Fall Prevention In Nursing

The occurrence of falls among the elderly is related to multiple factors, such as inherent and external issues. Studies have proven that when appropriate intervention is put in place, falls are preventable. A quality improvement according to Polit & Beck (2012) is created to examine the willingness of individuals to understand these studies and put them into practice or to appraise the results of interventions already in place. This paper will examine a practice issue facilitated by the advanced practice nurse (APN), explore the theoretical underpinning of change, describe an improvement tool and model for improvement and allocated resources towards the prevention of fall among the elderly.

The purpose and scope of the “RNAO Falls Prevention CPG” are: “To increase all nurses’ confidence, knowledge, skills and abilities in the identification of adults within health care facilities at risk of falling and to define interventions for the prevention of falling. It does not include interventions for prevention of falls and fall injuries in older adults living in community settings. The guideline has relevance to areas of clinical practice including acute care and long-term care,

The physical, social, psychological, and financial impact that falls can have on the elderly population is particularly tragic because falls are frequently preventable (CDC, 2012). This report will examine the findings of recent research into fall prevention in hospital settings, to better understand the preventive

Issue: In May 2015, the falls rate was 10 per 1000 patient days. She noticed that nurses were not implementing all of the prevention methods to prevent patients from falling. An increased falls rate, leads to increased health care utilization due to the many injuries that may occur, and research shows that about one-third of the falls that occur in the hospital can be prevented. Action: After researching different methods to prevent patients from falling in the hospital, she realized a patient’s underlying risk factors could be used to determine if a patient is low, moderate, or high risk. Though the staff was using the Morse Fall Risk Scale, random audits proved they were not implementing all of the proper precautions outlined to prevent

“My PICOT statement was: “In elderly hospitalized patients 60 years of age and above, do specific fall prevention interventions, as compared to standard care, reduce the amount of falls in an inpatient setting, during their hospitalization?” For this paper I will be reviewing a quantitative research article based around my PICOT on fall risk within the hospital setting. Patient falls within the hospital setting are a nursing-sensitive quality indicator based around the delivery and care of inpatient services. As identified by the American Nurses Association, “fall rates are perceived to be the indicator that could be most improved through safety strategies and interventions” (ANA, 2002, p.179). In order to create safety strategies to improve fall risk it is important to identify which preventative measures work best within the hospital. This paper will be reflecting on the peer-reviewed Quantitative journal article found on the GCU database titled, Effectiveness of multifaceted and tailored strategies to implement a fall-prevention guideline into acute care nursing practice: a before-and after, mixed-method study using a participatory action research approach. Within this research article it states the severity of inpatient falls, specifically in the elderly, stating, “Falls are a common problem in hospitals, particularly in patients aged 65 and older. Around 30% of all persons aged 65 or older suffer a fall each

Commonly used patient-centered strategies are “ risk for falls” colored wristbands, hourly rounding and visual monitoring either by camera or sitter. During hospital admission, a risk of fall

Falls are easily one of the biggest safety risks to any patient in acute or chronic care. Falls themselves can result in secondary problems that can change a patient’s life and every precaution should be taken to prevent falls in the first place, no matter where care is being given. Many precautions and plans have been made by many different types of health professionals to help assess and prevent the risks and decrease the probability of falls. The majority of the patients in hospitals and acute and chronic care centers are a fall risk and their safety is top priority. Increased education and implementation of fall safety will help nursing staff provide better care for their patients. If the same type of precautions, education, and care were given in every facility, the amount of falls could decrease dramatically. Hospitals are prime examples of a facility that makes fall safety one of their top priorities (Neiman, 2011). In centers like nursing homes and long term care facilities, the nursing staff can become less vigilant about implementing fall safety plans to their highest potential. The differences are little, but have a significant impact on the likelihood of a patient falling. The same risks are everywhere.

(2014); Shuman et al. (2016) have outlined that nurse’s role in providing sufficient and accurate education on falls risk prevention enable a better understanding of the patient on the risk involved to reduce numbers of bedside falls. In addition, Shuman et al. (2016) explained that preventing falls in the acute setting is a collaborative work that requires patient and family participation increases the compliance to follow health care providers’ advice that promotes patient

Falls can have an overwhelming effect on legal, economical, ethical, and political situations. Many questions arise as to how to keep patients safe when they are at risk for falls. “A fall is described as a sudden, unintentional, downward movement of the body to the ground or other surface; when a patient falls, he or she is at risk of serious injury, disability, and possibly death” Huey-Ming, 2012). Falls happen during the day, afternoon, at night and do not subside do to the amount of staff. Falls happen when patients are ambulating, transferring, getting up without assistance, reaching for personal items, along with many different reasons. It is our job and duty as health care professionals to ensure patients remain safe during their hospital stay. As we learned in my previous literature review, patients that have had previous falls tend to fall more than those who do not, falls will increase the patients stay when there is or isn’t an injury obtained.

The study’s findings revealed that of the 183 patients that fell while hospitalized, the average age was 63.4 with the ages ranging from 17 to 96. It also discovered that many of the falls were unassisted, occurred in the evenings and in the patient’s hospital room, and had fallen during ambulation. It was also discovered that falls related to elimination increased the risks for injury. Out of the medical, cardiology, neurology, surgical, oncology, orthopedic, and women/infant units that were included in the study, the medical and neurology units had the highest incidence of falls. These units also had the highest patient to nurse ratios (Hitcho et al., 2008). These findings also determined that falls occurred when patients were unassisted, ambulating, and were related to elimination needs. Because of these findings, prevention measures should focus on increasing staff assistance while patients are ambulating and supervised/assisted toileting schedules need to be provided. The findings can be applied to all areas of nursing. Despite prevention efforts, threats to reimbursement, and good intentions, falls still remain a serious and costly

Today it is a requirement of the Joint Commission for all healthcare facilities to have a fall-prevention program in place. Facilities are also required to conduct an ongoing evaluation of the program (Hubbartt, Davis & Kautz, 2013). Most prevention programs include the use of a bed alarm, but can bed alarms alone prevent falls? This paper will investigate the use of a bed alarm being used as the only tool to prevent falls. It is often found that even when a bed alarm is sounded the patient has already fallen before any nursing personal can get into the room. This paper will also investigate the use of other prevention measures that can be used independently or in conjunction with bed alarms to work toward decreasing the number of

Breimaier, Halfens & Lohrmann (2015) described that falls are a very common accident in the hospital, especially in the elder, people are 65year old or over. In addition, the evidence showed approximately 30% of the elder suffer a fall each year (as cited in Breimaier et al., 2014). According to Heinze, Halfens & Dassen (2007), 3.2%- 37% of inpatients fell and it depended on the department. Moreover, not all the fall prevention measure was taken to prevent fall-related injuries. Since all the research-based recommendations are not adopted and carried out, the potential positive effects of fall prevention on patient health outcomes cannot be realized. Inter-/national clinical practice guideline (CPGs) was created with scientific knowledge and one of them is the fall evidence-based guideline (the authors named it as Falls CPG) The Falls CPG was informed and delivered in all hospital setting. However, the fall prevention guideline was not applied in routine nursing practice. Therefore, the authors wanted to assess the effectiveness of implementation of CPG.

Falls are a serious health concern for people and an important issue for nurses. Many factors contribute to the causes of falls, apart from cognitive impairment. The consequences of patient falls are becoming a serious issue for patients and society.

Many more things could be implemented in preventing falls for patients in acute care and long-term care. Medication alternation, non-skid socks, and low bed positions are only a few interventions. Understanding that we do not live in a perfect world but with the help from the physicians, registered nurses, and the assistant personnel, accomplishing these preventive measures should be

The study highlighted that randomised controlled trial was used to compare the universal multiple intervention and the multiple targeted intervention in lowering the incidences of bedside falls in the hospital. It has a significant role in decreasing the incidences of falls. falls recorded based on daily monitoring of the EHOR. The group with usual care only has the highest numbers of falls rate compared to the intervention group with fewer incidences of falls. In addition, the research emphasises that Hendrick II Risk Model was the most sensitive, accurate and specific tool in identifying patient’s risk of falls. Additionally, this tool helps the nurses to provide better patient-centered education on falls prevention. The study has also outlined