Hospital Falls

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.

Many of these inpatient falls can be prevented when following the proper fall prevention measures. Not only does patient safety make preventing falls a priority but the financial impact these falls have on an institution make it a priority as well.

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

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.

The purpose of this research paper was to examine the latest research and evidence-based practices related to inpatient falls. Falls among the elderly within a hospital setting has increased within the last decade. Inpatient falls have become the second leading cause of death, causing longer hospital stays and indirect costs for the hospital. The research reviewed multiple studies, which discussed the causes of inpatient falls. A few causes included nurses and staff not knowledgeable of current hospital practices, lack of individualized plan of care, and lack of training related to falls. The findings assisted the writer to revise the current fall policy and procedure for Arrowhead Regional Medical Center (ARMC). A fall reduction program

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

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,

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.

Falls are the leading cause of unintentional injuries in the elderly patients living in the long-term care setting. The aim of this project was to identify risk factors associated with increase falls among the elderly in order to prevent and monitor safety related events relating to falls. There are numerous risk factors associated with falls among the elderly, as the direct care nurse, working in the long-term care setting, we need to identify any possible factors that can contribute to falls, in order to prevent injury. Through evidence-based research and education we can help decrease the incidents of falls in our elderly community.

Staggs, V. S., Mion, L. C., & Shorr, R. I. (2015). Consistent Differences in Medical

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

For too long, people have been sustaining unintentional injury and death in hospital due to falls. The most heartfelt are the elderly, cognitive impaired patients, and feeble patients. Fall in the hospital is one of the most crucial patient safety issues. Most times nurses do not take adequate measures to prevent this. According to Shuey and Balch (2014) the Centre for Disease Control and Prevention reported that approximately 26,000 deaths were attributed to unintentional falls. This statistics is alarming. Do we fold our arms and watch for people to continue to get injured and die? No, there is the need to prevent hospital falls among the elderly, cognitive challenged patients, and fragile patients and something has to be done about it now. It is crucial to address this issue now to maintain the core value of nursing profession.

Falls is the leading cause of injuries among older adult; however, falls should not be an inevitable result of aging. Falls affect not only on an older individual’s independence and well-being but also personal and the nation financial. It is important that older adults are aware of how to prevent themselves from falling. Health care providers play a crucial role in falls prevention. Providers should perform gait and balance screening older adults 65 years and older for falls risk at least once a years and should pay more particular attention to individuals who have history of falling. Additionally, older adults have a higher tendency of taking multiple medications, providers should review their older patients’ medication regimen periodically because some medication can increase risk for falls. Exercise is found to have a positive impact on preventing falls. Providers should encourage older patients to start exercise program to increase strength and improve body balance.