Acute Care Patient Falls: A Case Study

This work has significance because staff and patient education can help prevent falls. Specific interventions decrease falls. Nurses have a responsibility to their patients and their facility to be competent and confident in their abilities to do all that they can to prevent falls. Facilities have the responsibility to provide the tools and the training that is required to carry out fall prevention

Increased falls on a particular unit became a concern. The unit formed a fall prevention committee. This committee used evidence-based practice to create a plan and interventions to help reduce falls. The fall prevention committee then monitored trends in the fall prevention process, fall rates, medications, surgeries and disease comorbidities that were associated with fall. Implementing these techniques had a significate reduction of patient falls.

An assisted fall is when a staff member witnesses a patient's fall and attempts to minimize the impact of descend. Many patient falls occurring during hospital encounters may cause little or no harm but some can result in serious and even possibly life-threatening consequences for many patients such as hip fractures and head trauma. Even when a fall does not lead to death, it can require prolonged hospitalization. Some could suffer disability, loss of function, and lose their independence or premature death. “Patient falls in hospitals are a common and often preventable adverse event. Nurses routinely conduct fall risk assessment on all patients, but communication of fall risk status and tailored interventions to prevent falls is variable at best.” (Hurley,

Since healthcare organizations throughout the country strive for positive patient outcomes and patient satisfaction, preventing falls among patients in healthcare settings remains a nursing staff priority. Unfortunately, fall prevention is not a new problem. Nurses face the challenge of recognizing patients who may be at high risk for falls and intervening to prevent falls on a daily basis. To identify areas for improvement in fall prevention, a thorough review of the organizational function of the medical unit at Rex Healthcare in Raleigh, North Carolina, utilizing Roussel’s Evaluating Organizational Function Tool was completed (2013, fig 7-51). Interestingly, even with great effort from nursing staff to prevent falls, they appear to continue to occur on the medical unit. Therefore, the purpose of this paper is to review current literature to identify whether or not an association has been found between the rate of falls and hourly rounding.

Elderly people are highly susceptible to falling, as more than one in four people over the age of 65 fall at least once a year, and many will fall more than just once (NSW Health, 2011). More than half of the elderly living in aged care facilities fall at least once a year. In 2009, 26% of NSW residents who were aged 65 or over, fell at least once (NSW Health, 2011). Approximately 27,000 hospital admissions and at least 400 deaths of over 65 year olds were due to falls (NSW Health, 2011). More of these hospitalisations were for aged care residents than other elderly people. As well as this, hospitals generally have over 1400 falls cases per year, and aged care facilities experience reports of falls from 60% of residents (Victorian Quality Council Secretariat, 2014). In hospital and aged care settings, there are a variety of falls risks, and causative factors that may lead to falls. For example, there are environmental (extrinsic) and personal (intrinsic) factors (Victorian

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,

Falls in an acute care setting lead the list of injury related deaths and deaths in the elderly. “A fall is defined as any event which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors” (Kalisch, Tschannen, and Lee, 2012, p. 6). Medicare and Medicaid changes in 2008 list falls as one of the 10 hospital acquired conditions for which hospitals will no longer be reimbursed because falls are considered preventable conditions. Joint Commission accredited hospitals are required to assess for falls risk and implement falls prevention measures.

Patient safety is one of the nation's most imperative health care issues. A 1999 article by the Institute of Medicine estimates that 44,000 to 98,000 people die in U.S. hospitals each year as the result of lack of in patient safety regulations. Inhibiting falls among patients and residents in acute and long term care healthcare settings requires a multifaceted method, and the recognition, evaluation and prevention of patient or resident falls are significant challenges for all who seek to provide a safe environment in any healthcare setting. Yearly, about 30% of the persons of 65 years and older falls at least once and 15% fall at least twice. Patient falls are some of the most common occurrences reported in hospitals and are a leading

On my committee pertaining to patient falls, I would have two night shift and day shift nurse aides, two day shift nurses who have high seniority, and two night shift nurses with low seniority. Nurse aides are extremely involved in this project because they get the patients up often, sometimes more than the nurses. I chose night shift and day shift because I want to be sure the information does not get communicated wrong shift to shift. I chose older nurses and younger nurses to include different generations of nurses.

As a nurse we want to ensure that our patients receive a high quality of care. Patients should feel safe and satisfied while hospitalized. Many hospitals are continually looking for answers and implementation to significantly reduce the inpatient fall incidents. According to Bechdel et al (2014), the top priority of health care organizations nationwide is to reduce and eliminate falls within the clinical care settings. One of the serious problems in acute care hospital is the patient’s fall. The unfamiliar environment, acute and co-morbid illnesses, prolonged bedrest, polypharmacy, and the placement of tubes and catheters are common challenges that place patients at risk of falling. Most of the falls that I have encountered while working involves

Now, I am aware about the significance of safety measures to avoid falls and have been applying the measures to promote safety to the patients. “Injury preventation is a major concern for older adult. For some, vision is limited, reflexes are slowed, or bone are brittle “(Kozier et al, 2014). It clearly depicts the facts that falls is a major problem in elderly and health care professional need to apply each and every possible safety measures in the health care facility to minimise the incident of fall. It is clear that the bed rails will provide support and act as a barrier that prevents older adults from falling out of bed. In long term care disorder of gait and balance is the main problem of fall for older people. Because of that older

Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator

Falls are the second most common adverse event within health care institutions following medication errors, and an estimated 30% of hospital-based falls result in serious injury. The severity of this problem led the Joint Commission to make reducing the risk of patient injuries from falls a national patient safety goal for hospitals in 2009 (AHRQ, 2006). Falls are a leading cause of hospital-acquired injury and frequently prolong and complicate hospital stays and result in poor quality of life, increased costs, and unanticipated admissions to long-term care facilities.

The evidence indicated that age, narcotic/sedative use, and overnight shift significantly and independently predicted the likelihood of a fall during the hospitalization (Cox et al., 2015). Moreover, cardiovascular comorbidities, neuro/musculoskeletal disease, evening shift, implementation of fall prevention strategies, and a higher RN-to-unlicensed assistive personnel (UAP) staffing ratio (RN/UAP) were significantly and independently associated with a decreased likelihood of a fall during the hospitalization. Additionally, the initiation of fall prevention strategies following a prescribed fall prevention protocol was found to decrease the likelihood of fall occurrence (Cox et al., 2015). From the evidence of the study, results can indicate that evidence-based fall prevention intervention can be effective modalities that can decrease fall occurrence for inpatients and the presence of RNs is indispensable to fall prevention setting (Cox et al., 2015).

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