Mrs. Cabrera Case Discussion

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

A secondary process of calibration is needed to make the scales applicable to a specific institution to which a patient has been admitted. After the scales have been calculated for each patient by a healthcare professional, the cutoffs for the low, moderate and high risk categories must be calibrated to the conditions of the specific care facility(Kim et al. 2007)(Bailey et al. 2011). Aspects to take into consideration during the assessment process are the presence of barriers , general lighting in the hospitals , staff number , and need for an individual patient to move(Kim et al. 2007). This process needs to be managed by an combining fall prevention team because the scale and consequent risk categories are specific to the specific institution and the process needs to be dynamic to account for falls occurring at the institution. After addressing the patients who are at risk a standard interventions are needed to ensure patients safety by addressing environmental issues that need minimize a systemic risk of the hospital environment(Bailey et al. 2011). The first area that can be improved to reduce the number of falls is the use of assistive equipments for

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.

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.

Provide mandatory, up-to-date education related fall prevention. Every single one in this facility can have the adequate capacities to prevent falls and offer education to patients, family members and caregivers regarding skills and knowledge of fall prevention. Develop policies in multifaceted and tailored strategies with evidence-based practice (Breimier, Halfens, & Lohrmann, 2015). Have more awareness and "need for individualizing the care plan and communicating the plan to those working with the patient becomes evident when implementing a fall reduction program" (Ambutas, Lamb, & Quigley, 2017, p 179). In addition, maintain consistency or accuracy in risk identification and action planning, as well as obtain patient and caregiver’s commitment to adhere to the safety plan on the daily basis (Silva, & Hain, 2017). Everyone is in the same page and conduct measures effectively and efficiently. Evaluate and assess the implementation of strategies monthly. Change and correct properly and timely to reach the aim of zero falls.

In DC, community based fall prevention programs have been rising to address falls but fall related incident, injuries and the cost has continuously been rising among elderly people (Costello & Edelstein, 2008). In the study conducted by Berland et al. (2012), showed that in home health, not viewing patient safety as primary prevention, lack of investigation causing fall and frailty of elderly adult have been some factors contributing to falls in home health. Falls negatively impacts an individual living in their home by causing them physical, emotional problem, giving rise to additional cost by losing workdays and income.

The increase in patients falls and the number of patients that are fall risks has greatly increase. Part of this is due to the aging population. While there are many prevention methods in place, patients are continuing to experience falls. “Problem solving relies on decision-making, critical thinking, and/or clinical judgement” (Chamberlain College of Nursing, 2015). I recently had a patient that had two falls during his admission. I placed the patient on 1:1 observation. He was a fall risk due to his history, mental status, and medications (narcotic pain meds and antipsychotics). The patient did not fall again while I was at work. However, after my days off I came back and got report that the patient fell again. The patient had been taken

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

Contributing elements of patient falls include patients’ balance, gait, impaired cognition, and a history of falling (Tzeng & Yin, 2015). Studies have proven there is a correlation between “nursing staff and adverse patient

Falls in an acute care setting lead the list of injury related deaths and deaths in the elderly. “A fall is defined as any event which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors” (Kalisch, Tschannen, and Lee, 2012, p. 6). Medicare and Medicaid changes in 2008 list falls as one of the 10 hospital acquired conditions for which hospitals will no longer be reimbursed because falls are considered preventable conditions. Joint Commission accredited hospitals are required to assess for falls risk and implement falls prevention measures.

To begin with, the very common case in most of care homes, especially residential care homes where residents are more independent compare to other nursing home, residents are tend to be high risk of falling. As health professional we have duty to put risk control measures in to place once resident has bee identified to have high risk of falling. Because if we failed to provide methods to prevent the risk of falling, the resident could end up

Risk factors for falls are categorized by intrinsic or extrinsic (Tzeng, & Yin, 2009). According to Tzeng and Yin (2008), intrinsic factors, referring to the patient themselves, are related to their health status and possibly associated with age-related changes: previous falls, reduced vision, unsteady gait, musculoskeletal system deficits, mental status deficits, acute illness, and chronic illness. Extrinsic factors are involved in the patient’s environment, including medications, lack of support equipment, furniture, bathroom designs, small patient rooms, poor lighting, and improper use of and inadequate assistive devices. Tzeng & Yin (2008; 2009) focused on the extrinsic risk factors for the basis of their studies.

Additionally, individual risk factors such as medications, vital signs, and patient’s functional and emotional status on admission were assessed (Rheaume, 2015). Moreover, other factors examined included: time of day when the fall occurred, location of falls, unit staffing, risk assessment score, rounds, fall prevention interventions at the time of fall, equipment related to fall, people with patient at time of fall and patient activity at the time of fall. Post fall data included injury sustained, treatment of related injury and patient outcomes (Rheaume, 2015). A total of six patients were reviewed, three females and three

The senior adult should take personal responsibility in ensuring that the risk factors are reduced. The individual should completely quit the consumption of alcohol and cease smoking to ensure his balance is not impaired. He should also engage in regular exercises which will enhance his physical fitness and hence flexibility. F.P. should also ensure that he sticks to prescriptions to help him avoid the consequences of underdoes which could increase the possibility of falling.