Acute Rehabilitation Case Study

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

(Tzeng, 2008) It would be ideal to create a fall prevention team that includes current staff who are directly involved in the care of clients. This team would include physicians, former or current staff nurses, assisting personnel, and other healthcare members since they all spend time at the patients’ bedside, and they may have insight into areas of improvement that others may not see. An interdisciplinary effort would be an overall better approach when dealing with precautions that would affect the facility’s policy and procedure changed in the facility. (Hughes, 2007) All of the members input about healthcare improvement may be highly constructive and would greatly benefit safety goals. The Joint Commission emphasizes that a better physical design of facilities may also lead to improved healthcare outcomes such as fewer patient falls. (Joint Commission, 2007)

In accordance to this theme, the TCAB design team developed goals and changes that would show improved outcomes. One of these “high-leverage changes” (Rutherford et al, 2009) was preventing patient injuries from falls. Patient falls is one of the high occurrences in patient safety and injury, as well as the leading cause of death of patients 65 and older (Rutherford et al, 2009). By incorporating the TCAB initiative, the pilot hospitals average of patient falls was reduced by fifty-two percent (Rutherford et al., 2009). One of the ways that patient falls were reduced was by involving the personal care attendants (PCA) in making frequent rounds with patients and asking them if they were comfortable or if they needed anything. By involving the PCA’s in falls prevention, the study showed an average fall rate per one thousand patient days decreased from 6 to 4.5 (Stefancyk, 2009). One of the main themes between the studies is preventing patient injury during their hospital stay. In doing so, the ethical principle of beneficence and nonmaleficence have been addressed. A second intervention was also implemented in reducing injuries to the elderly client was placing a sensory cart on the unit and to be utilizing

A fall can make wide spread consequences on the health service or can be affected seriously by the increased health care utilization. Among the fallers approximately 30% of falls result in physical injury leading to extensive hospitalization with significant hospital expenses (Tzeng & Yin 2010). Preventive care phases can support health services to regulate the spare expenditure to a greater extend. A fall in hospital consequently affects the nursing staff, which lead to impaired job satisfaction, additional work load and startling time consume. As the front line of care, nurses can prevent falls and reduce fall injury rates in acute care unit with available resources (Dykes et al. 2013). This literature review aims to assess the efficiency of planned interventions to reduce the incidence of falls in acute medical units. The discussions of the main findings of the review as well as the recommendations for further research are revealed to conclude this study.

Method: The study question investigated was; what impact will individualized fall-prevention education, supported by training and feedback for staff reduce have on the number of falls during hospital stays? The study was a pragmatic study of patients admitted to one of 8 rehabilitation units in general hospitals that were over sixty years old, with a projected hospital stay of at least three days, and had basic cognitive functioning. 3,606 patients admitted were admitted to the eight units during the study period, with 1,983 in the control group and 1623 in the intervention group. The pragmatic nature of the study is a strength given the nature of the intervention. However, the investigators do not explain the logic of limiting the study to patients over age 60, with a length of stay of at least three days, and this restricts the extrapolation of the results to these groups.

The Joint Commission Center for Transforming Healthcare has identified 11 targeted initiatives. One of the initiatives focuses on patient falls. In fact, it is reported that “30 to 35 percent of patients who fall will sustain an injury” (Sentinel Event, 2015). Therefore, it is imperative for healthcare organizations to

In my long-term care and rehab facility, we are involved in applications of evidence-based practices. We recently started a new initiative due to evidence based practice for our increase in UTIs, the outcome for this EBPs is still pending, but I am hopeful for a positive outcome to improve the quality of care for our patients. One EBP we have initiated with positive patient outcomes were from our fall prevention interventions. We implemented Fluid, Ask, Bathroom (FAB) rounds at shift change due to a high number of falls occurring during this time. Implemented monthly meetings with the multidisciplinary team to address recent falls. Each disciplinary making individualized patient recommendations, such as physical therapy, occupational therapy, speech therapy for cognition if there is a recent decline noted. We evaluate the need for a specialty bed, impact mats or

Prior to implementation previous data from the Quality Assurance Committee on falls frequency and falls history for past year will be analyzed for the participants. Each participant will be de-identified for confidentiality purpose and in compliant with IRB to protect the individual. During this multi-pronged approach, the project implementation will include weekly training of all shifts through formal and informal method, weekly tracking record of fall occurrences, the implementation of BRIGGS Healthcare fall risk assessment, and weekly interdisciplinary team meeting using the BRIGGS Interdisciplinary Post Fall Assessment for

Highland Regional Rehabilitation Hospital a 41-bed facility located in the heart of the desert of the southwest located in El Paso, Texas. The facility in September of 2015 went into partnership with Vibra Healthcare. Vibra Healthcare is a private corporation that specializes in development and operation of freestanding Acute Medical Rehabilitation Hospitals (IRF) and Long Term Acute Care (LTAC) hospitals. Highland Regional Rehab employs 92 workers and it is CARF certified facility with all the beds being Medicare-certified. Highland Regional is one of the smaller rehabilitation facilities located in Texas. Highlands Regional Rehabilitation Hospital is an inpatient rehabilitation hospital concentrating in recovery from amputations, brain injury,

Spire Rehabilitation Hospital will open on July 1, 2017. Currently, the focus is on passing the state licensure survey in order to open the doors for admission on July 1. The priorities are to execute all contracts, complete policies and procedures, hire and train staff, and meet all regulatory standards in order to pass the survey scheduled for early June. Staff will target to admit 20-30 patients on July 1, and then prepare to meet Joint Commission Requirements (JCAHO) during the survey scheduled in mid-July.

Authors Cox et al. (2014) presented an interesting article discussing their study related to factors associated with acute care patient falls. The main area of focus was to identify the number of falls, type of falls, whether injuries were associated with the patient falls and if any correlation between the staffing ratios and falls existed (Cox et al., 2014).

Specializing in providing the highest quality home health care services, ACCESS Nursing Services offers the best comprehensive medical care packages to families throughout the country. With five offices and seven hospital-based locations around New York, New Jersey, and Maryland, this ACCESS Nursing Services has been helping patients receive the health care they need for more than 30 years.

achieve this goal is urgent. Therefore, the unit Manager, the Environmental Manager and staff members will have a meeting in 2 days. The details about the plan of action will be discussed, role play, and the watching of a short video. Copies of the revised fall prevention policy and protocols will be distributed; patients and family will be aware of implementations that are in place to prevent obliterating falls.

In response to your inquiry, you have concerns regarding the denial of stay at Burke Rehabilitation hospital. Our records show that a letter was mailed out to your on January 19, 2016, regarding the denial of admission to skilled nursing facility under authorization 105296024. We are continuing to deny the service. However, your case has been submitted to Maximus Federal Services, Inc. is the independent review entity that Medicare uses to review cases. We have enclosed a copy of your appeal final letter for your review to show you what the next step is.

Thank you for your great post. I am also working on the fall prevention and reduction but in acute hospital setting. The references you share may also benefit me. Falls affect everyone and can occur in everywhere. However, people in health care facilities are already fragile and falls can lead to more injury and extend the stay in facilities. The is a good topic to create a better change for the organization and patient care.