Inpatient Injurious Falls

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

Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing

Before exploring the nurse’s role in fall prevention, one must first understand the risk factors for falls, the consequences of patient falls, and the organizations that influence how hospitals and long-term care facilities report falls. Although falls can occur to anyone at any time, a few factors increase the

Current nursing practices are based on strict standards and requirements issued by The Center for Medicare and Medicaid Services (CMC) and The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The CMS requires facilities to provide a safe environment for care and failure to do so risks losing Medicare Medicaid funding. In fact, facilities no longer receive payments for treating injuries caused by in-hospital falls. The JCAHO National Patient Safety Goal (NPSG) requires nursing home to reduce the risk of patient harm resulting from falls and to implement a falls-reduction program. The NPSG has been upgraded to a standard that requires facilities to assess and manage the patient’s risks for falls and implement interventions to reduce falls based on this assessment. The current nursing practice for fall interventions begins with assessment. Patients are assessed and reassessed to identify and address any risks factors including underlying medical or medication conditions. Risk Assessment Tools for predicting falls score each category identified as a potential risk. For example, categories include Medication, Activity/Mobility, Elimination, Previous Falls, Length of Stay, Mental Status, and Age all can influence the

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,

Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator

Falls are the second most common adverse event within health care institutions following medication errors, and an estimated 30% of hospital-based falls result in serious injury. The severity of this problem led the Joint Commission to make reducing the risk of patient injuries from falls a national patient safety goal for hospitals in 2009 (AHRQ, 2006). Falls are a leading cause of hospital-acquired injury and frequently prolong and complicate hospital stays and result in poor quality of life, increased costs, and unanticipated admissions to long-term care facilities.

The lack of proper education on identification of falls risk and falls prevention measures impact patient falls. Staff turnover and the use of temporary staff contribute to miscommunication or lack of communication on processes such as fall prevention measures. Experience levels vary on any given unit. Educational needs assessments should be routine and include temporary and new staff. Authors Manojlovich, Sidani, Covell, and Antonakos (2011) define nurse dose as “the level of nurses required to provide patient

Problem Significance Fall is a nursing sensitive issue that require more attention from all healthcare professionals. As patients’ safety is one of many responsibilities of nurses, it is crucial for nurses to address issue related to fall injuries. The goal of nursing practice is to promote health and to alleviate pain and

According to the Joint Commission Resources-JCR (2005), there is no universally accepted definition of a fall. Thus several definitions have been floated over time in an attempt to define the same. One such definition of a fall is "an untoward event that results in the patient or resident coming to rest unintentionally on the ground or another lower surface" (Joint Commission Resources, 2005). Falls are regarded common causes of injury at every age. However, it is important to note that for seniors, falls can have serious consequences. This is more so the case given that a fall can bring about pain, trauma, or even death. With that in mind, the primary purpose of this program remains the reduction of falls and hence the aversion of related injuries amongst the concerned patients. Of key importance remains the identification of patients who appear to be at high risk of falling. This way, appropriate strategies can be developed to reduce the injuries related to inpatient falls.

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.

Burns, E.R., Stevens, JA. & Lee, R. (2016). The direct costs of fatal and non-fatal 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

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