A literature Review on inpatient falls

A patient who is admitted to a facility may be alert, oriented, and independent in ambulation. Add on intravenous (IV) tubing attached to a pole, a telemetry monitor, a foley catheter, and new medications for the patient. This patient now has fall risk factors. The purpose of this paper is to describe and evaluate change in preventing falls in the hospital setting.

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

Current literature has exposed many risk factors for falls. There are both intrinsic risk factors and extrinsic risk factors. Intrinsic risk factors include changes that come with age, such as gait issues, urinary incontinence, and fear of falling. Extrinsic risk factors include those that are related to the physical environment such as improper use of assistive devices and poor floor surfaces. No matter the type of risk factor, it is crucial to conduct a risk assessment when trying to prevent falls from occurring. Pearson and Coburn (2011) found that identifying risk factor for falls will help identify appropriate prevention strategies. Fall risk assessments help determine Talk about

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

Most hospitalized patients of 65 years and above have been established to be more vulnerable to falling within their homes or in a facility. These falls have been attributed to various causative agents that need to be assessed and managed in an attempt to completely avert falls (Wilbert, 2010). Prevention of falls should be mandatory since they cause more danger to patients, including breakage of the main bones and even death. As a result, the patient may develop a more serious condition such as decrease functional immobility in addition to that which caused hospitalization. Most of these falls have been found to be caused by therapeutic impacts and ignored diagnostic information (Naqvi, Lee & Fields, 2009). For instance, a great number of elderly people who are hospitalized are diagnosed with dementia at the time of admission; hence, such information needs to be taken into consideration during the care of such a patient. Dementia is likely to cause disorientation and confusion which may result in recurrent falls. Therefore, falls may be described as the abrupt and unintended loss of uprightness that leads to body displacement towards the ground falls (Wilbert, 2010). The purpose of this paper is to develop a falls prevention, management program that will reduce the number of falls occurring within an organization.

Capan, K., & Lynch, B. (2007). Reports from the field: patient safety. a hospital fall assessment and intervention project. Journal of Clinical Outcomes Management: JCOM, 14(3), 155-160.

Nurses help to ensure patient safety, which includes preventing falls and fall-related injuries (Quigley, Neily, Watson, Wright, & Strobel, 2017). The general population is at risk for falls and fall-related injuries, more specifically the elderly, 65 and over (Quigley, Neily, Watson, Wright, & Strobel, 2017). Patient falls are one of the top events for hospitals and long-term care facilities due to loss of physical function or cognition (Quigley, Neily, Watson, Wright, & Strobel, 2017). Fall-related injuries are a serious health issue for the elderly population (Quigley, Neily, Watson, Wright, & Strobel, 2017). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention

The purpose of this research paper was to examine the latest research and evidence-based practices related to inpatient falls. Falls among the elderly within a hospital setting has increased within the last decade. Inpatient falls have become the second leading cause of death, causing longer hospital stays and indirect costs for the hospital. The research reviewed multiple studies, which discussed the causes of inpatient falls. A few causes included nurses and staff not knowledgeable of current hospital practices, lack of individualized plan of care, and lack of training related to falls. The findings assisted the writer to revise the current fall policy and procedure for Arrowhead Regional Medical Center (ARMC). A fall reduction program

The functional independence measure (FIM) was utilized to identify patients who are at a high risk for fall and found that patients who fell had a lower admission and discharge FIM scores than the ones who had not fallen; they also found that those with lower FIM scores were stroke rehabilitation patient and had the highest rate of fall. FIM is defined as a measurement of disability specific to patients in rehabilitation; it has has 18 categories broken down into motor and cognitive components with each category scored on a scale of 1 for total dependence to 7 for total independence. The authors of the research article determined that FIM score have significance in predicting patients who are at a highest risk of falls and is more appropriate to aid in implementing interventions. With the above discovery, Salamon, Victory & Bobay (2012) undertook retrospective pilot study to compare the Morse Fall Scale scores and components of the FIM. The result from the pilot study yielded several important correlations between the Morse Fall Scale and the FIM scores. The study revealed that patient with cognitive impairments, and those with decreased ability to expressed needs are more likely to fall and no correlation with comprehension was found with the

Fall risk assessments tools, which help to identify those patients at risk of falling, play a vital role in reducing the number of falls. The basis for this assessment is that if patients at high fall risk can be

A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization

Risk factors for falls are categorized by intrinsic or extrinsic (Tzeng, & Yin, 2009). According to Tzeng and Yin (2008), intrinsic factors, referring to the patient themselves, are related to their health status and possibly associated with age-related changes: previous falls, reduced vision, unsteady gait, musculoskeletal system deficits, mental status deficits, acute illness, and chronic illness. Extrinsic factors are involved in the patient’s environment, including medications, lack of support equipment, furniture, bathroom designs, small patient rooms, poor lighting, and improper use of and inadequate assistive devices. Tzeng & Yin (2008; 2009) focused on the extrinsic risk factors for the basis of their studies.

Physiotherapists can carry out assessments on patients using falls risk assessment tools (FRAT). FRATS use questions and observations to categorise patients as low, moderate or high falls risks (Miedany, Gaafary, Toth, Palmer & Ahmed, 2011) and identify the necessary level of intervention needed. Wong-Shee, Phillips & Hill 's (2012) research promotes the use of the TNH-STRATIFY falls score assessment tool. The TNH-STRATIFY has an extensive question list, identifying more falls risk factors. Wong-Shee et al 's. (2012) research suggests the TNH-STRAITFY has high inter-rater reliability with an excellent intra-class correlation score of 0.96. 1 is deemed a perfect score (Hallgen, 2012). The high inter-rater reliability score adds statistical power to the research regarding the use of TNH-STRATIFY due to consistency of the tool used on consecutive patients (Hallgren, 2012). Although the two raters of the tool scored high intra-class correlation scores contributing to high inter-rater reliability, the tools predictive risk factor specificity rating scored only moderately, with 0.52 (Wong-Shee et al., 2012). For FRATS to be considered as having a high level of predictive risk accuracy the predictive specificity rating needs to be greater than 0.7 (Myers, 2003). This moderate rating of accuracy significantly limits the TNH-STRATIFY 's use in clinical practice. This is due to the fact that although the tool rates highly for reliable use between clinicians, the risk factor

Internet Citation: Tool 3H: Morse Fall Scale for Identifying Fall Risk Factors. Content last reviewed January 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk-tool3h.html

Falling is inevitable at some point in life, and although most of the time falls are not serious, some can be life-threatening. Falls are a danger to both physical and psychological well-being because they may diminish a person’s ability to maintain an active and independent lifestyle.1 There are many factors that place individuals at risk for falls such as age, muscle weakness, difficulty with balance or walking, psychological diagnosis, and several medical conditions.1,2 Approximately one-third of people over the age of 65 fall at least once a year.3 Individuals that are status post stroke are at an increased risk of falls, making falls assessment and prevention a common priority for clinicians treating this population.1,2 Therefore, to direct the experimental methods and build on a basis of previous literature on this topic, the search began using OneSearch, CINAHL, PubMed, and