Multifactorial Fall Prevention

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.

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.

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 Center for Disease Control and Prevention (CDC) (2016) press release one of the leading cause of accidental deaths of the elderly is falls. This is an issue for our seniors many long-term care (LTC) facilities across the nation. However, one of our primary goals in health care is patient safety. Although, no one can guarantee a patient will never fall, it is our job to maintain a safe environment, prevent falls and injuries. The families of our elders move them into a nursing facility expecting an accident free, uneventful stay for the remainder of their loved ones days. In some cases, frequent calls at various hours of the day to report adverse event which are often falls becomes the reality.

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

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 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.

Patient safety is one of the nation's most imperative health care issues. A 1999 article by the Institute of Medicine estimates that 44,000 to 98,000 people die in U.S. hospitals each year as the result of lack of in patient safety regulations. Inhibiting falls among patients and residents in acute and long term care healthcare settings requires a multifaceted method, and the recognition, evaluation and prevention of patient or resident falls are significant challenges for all who seek to provide a safe environment in any healthcare setting. Yearly, about 30% of the persons of 65 years and older falls at least once and 15% fall at least twice. Patient falls are some of the most common occurrences reported in hospitals and are a leading

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

Qualitative data analysis was obtained in this study in which eight major themes were revealed. The overall perception includes past falls, fall risks, and fear of fall-related injuries. (Shuman, 2016). Overall, the initial perception of the patients was they did not receive fall prevention information. As the interview continues the participants were able to give examples of fall preventions given to them by the healthcare providers’. The data analysis supports the conclusion that healthcare providers need provide clarity to patients and family member in order to prevent falls.

I discovered preventive strategies could be used as a theory to minimise falls in older people using different literature reviews. A fall however can be defined as an unexpected, involuntary loss of balance by which a person comes to rest at lower or ground level (Commodove, 1995). The older population is growing in number, and falling is common in this group up to one-third of people over the age of 65 falls each year, with half reporting multiple falling episodes (Bludau and Lipsitz, 1997). Savage and Matheisk-Kraft, (2001) states that fall-related injury is the sixth highest cause of in older people.

In conclusion the research shows that further communication is needed between the patient and caregiver. The exploratory study revealed that the informants received fall prevention interventions while hospitalized and at hospital discharge, even though they did not perceive these as such initially. (Clayton 2016). By fully engaging with the patient and family member through better communication this can help their understanding of risks of falls. With effective communication and understanding of the risk of falls, fall prevention can effectively be implement without patient misconceptions.

The current organization that this implementation is being focused on is a full support to design a program that will involve the patient and multi-disciplines to reduce falls along with faster post fall assessments to reduce medical complications. Current the organization has