Analysis of Literature about Hospital Falls

The following paper is a written critique of the following research article “Improving the evaluation of risk of fall through clinical supervision: an evidence” (Cruza, Carvalhoa, Lopesb, 2016). The purpose of this critique is to analyze, evaluate, and review each section of the above stated quantitative research article. This quantitative, descriptive and correlational study focuses on improving patient safety and quality of nursing care by improving the evaluation of a patients' fall risk using the Morse Fall Scale (MFS) assessment tool in practice under the implementation of a clinical supervision model. (CS)

Falls are one of the major patient safety problems that every facility encounter on a day to day basis. An aging patient population, combined with multiple diagnosis and medications are prime contributing factors for patient fall. Other contributing factors are shortage of nursing and auxiliary staff, ineffective work environment and shortage of appropriate equipment. According to the Joint Commission around 30-50 percent of the falls happening in the hospitals have resulted in injury to the patients. Since Joint Commission started keeping records of fall from 1995 to 2012, it has been reported that there were 659 fall related death or permanent disability, which were voluntarily reported as a

The incidence of fall-related injuries in the elderly U.S. population will continue to increase (Quigley, Neily, Watson, Wright, & Strobel, 2017).

Before exploring the nurse’s role in fall prevention, one must first understand the risk factors for falls, the consequences of patient falls, and the organizations that influence how hospitals and long-term care facilities report falls. Although falls can occur to anyone at any time, a few factors increase the

In USA, one in three adults over age 65 suffer fall while 20% to 30% experience moderate to severe injuries (Centers for Disease Control and Prevention, 2010). In 2010, the cost of falls among elderly people for US health care system was over $30 billion (Centers for Disease Control and Prevention, 2010). Over the last few decades the rate of fall related deaths in USA has sharply been escalating. Many older adults have developed the fear of falling, limiting their social activity and forcing them to live in fear. Some adults suffer lacerations, fracture and trauma during fall, deteriorating their quality of life.

According to the reports published by the Centers for Disease Control and Prevention Injury Centre (2007), falls are the third most common cause of unintentional injury death across all age groups and the first leading cause among people 65 years and older. A hospital can be a dangerous and erratic place for inpatients because of its unfamiliar

Current nursing practices are based on strict standards and requirements issued by The Center for Medicare and Medicaid Services (CMC) and The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The CMS requires facilities to provide a safe environment for care and failure to do so risks losing Medicare Medicaid funding. In fact, facilities no longer receive payments for treating injuries caused by in-hospital falls. The JCAHO National Patient Safety Goal (NPSG) requires nursing home to reduce the risk of patient harm resulting from falls and to implement a falls-reduction program. The NPSG has been upgraded to a standard that requires facilities to assess and manage the patient’s risks for falls and implement interventions to reduce falls based on this assessment. The current nursing practice for fall interventions begins with assessment. Patients are assessed and reassessed to identify and address any risks factors including underlying medical or medication conditions. Risk Assessment Tools for predicting falls score each category identified as a potential risk. For example, categories include Medication, Activity/Mobility, Elimination, Previous Falls, Length of Stay, Mental Status, and Age all can influence the

Contributing elements of patient falls include patients’ balance, gait, impaired cognition, and a history of falling (Tzeng & Yin, 2015). Studies have proven there is a correlation between “nursing staff and adverse patient

Purpose: The purpose of this study is to determine if registered nurses are utilizing evidence-based practice fall-preventative strategies, such as modification of patient-specific risk factors and implementation of a proper physical training program, to reduce and prevent falls and injuries in the elderly population.

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.

Evidence Based Management of Fall Prevention in the Health Care Setting Patient’s fall is an unexpected event, and it is one of the challenges that nurses face in caring for patients. Sometimes, finding answers to why a patient fell could be difficult, but providing a strategic approach to prevent the fall event will improve the existing practice and preserved patient safety. The evidence based practice is the new world which nurses live in through a research and is the best tool for providing quality care for patients. To improve the existing practice for a fall prevention, this paper will examine the effectiveness of the fall preventive measures provided for patients during the period of hospitalization and the process of an health assessment’s visit by answering a clinical PICO(t) question which stated; in older adult patients, what is the efficacy of using fall prevention compared to no fall prevention for preventing fall during the period of hospitalization and the process of health assessment in the primary care setting?

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

he incidence of falls has a large impact in healthcare today, including legal, ethical, economical and safety implications, for patients, healthcare organizations and the community. Adhering to standards of care, and preventing falls assist the nurse, organization and patient in avoiding legal implications from falls. Protecting the patient's’ well-being, providing autonomy, and freedom are ethical obligations the nurse must consider when taking care of patients. Financial implications for falls can be devastating to the patient, as well as the organization and community. The safety of the patient is our number one goal in healthcare, and reducing fall incidence will not only improve patient safety, but it will improve healthcare as a whole.

Children also have a tendency to have falls since their muscles and bones haven’t fully developed yet. In a study with 782 pediatric patient falls inside of a hospital, 86% of the pediatric patients had appropriate cognitive abilities for their age while the other 14% of the patients had delayed cognitive abilities. Even though that in this pediatric hospital supervision is much more keen, 77% of the falls recorded had adults watching them (Jamerson & all, 2014). In Jamerson’s study 49% of the falls resulted from ambulating, while the other 51% were transitioning to a different position. With younger aged patients, increased surveillance and instructions of fall risks help reduce the risk of falls, along with increasing status communication to other nurses (Jamerson & all, 2014). Now it’s time we look at geriatric patients in a hospital setting. There were a total of 893 falls in a single year at a geriatric clinic of academic teachings, with 240 of these falls being injurious (Kruse). After nurses educated their patients on fall risks, the number of falls in this geriatric hospital dropped down to 468 in-patient hospital falls, a 52% decrease in falls, with only 129 of these falls (28%) being injurious. As the education for the older generation and the safety regulations on the younger generation increased, the amount of injuries relating to falls decreased immensely.

4. For patients with the risk of falling to do intervention and monitoring that includes a description of the risk falls on the patient, make sure the bell function and within reach of the patient's hand, position the lower bed, locked wheels, bed side rail mounted all, help patients when the transfer/ambulasi, post a sign risk appetite fell near the bed of the patient, make sure the yellow rings mounted on the patient's wristband, describe the drug effects anestesia , anti seizure, anti histamine, an anti seizure, narcotics, psychotropic substances, diuretika.