will be a required formation of inter professional team with due consideration of the benefits of acquiring knowledge through implementation of a multidisciplinary approach (Bruner et al. 2015). The teaching team so formed would consist of registered nurses, advanced nurses, a specialist meant for imparting education concerning the various physiological implications resulting from falls along with the required safety procedures and an additional fitness trainer to educate students concerning the various exercises to be learnt and taught to elderly patients or assisted during functioning of registered nurses in administering aged care amongst the elderly. Students will be required to engage in audio visual presentations and discussions, followed by involvement in interactive discussions, giving due importance of social learning theories. A social learning theory will be the cornerstone of the implementation of this phase of the concerned learning resource training where students will acquire ideas and overcome sufficient learning gaps through interactive discussions and reflections, paving the way for enhancement of knowledge and scope for improvement (Heyes 2016).

· Second Phase of Learning (2^nd week): The second week of training by students required for completion of the learning resource would be characterised by demonstration learning method. A demonstration learning method has been documented to yield beneficial impacts on the learning outcomes of the concerned students (Wahyuni 2016), due to the usage of practical based learning applications and the resultant student demonstrative activities where they will be asked to showcase their knowledge by practically performing the tasks in controlled as well as live patient settings. Students will be required to engage in extensive interaction and training by the appointed fitness trainer and falls prevention specialist, and learn the ‘Otago Exercise Program to Prevent Falls in Older Adults’ – an exercise program documented to implicate beneficial implications in the prevention of falls amongst patients in elderly care (Park and Chang 2016). Upon learning, the potential assistants-in nursing (AINs) will be required to demonstrate their skills in teaching the required exercise skills to patients as well during assistance to the trained nurse, in controlled training setups as well as live patient situations in clinical or rehabilitation wards of the hospital.

· Third phase of Learning (3^rd week): The final phase of learning would involve conductance of extensive evaluation and examination procedures which will assess the students performance concerning the principles of the learning resource. Students must undertake sufficient written examinations along with practical tests, which have been documented to efficiently assess student performance and practical learning outcomes (Woessmann 2016). Students will also be interviewed by the multidisciplinary team for the purpose of feedback, since sufficient feedback mechanisms are the key to gathering student knowledge concerning the implementation of a learning resource tool and teaching program (Flores et al. 2015).

References:

Brett, L., Traynor, V. and Stapley, P., 2016. Effects of physical exercise on health and well-being of individuals living with a dementia in nursing homes: a systematic review. Journal of the American Medical Directors Association, 17(2), pp.104-116.

Brunner, M., Gore, S.M., Read, R.L., Alexander, A., Mehta, A., Elliot, M., Milross, C., Boyer, M. and Clark, J.R., 2015. Head and neck multidisciplinary team meetings: effect on patient management. Head & neck, 37(7), pp.1046-1050.

Canning, C.G., Sherrington, C., Lord, S.R., Close, J.C., Heritier, S., Heller, G.Z., Howard, K., Allen, N.E., Latt, M.D., Murray, S.M. and O’Rourke, S.D., 2015. Exercise for falls prevention in Parkinson disease: a randomized controlled trial. Neurology, 84(3), pp.304-312.

Chang, H.Y. and Chang, H.L., 2015. A review of nurses’ knowledge, attitudes, and ability to communicate the risks and benefits of complementary and alternative medicine. Journal of clinical nursing, 24(11-12), pp.1466-1478.

Cowan, D., Brunero, S., Lamont, S. and Joyce, M., 2015. Direct care activities for assistants in nursing in inpatient mental health settings in Australia: A modified Delphi study. Collegian, 22(1), pp.53-60.

Flores, M.A., Veiga Simão, A.M., Barros, A. and Pereira, D., 2015. Perceptions of effectiveness, fairness and feedback of assessment methods: a study in higher education. Studies in Higher Education, 40(9), pp.1523-1534.

Heyes, C., 2016. Who knows? Metacognitive social learning strategies. Trends in cognitive sciences, 20(3), pp.204-213.

Huijg, J.M., Gebhardt, W.A., Verheijden, M.W., van der Zouwe, N., de Vries, J.D., Middelkoop, B.J. and Crone, M.R., 2015. Factors influencing primary health care professionals’ physical activity promotion behaviors: a systematic review. International journal of behavioral medicine, 22(1), pp.32-50.

Johansson, J., Nordström, A., Gustafson, Y., Westling, G. and Nordström, P., 2017. Increased postural sway during quiet stance as a risk factor for prospective falls in community-dwelling elderly individuals. Age and ageing, 46(6), pp.964-970.

Leggat, S.G., Balding, C. and Schiftan, D., 2015. Developing clinical leaders: the impact of an action learning mentoring programme for advanced practice nurses. Journal of clinical nursing, 24(11-12), pp.1576-1584.

Luk, J.K., Chan, T.Y. and Chan, D.K., 2015. Falls prevention in the elderly: translating evidence into practice. Hong Kong Med J, 21(2), pp.165-71.

Palvanen, M., Kannus, P., Piirtola, M., Niemi, S., Parkkari, J. and Järvinen, M., 2014. Effectiveness of the Chaos Falls Clinic in preventing falls and injuries of home-dwelling older adults: a randomised controlled trial. Injury, 45(1), pp.265-271.

Park, Y. and Chang, M., 2016. Effects of the Otago exercise program on fall efficacy, activities of daily living and quality of life in elderly stroke patients. Journal of physical therapy science, 28(1), pp.190-193.

Sadeghi, H., Amri, S.B., Razeghi, M., Hamid, T.A. and Abdollah, M.N.H., 2017. Effects of Combined exergame and conventional exercise to reduce and prevent fall risk among elderly people: A Hypothesis. International Journal of Applied Exercise Physiology, 6(3), pp.80-84.

Sherrington, C., Michaleff, Z.A., Fairhall, N., Paul, S.S., Tiedemann, A., Whitney, J., Cumming, R.G., Herbert, R.D., Close, J.C. and Lord, S.R., 2017. Exercise to prevent falls in older adults: an updated systematic review and meta-analysis. Br J Sports Med, 51(24), pp.1750-1758.

Wahyuni, S., 2016. The Effectiveness of Demonstration Method Through Audio Visual Media to the Students’ Speaking Ability. Mandar Social Science Journal, 1(1), pp.40-54.

Woessmann, L., 2016. The importance of school systems: Evidence from international differences in student achievement. Journal of Economic Perspectives, 30(3), pp.3-32.