Fall Risk Prevention in a Hospital Setting
As we age, our bodies tend to weaken and we become more susceptible to disease and illness. When we have a disease, this causes us to become weakened and we will have a higher chance having a fall, which is America’s highest unintentional killer in hospitals. The definition of a fall is an unintentional change in body position that results in the patient’s body coming to rest on the floor or ground (Ignatavicius & Workman, 2016). At one point in our lives, we all have taken a stumble or two, possibly injuring ourselves or worse, but as we get older, our chances of falling increase dramatically. Aging is inevitable and we will all have injuries and illnesses that increase our chances of having a
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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.
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
The Center for Disease Control (CDC) reported that more than one third of adults 65 and older fall each year. Half of the elderly people, who fall, do so repeatedly. Aside from the health problems related to falls, nearly $20 billion of direct medical costs are associated with fatal and non-fatal falls (Larson & Bergmann, 2008).
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.
Every year, about one third of everyone over the age of 65 falls, and do not report it to their doctors. Falls are the leading cause of fatal and nonfatal injuries in older people (Falls Among Older Adults). Falls become more common as people age because their bones become more brittle and their muscle mass decreases. In society today, the baby boomers are aging, which means falls will continue to increase in frequency. When a person falls, it doesn’t just affect the victim; it affects everyone. In 2012, approximately $30 billion went towards medical costs that were associated with falls (Falls Among Older Adults). To prevent more people being injured and more money being spent, there has to be a change.
Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term
The incidence of fall-related injuries in the elderly U.S. population will continue to increase (Quigley, Neily, Watson, Wright, & Strobel, 2017).
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.
Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control
Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues,
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
Your presentation was clear and the format was sleek which made the information easy to read and follow. You did a great job at listing the factors that attribute to falls, and your graph of the times that falls most often occur was a great addition. Communication tools to indicate fall risk for staff is a widely implemented model. At my facility we use signs, fall risk bracelets, and yellow gowns to indicate patients at risk for falls. A patient care plan should including current and accurate fall risk status with associated tailored and feasible interventions readily identifiable and accessible to staff (Dykes, Carroll, Hurley, Benoit, & Middleton, 2009). The entire healthcare team, the patient, and families should be made aware of the potential
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization
The World Health Organization (2012) define falls as “an event which results in a person coming to rest inadvertently on the ground or floor or other lower level” (WHO, 2012). They can happen to anyone but are more likely to happen to those over 65 years (Rubenstein L. 2016). Individuals who have already fallen are more likely to fall and sustain an injury than those who haven’t (Rubenstein L. 2016). Because falls are not a result of just one cause, they stem from a myriad of reasons further inhibiting the prevention of them (Rubenstein L. 2016). The more we understand about falls and its complexities (Rubenstein L. 2016); the emotional, physical, and financial consequences, as well as the many ways we can prevent them; the more we are able to enjoy a high quality of life in our later years.
If patient safety is the most important issue in Health Care facilities then how come hospital inpatient falls continue to be the most reported of all accidental falls (Tzeng & Yin, 2009)? Throughout the years, hospitals continue to make changes to decrease the risk of accidents and increase the quality of patient safety. With research studies and improvements made, patient falls still hold the largest portion of reported incidents in hospitals (Tzeng, & Yin, 2008). According to Tzeng & Yin (2008), “fall prevention programs apparently do not effectively reduce inpatient fall rates because of human factors and ergonomics in a hospital environment (p.179, para. 2). The two studies reviewed in this paper were performed with the hopes of
Aging affects the musculoskeletal , respiratory, cardiovascular, and nervous systems, as well as posture and gait, which all lead to a decrease in activities of daily living, fitness ability, and falls (Nitz & hourigan, 2004).Falls may have significant devastating effects on the elderly population including pain, reduced confidence to return to normal mobility, becoming dependant on relatives and other people, premature transition to care homes, and most importantly injuries (NICE guideline, 2004) .The World Health Organisation (2012) reported falls as being the 2nd main cause of unintentional injury leading to death.