Risk for injury to shuffling gait secondary to Parkinson’s Disease and poor visual acuity as evidenced by tripping on a rug.

I came up with this highest top priority nursing diagnosis:

Risk for injury to shuffling gait secondary to Parkinson’s Disease and poor visual acuity as evidenced by tripping on a rug.

Develop a Nursing Care Plan to address the safety needs of the patient during hospitalization and in preparation for his discharge home.

What are some of the desired outcomes based on the nursing diagnosis as stated above?

List 7-8 nursing interventions and their rationales.

List each evaluation from the rationales.

ANSWER

Nursing Care Plan for Addressing Safety Needs in Parkinson’s Disease with Poor Visual Acuity

Risk for injury to shuffling gait secondary to Parkinson’s Disease and poor visual acuity as evidenced by tripping on a rug.

Desired Outcomes

The patient will maintain a safe and stable gait during hospitalization.

The patient will demonstrate improved visual acuity to minimize the risk of tripping and falling.

The patient will receive education and training on home safety measures to prevent injuries after discharge.

Nursing Interventions and Rationales

Conduct a comprehensive assessment of the patient’s gait and visual acuity

A thorough assessment will help identify specific deficits and develop a tailored plan of care to address the patient’s needs. Evaluating the patient’s gait and visual acuity will provide a baseline for measuring progress.

Evaluation: The nursing assessment findings will guide the development of an individualized care plan and help set realistic patient goals.

Implement fall prevention strategies

Keep the patient’s environment clear of clutter, rugs, and obstacles.

Ensure adequate lighting in the patient’s room and common areas.

Install handrails along the patient’s bed, bathroom, and hallway. Rationale: Minimizing environmental hazards and improving visibility will reduce the risk of falls. Installing handrails provides additional support during ambulation.

Evaluation: Regular environmental checks will ensure a safe environment for the patient. The absence of clutter, adequate lighting, and handrails will indicate the successful implementation of fall prevention strategies.

Educate the patient on proper body mechanics and safe walking techniques

Encourage the patient to take small, deliberate steps while walking.

Teach the patient to use assistive devices, such as a walker or cane, for stability. Rationale: Promoting proper body mechanics and safe walking techniques can help improve gait stability and reduce the risk of falls.

Evaluation: The patient’s ability to demonstrate proper body mechanics and use of assistive devices indicates their understanding and readiness to apply these techniques.

Collaborate with physical therapy for gait training and balance exercises

Working with physical therapy specialists will provide the patient with targeted interventions to improve gait stability and balance, which are essential for preventing falls.

Evaluation: Regular communication and collaboration with physical therapy will ensure a coordinated patient care approach (Gervais et al., 2014). Improved gait stability and balance will indicate progress in meeting the desired outcomes.

Refer the patient to an ophthalmologist for a comprehensive eye examination

Addressing the patient’s visual acuity issues requires a thorough assessment by an eye care specialist. Correcting visual impairments can significantly reduce the risk of falls.

Evaluation: Documentation of the referral and follow-up with the ophthalmologist will demonstrate proactive management of the patient’s visual acuity (National Institute for Health and Care Excellence (NICE), 2017). Improved visual acuity, as determined by the ophthalmologist’s assessment, will indicate successful intervention.

Engage the patient in a multidisciplinary team approach

Collaborating with healthcare professionals from different disciplines, such as physical therapists, occupational therapists, and ophthalmologists, will ensure a holistic approach to the patient’s care, promoting safety and reducing the risk of injury.

Evaluation: Regular team meetings and interdisciplinary communication will demonstrate effective coordination and integration of care (Taberna et al., 2020). The patient’s progress, as assessed by each discipline, will reflect the success of the multidisciplinary approach.

Provide education and training on home safety measures

Teach the patient to maintain a well-lit and clutter-free home environment.

Instruct the patient to remove or secure rugs to prevent tripping.

Discuss the importance of wearing appropriate footwear with good traction. Rationale: Educating the patient about home safety measures will empower them to create a safe environment and reduce the risk of falls once they are discharged.

Evaluation: The patient’s ability to verbalize and demonstrate understanding of home safety measures will indicate successful education and training. Additionally, a follow-up assessment during home visits can confirm the implementation of these measures.

In conclusion, addressing the safety needs of a patient with Parkinson’s Disease and poor visual acuity requires a comprehensive and multidisciplinary approach. By implementing fall prevention strategies, providing education and training, collaborating with physical therapy and ophthalmology specialists, and engaging the patient in their care, nurses can help mitigate the risk of injury and enhance the patient’s overall safety. Ongoing evaluations of the interventions will ensure the effectiveness of the care plan and guide adjustments as necessary, ultimately optimizing the patient’s outcomes and quality of life.

References 

Taberna, M., Moncayo, F. L. G., Jané-Salas, E., Antonio, M., Arribas, L. P., Vilajosana, E., Torres, E., & Mesia, R. (2020). The Multidisciplinary Team (MDT) Approach and Quality of Care. Frontiers in Oncology, 10. https://doi.org/10.3389/fonc.2020.00085 

National Institute for Health and Care Excellence (NICE). (2017, October 1). Indicators for referral. Cataracts in Adults: Management – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK536578/ 

Gervais, T., Burling, N., Krull, J., Lugg, C., Lung, M., Straus, S. E., Jaglal, S. B., & Sibley, K. M. (2014). Understanding Approaches to Balance Assessment in Physical Therapy Practice for Elderly Inpatients of a Rehabilitation Hospital. Physiotherapy Canada, 66(1), 6–14. https://doi.org/10.3138/ptc.2012-57 

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