Inpatient Injurious Falls

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.

Falls are a big concern for all employees in a hospital setting daily. The worst thing that can happen to a patient while being hospitalized is a fall, or a major fall, that could result in skin damage (i.e. wounds, skin tears, or abrasions), a fracture or break, thus limiting their independence. This student’s goal was to develop a way to educate staff members in ways they can help reduce the number of falls that occur. Developing a sample Fall Risk Prevention Policy as well as a Staff in-service on fall risk and Prevention achieved this goal.

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

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

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.

In accordance to this theme, the TCAB design team developed goals and changes that would show improved outcomes. One of these “high-leverage changes” (Rutherford et al, 2009) was preventing patient injuries from falls. Patient falls is one of the high occurrences in patient safety and injury, as well as the leading cause of death of patients 65 and older (Rutherford et al, 2009). By incorporating the TCAB initiative, the pilot hospitals average of patient falls was reduced by fifty-two percent (Rutherford et al., 2009). One of the ways that patient falls were reduced was by involving the personal care attendants (PCA) in making frequent rounds with patients and asking them if they were comfortable or if they needed anything. By involving the PCA’s in falls prevention, the study showed an average fall rate per one thousand patient days decreased from 6 to 4.5 (Stefancyk, 2009). One of the main themes between the studies is preventing patient injury during their hospital stay. In doing so, the ethical principle of beneficence and nonmaleficence have been addressed. A second intervention was also implemented in reducing injuries to the elderly client was placing a sensory cart on the unit and to be utilizing

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

Healthcare organizations rely on incident reports for counting the frequency of falls and collecting fall-related data (Quigley, Neily, Watson, Wright, & Strobel, 2017). When a fall occurs in a healthcare organization, an incident report is completed to record the occurrence and circumstances surrounding a fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). The definition of a fall is a loss of upright position (Quigley, Neily, Watson, Wright, & Strobel, 2017). A sudden, uncontrolled, unintentional, non-purposeful, downward displacement of the body to the floor, ground, or on an object (Quigley, Neily, Watson, Wright, & Strobel, 2017). When a fall occurs in a healthcare organization, an incident report is completed to record the occurrence and circumstances surrounding a fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). The data might include time of day, location, activity, vital signs, and incontinence (Quigley, Neily, Watson, Wright, & Strobel, 2017). From the analysis of the data, one can determine the type of fall, such as accidental, anticipated physiological, and unanticipated physiological fall (Quigley, Neily, Watson, Wright, & Strobel, 2017). Along with the severity of the injury, minor, moderate, major, or severe, as well as to identify overall patterns and trends surrounding fall occurrence (Quigley,

The aim of this study was to determine whether the nurse on the acute hospital floor missing nursing care interventions leads to a greater number of patient falls, using actual fall rates gathered from the study hospitals and controlling for nurse staffing (hours per patient day) levels. The related research questions were as follows: (1) Do nurse staffing levels predict patient falls? (2) Does missed nursing care mediate the effect of staffing levels on patient falls?

Inpatient falls after joint replacement surgeries can cause many complications, prolong hospitalizations and increase healthcare costs. These falls can lead to things such as wound infections and sometimes falls can even require a patient to have a revision surgery. This is especially true in postoperative joint replacement surgical patients. While assessing the orthopedic surgical unit where I work, gaps were found in completing fall risk assessments on patients, which is a requirement. Strategies to prevent falls were not always being followed. Things like a postoperative patient that may require two people to help while ambulating at least for the first day or so was not being done. If the requirement for a two person assist is not

During hourly rounds assess the patients pain level and take necessary intervention to alleviate pain, reposition patients who need assistance and make sure that urinals and call light and telephone are within reach of the patient. Taking care of these needs in a timely manner will make the patient comfortable, which will reduce anxiety and stress levels in the patient and reduce the risk of falls. The nurse should always make sure that the environment is safe for the patient by keeping the area clutter free. Comfort measures like tightening the wrinkled bed, giving warm blanket, changing moist dressings or repositioning the tubes or other objects that bothering the patient can enhance their comfort level Monitor high risk patients with delirium, dementia, hypotension, medications, and other conditions which can increase the risk of fall. Providing safety companions for continuous observation and to help the patients will reduce the number of falls. Nurses should educate and encourage patients to use the call light and phone to call for help. Provide patients with appropriate assistive devices like cane, walker as needed to keep them steady. I believe the concept in this theory of comfort can be utilized to reduce the occurrence of falls in health care settings.

At Brigham and Woman Hospital, this fall prevention program has been instituted throughout the facility. The protocol requires all patients to be screened for fall risk factors upon their admission to the hospital. Upon admission, nurses must conduct a throughout medical assessment, and use the Morse Fall Scale to assess patients mobility, muscle strength, gait, vision of patients because those conditions can put patients at increase risk for falls. At the end of each assessment, a number is provided to each patient determining the degree of fall and documented in the patient chart. For example, a patient might be a low risk for fall while another might at high risk for fall. In addition, the nurse must create a plan of care and

The Cochrane Library search with the MeSH heading accidental falls yielded 7694 articles. To further narrow the search, the MeSH headings bed alarm AND hourly rounding were added. This yielded six articles, one of which was applicable to this study.

Tzeng and Yin (2008) state that nurses assume the responsibility and are liable when a patient falls in their care. Nurses spend the most time with patients at their bedside; however, nurses don’t have any

The evidence based assessment tool, Morse Fall Scale is used to assess the risk for falls.