Falls In Acute Care Case Study

I went to Tampa General Hospital Fall Repiratory Care Conference that was held October 27, 2015 at USF CAMLS building downtown Tampa. I chose to try and attend two events in case I could not make one. Working in patient care means that sometimes you won't get out on time to make your arrangement.

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

increase. The purpose of this paper is to improve patient’s safety examining risk factors for falls using evidence based practice research studies. The studies suggested that falls are associated with many factors like impairments, medication, lack of exercise, and nursing intervention. Strategies for implementation of a fall prevention are listed, along with current nursing practice. Another essential step is to have a completed risk assessment of resident upon admission, modification of the environment assessment and implementing strategies to identified any potential risks.

Fall prevention is a primordial safety concern in hospitals. There can be multiple bad outcomes from a simple fall. The fall of a patient can result in immediate death. This is to say that a patient could fall and die on impact. Weak and confused, a patient may fall on the floor without a way to lessen the impact from the fall. This patient may fracture his or her skull. Fractured femur or hip bones can result from falls in the elderly because of their weaker bones. This would extend the length of the hospital stay for the patient. This would be terrible considering that many of these falls are preventable. The patient can become permanently disabled form a fall while hospitalized. The measures against falls are many because they can be caused

196-199), Older Adult Inpatient Falls in Acute Care Hospitals: Intrinsic, Extrinsic, and Environmental Factors used a varying sample size of 71 to 34,972 acute care hospital patients, including the ages of 17 to 104 years old (Zhao, Kim, 2015, pp. 29-43), Hospital Fall Prevention: A Systematic Review of Implementation, Components, Adherence, and Effectiveness met the criteria of a study due to the inclusion of studies that report in-hospital falls in acute care hospital setting, however this study wasn’t age specific (Hempel et al., 2013, pp. 483-493), An Analysis of Patient Falls and Fall Prevention Programs across Academic Medical Centers analyzed 154,618 inpatient falls, this study did not specifically focus on this groups’ targeted age population (Williams, Szekendi, Thomas, 2014, pp 19-29). Evidence-Based Falls Prevention in Critical Access Hospitals was another study that focused on inpatients but wasn’t specific to the 65 year old or older

Studies have shown that in acute care hospitals that fall rates range from 1.3 to 8.9 falls/1000 patient days and that rates are higher in areas that focus on neurology, rehabilitation and eldercare. (QualityMeasures, 2017). Unintentional falls can cause serious injury to the patient which can increase then their length of stay as well as increasing their cost of care. Notably, the most common cause of traumatic brain injuries are falls. (CDC, 2017). In addition, falls can cause bones to fracture and break which could require surgery. Thus, if surgery is required that may require additional rehabilitation after the hospital or a stay a skilled nursing facility or some are left permanently disabled. Consequently, falls can increase

On average acute care hospital facilities can experience 6 falls/1000 admissions (0.6%) to facilities. These occurrences are resulting in compromising the patient’s recovery timelines. Discharges are being delayed and coupled with added costs of the hospital stay; most hospitals have assigned this as an opportunity for improvement. All of these ramifications resulting from a patient fall. In this paper we will discuss inpatient hospital falls, what exposes a patient has to experiencing a fall while admitted, what hospital systems are doing to reduce the risk of falls and which preventative methods on reducing falls seems to work well. The incident may not be eliminated from occurring, however with prevention, occurrences can be reduced.

Fall prevention is a vital aspect of a nurse’s job in the hospital. In this article, it explains hospitals having fall risk assessment tools, but many of them have not implemented interventions to mitigate patient-specific fall risk to these tools. The research problem addressed even though fall prevention should be modified to the individuals risk factors. Hospitals have not implement the use of fall prevention intervention to targeted patient with specific risk factors. Each patient is an individual and may have different risk factors than the patient in the next bed. The gaps in knowledge for fall risk patient are medical personnel don’t consider patient specific fall risk factors in the hospital setting. This study understands little research

Fall and fall related injury is a huge problem in hospital settings; however, the number of fall rate has been increasing as well as the cost of staying in the hospital too. Preventing the falls in acute care settings is challenge due to severally ill patients, mean age ranging from 64 to 74 years, increased numbers of hospital staying, and higher level of dependence (Abreu, Mendes, Monteiro, & Santos, (2012). According to the Joint Commission (2015), the Medicare and Medicaid do not reimburse the cost if patient had fall in hospital. All the treatments and tests cost are provided by the hospital due to in-hospital falls. Because of many incidences of patient falls, it is a serious and known clinical problem to identify cause, understand

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).

Studies show that adults of ages 65 and above account for 80 % falls in acute care setting (Rheaume, 2015). A variety of factors predispose this group of vulnerable population to falls and include: age, urinary incontinence, impaired mobility and vision, orthostatic hypotension, history of falls, mental status changes, and acute illness. Falls can result in increased hospital cost, injury or even worse, death. The study focused on six case reviews on patients between the ages of 64 and 87, who sustained falls while hospitalized (Rheaume, 2015).

There’s an increased rate at which patients fall in hospital settings are affecting the healthcare industries, patients and family members. According to studies performed, it is evident that those who are mainly affected are the adults that are over 60 years of age. Some of the factors that lead to these falls are; visual impairments, wrong footwear and tripping are some of the external causes of falls among these hospitalized patients. Because this has become a major concern, research has embarked on how these factors have led to increased falls in these patients. Adult patients falls are major threat to patients safety and cost management in hospitals making prevention measures a key area of concern and

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.

Patient falls are the leading patient safety event that causes injuries in health care organizations today. The National Database for Nursing Quality Indicators describes a patient fall as an “unplanned descent to the floor”. Inpatient falls account for forty percent of all hospital acquired injuries (Rheaume & Fruh, 2015, p. 318). Fall rates are higher for older adult patients, and half of all falls result in injury. Patient falls contribute to an increased length of stay and an increased cost of hospitalization. The medical costs related to patient falls is approximately $30 billion dollars per year (Centers for Disease Control and Prevention [CDC], 2016). In 2008, the Centers for Medicare and Medicaid Services (CMS) introduced pay-for-performance

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.