Geriatric Inpatient Falls: A Case Study

A study was done at a 1,300 bed urban facility over a 13-week period. The purpose of the study was to describe the causes of inpatient falls in hospitals (Hitcho, et al., 2004). All falls were reported except falls in the psychiatry service and during physical therapy sessions. During the 13-week period, a total of 183 patients at an average age of 63.4 years old fell. Of the total number of falls 79% were unassisted, 85% happened in the patient room, 59% occurred during the evening or overnight shift, 19% were while walking, and 50% were elimination related (p. 732). In this study it was identified that many patients did not use their call bell before getting up because they did not believe they needed assistance. It was stated that, “perhaps patients need to be better educated on the effects that a new environment, decreased activity, medications, tests, and treatments can have on patients’ energy and ability to ambulate safely” (p. 737). The findings of this study showed that falls not only happen in the elderly, but in the younger population as well. Patients that fall in hospitals are often unaided and are due to elimination needs. To prevent falls and decrease injury rates, more studies need to be done.

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

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.

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

Nurses help to ensure patient safety, which includes preventing falls and fall-related injuries (Quigley, Neily, Watson, Wright, & Strobel, 2017). The general population is at risk for falls and fall-related injuries, more specifically the elderly, 65 and over (Quigley, Neily, Watson, Wright, & Strobel, 2017). Patient falls are one of the top events for hospitals and long-term care facilities due to loss of physical function or cognition (Quigley, Neily, Watson, Wright, & Strobel, 2017). Fall-related injuries are a serious health issue for the elderly population (Quigley, Neily, Watson, Wright, & Strobel, 2017). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention

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 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

Part B: Annotated Bibliography Article One: Why do hospitalized older adults take risks that may lead to falls? Citation: Haines, T. P., Lee, D. A., O'Connell, B., McDermott, F., & Hoffmann, T. (2015). Why do hospitalized older adults take risks that may lead to falls? Health Expectations, 18(2), 233-249.

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

Methods: A case control study of patients aged >65 years with an incident in-hospital fall during admissions under a General Internal Medicine Unit over a six month period was conducted. The relevant data were collected by review of medical records and analysed in univariate and multivariate models.

“Fall may be defined as an unexpected event in which the person comes to rest on the ground, floor, or lower level” (Struksness, Lindström, Lord, Slaasletten, Johansson, et al., 2011). In older populations, falls are quite common, but with a mental illness such as dementia, the problem is worsened. This cross-sectional study showed that the most common causes of falls reported by nursing staff were individual factors like physical impairment and mental impairment.