Fall Prevention Programs Are Not As Successful As Desired

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)

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

Patient falls in hospitals are a critical problem and are used as a standard metric of nursing care quality. According to the Joint Commission, thousands of patients fall in hospitals each year. Approximately 30-50% of falls result in injuries and prolonged hospital stays. Any patient in a hospital is at risk for falling and certain measures should be in place to prevent this. Preventing falls and injuries are not only important for the patient, but also for their families, the hospital, health care team, and insurance companies. It is estimated the average cost of a hospital admission due to a fall is $20,000 and by 2030, an estimated $54 billion will be spent on health care costs due to falls. The purpose of this paper is to explore the risk factors of falls in hospitals and interventions used to combat this problem.

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.

The aim of this study was to determine whether the nurse on the acute hospital floor missing nursing care interventions leads to a greater number of patient falls, using actual fall rates gathered from the study hospitals and controlling for nurse staffing (hours per patient day) levels. The related research questions were as follows: (1) Do nurse staffing levels predict patient falls? (2) Does missed nursing care mediate the effect of staffing levels on patient falls?

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.

In the healthcare system, Core Measure sets are used to measure quality care. It consists of pneumonia, heart attack, immunizations, emergency department, sepsis, for infection prevention, and others. Evidence-based treatments are used to prevent occurrences using structures, processes, and outcomes. In nursing, they have adopted a similar method of performance measures, known as nursing-sensitive indicators. It includes falls, and this indicator is implemented in each unit of the hospital and managed by the manager and educator along with others like CAUTI and CALBSI. According to the American Hospital Association article (2015) “Falls with Injury,” Patient falls-an unplanned descent to the floor with or without injury to the patient affects between 700,000 and 1,000,000 patients each year.”

If there is a fall with injury, the manager has the ability to go back and check how long the call light was on prior to a fall. However, this information is not used to prevent and emphasize the relationship between the length of time a call light is on and the rate of fall. Most nurses and patient care technicians are not aware that the manager can back-track the call light and find out this information. To measure the rate of falls to the length of time a call light is answered, the nurse working on the project choose the histogram. This illustrates the length of time in the Y axis and the rate of falls in the X axis during the period of study (time frame). The histogram itself will include a control group, average answers, and delay answers to call light. This example was imported and modified from a previous study done comparing the numbers of call lights and nursing rounds by (Meade et al. 2006).

In addition, high risk participants received education relating to falls which involved nurses instructing participants not to get out of bed without assistance, to press the call-bell for assistance and how to use the call-bell. As part of this study protocol, participants in the intervention group received usual care which include: fall risk assessment, placing the call-bell, TV remote control, eyeglasses, dentures, and hearing aids within the patient’s reach. Other interventions that have been used were bed and chair alarms, bed was in the lowest position at all time except when care was being provided and bed brakes were locked at all times. The patient’s elimination needs were scheduled every two hours, bedside commode was provided for frequent elimination needs, the patient was not left unattended while on bedside commode or in the bathroom. For a safe bathroom environment toilets was raised, toilet seats were secure, and handrails was strong enough to support patients, and patient was also instructed to pull the call light if feeling dizzy or in need of any assistance . Furthermore, the room temperature was

The following research question was addressed: What is the effect of falls in the older adults while hospitalized? CINAHL Complete and Google scholar databases were used to search for relevant quantitative research articles. CINAHL Complete was searched using words like “falls in older adults while inpatient”, “impact of falls in older adults while hospitalized”, falls in older adults”, “and falls in the hospital amongst older adults“, ” fall impact in older adults while hospitalized”. Google scholar databases was searched using keywords such as “impact of falls in hospitalized older adults”, “Fall in the older adults during hospitalization”, “effects of fall on older adults while hospitalized”. Quantitative research article published in English, where any author is a nurse, and adult subjects were analyzed; dates of publications for all articles were limited to the years between 2011–2016. The University of Texas at Arlington’s library site titled finding quantitative and qualitative research was used to evaluate the qualities of the research article to ensure quantitative articles were utilized. Research articles that were utilized were those that involve interventions focused on effects of falls in the older adults population while hospitalized. Multifactorial fall prevention programs, environmental, educational

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

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.

Nearly every one of our client have a care plans related to fall prevention. During our nursing assessment we assess their ability to perform ADL’s, strength and gait, cognition, hearing, visual acuity, use of assistive device and medications. These factors help us to determine whether the client is less likely to have a fall and can continue to live independently

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.