Hendrick II Risk Model: A Clinical Study

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

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

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.

Patients are medicated, in an unknown environment, attached to lines, drains, and physiologically impaired in some manner. They are at a very high risk for falling. The American Hospital Association explains how participating hospitals have reduced falls by 27% by using the bundles and toolkits from Hospital Engagement Network (AHA HEN), this process requires the interdisciplinary team involvement. Each has their own role, nursing plays a critical role in fall prevention, they are with the patient for 12hours in a hospital setting and have direct care with assessing, creating a care plan, implementation of interventions, and evaluation. They can report any concerns or data to the

Each year, one out of three elderly people fall (U.S. Centers for Disease Control and Prevention [CDC], 2015). The CDC (2015) also reports that once an individual has fallen, the chance that they will fall again doubles. Falls also contribute to an increase in direct medical costs. The CDC (2015) states, “Direct medical costs for fall injuries are thirty-four billion dollars annually. Hospital costs account for two-thirds of the total.” The amount of elderly people who fall each year along with the economic costs that result from falls indicates that preventing patient falls remains an important goal for healthcare workers including nurses. Nurses can use the nursing process—assessment, diagnosis, planning, intervention, and evaluation—to prevent patient falls and meet the fall prevention standards set by various regulating bodies.

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

This project is part of an existing Quality Improvement Project by the organization on falls prevention, the most important aspect of a falls prevention initiative is using a standardized fall risk assessment (such as the BRIGGS Healthcare Falls Risk Assessment) to support the Quality Improvement Project. Quality Improvement projects are vital to any organization; they are data-driven, usually involve human participation. Also, it is a systematic approach, data-guided activities designed to bring about improvement in health delivery system. The fundamental obligation of health care providers and stakeholders are improving the quality of care of patients (Zaccagnini & White, 2011).

Statistical analysis showed that there is a high correlation between patient falls and the factors of nurse staffing that were addressed in this study. This shows that nurse staffing is significant in preventing patient falls and safety concerns in the hospital. The findings in data collected reinforce previous findings that greater staffing leads to fewer patient falls in the hospital. There were several correlations between the data collected and patient falls.

The Centers for Medicare and Medicaid Services (CMS) has identified eight adverse conditions, and inpatient injurious falls continues to be the most common adverse condition (as cited in Tzeng, Hu & Yin, 2016). The inpatient falls in the “US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (as cited in Bouldin et al, 2013, p.13). Roughly 25% of patients are injured when they fall (Bouldin et al, 2013). Since 2005, the USA’s National Patient Safety Goal listed fall prevention as a goal (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014). Since 2008, hospitals no longer receive payments from CMS for health care cost connected to inpatient falls (Bouldin et al, 2013). CMS views inpatient injurious falls as injuries that should never occur (Bouldin et al., 2013). There is no doubt that quality improvement must continue to address inpatient injurious falls. Preventing falls and implementing interventions to lower the rates of falls is a major concern for hospitals and must be included in any quality improvement measure.

Evidence Based Management of Fall Prevention in the Health Care Setting Patient’s fall is an unexpected event, and it is one of the challenges that nurses face in caring for patients. Sometimes, finding answers to why a patient fell could be difficult, but providing a strategic approach to prevent the fall event will improve the existing practice and preserved patient safety. The evidence based practice is the new world which nurses live in through a research and is the best tool for providing quality care for patients. To improve the existing practice for a fall prevention, this paper will examine the effectiveness of the fall preventive measures provided for patients during the period of hospitalization and the process of an health assessment’s visit by answering a clinical PICO(t) question which stated; in older adult patients, what is the efficacy of using fall prevention compared to no fall prevention for preventing fall during the period of hospitalization and the process of health assessment in the primary care setting?

Montalvo, (2007) stated falls should be under both a process and an outcome measure category. Falls are a very important nurse indicator because falls/injury can cause the hospital to spend a lot of money to treat accidents that happen after the fall. Falls can be prevented if the hospital has adequate staff, well light and clutter free rooms. My rationale for considering this nursing indicator will endorse awareness into patient safety on fall preventions while providing quality healthcare. I believe if the hospital facilities monitored for fall risk and prevention methods more closely they could have drastic decrease in the number of falls.

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.

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

As previously stated, falls account significantly for injuries witnessed in hospitalized patients. Falls are attributable to risks which can either be intrinsic or extrinsic. Intrinsic factors predisposing patient to falls relates to their physical state or their overall level of wellbeing (Miake-Lye et al., 2013). For instance, issues such as their age, gender, balance, ailments such as arthritis affecting their level of incapability, etc. Extrinsic factors relate to the patient's environment such as the lighting levels, the slipperiness of hospital floors and other contributory factors (Miake-Lye et al., 2013). The bottom line, however, is that most of these risk factors can be assessed, and appropriate measures taken to prevent most of these

Nurses always gives their best to provide better patient care for prevent the disease and promote the health. With the hourly rounding, they can prevent the falls, but sometime nurses can’t give hourly rounding because of shortage of nurses and this problem put the patient at high risk of fall. The best solution is maintaining the proper staff and talked with the manager or supervisor for help. Nurses needs to evaluate and provide safe environment around the patient. On admission ask the patient of previous number of falls. Discussion with patients and families about fall prevention measures for patient safety. During patient care nurses can use of tools visually such as, yellow socks, yellow tag, and magnets on patient locater board. Unfortunately,