Patient Falls: A Case Study

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?

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.

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

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,

Today it is a requirement of the Joint Commission for all healthcare facilities to have a fall-prevention program in place. Facilities are also required to conduct an ongoing evaluation of the program (Hubbartt, Davis & Kautz, 2013). Most prevention programs include the use of a bed alarm, but can bed alarms alone prevent falls? This paper will investigate the use of a bed alarm being used as the only tool to prevent falls. It is often found that even when a bed alarm is sounded the patient has already fallen before any nursing personal can get into the room. This paper will also investigate the use of other prevention measures that can be used independently or in conjunction with bed alarms to work toward decreasing the number of

Falling is a crucial issue among the hospitals. Even the hospitals make all the efforts to prevent falls, falls still occur frequently and some repeatedly. According to Currie (2008), approximately 700000 to 1000000 individuals fall in the United States hospitals each year. A fall in a health care organization is considered a never-event by Medicare and Medicaid services(CMS) (Cox et al., 2015). As the result, health care facilities are not reimbursed for hospitalized falls which increase the economic burden of hospitals.

As of 2008, the Center for Medicare and Medicaid Services (CMS) identified falls as a Hospital Acquired Condition (HAC). HAC is a complication or comorbidity that occurs as a consequence of hospitalization and is high volume and/or high cost, and be reasonably prevented using evidence-based guidelines (Radey & LaBresh, 2012). The Center for Medicare and Medicaid Services will no longer cover the cost of care as a consequence of an inpatient fall based on the presumption that falls are preventable by the organization (CMS,

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.

There are various reasons why elderly patients in a surgical ward may fall, injuring them even more almost instantly, the issue of patient’s safety and security have been the primary concern of most hospital and clinical institution but elders do fall unpredictably. Elderly patients at the age of 65 falling is a serious problem, medical professionals has realized the needs to develop a plan to purposely prevent such incidents from happening. No matter how careful the clinical person and their staff including the patients’ family some accidents may happen unknowingly due to slipping or tripping and other misbehavior of elderly patients may cause such accidents.

hospitals, participating in the National Database of Nursing Quality Indicators. The results were staggering. The association between staffing levels and patient falls varied by unit. While not every unit showed an impact between staffing of nurses and patient falls, some units do have a direct impact between the two factors. For example, in the medical-surgical units the incidence of patient falls decreased by an average of 2% for every RN added to staffing. An even stronger relation between RN staffing and decreased falls were shown in the study on medical units. The study reveals, “At the lowest staffing levels (∼2 RN HPPD), the predicted fall rate was 19% lower than at the median staffing level (5.8 RN HPPD). For unit-months with RN staffing above the median, higher RN staffing was associated with lower fall rates, although the effect was not large. For example, the fall rate at the 95th percentile (8.5 RN HPPD) was only 4% lower than at the median” (Staggs & Dunton, 2014).

As a hospital administrator I will do everything in my power to try to avoid falls and overall patient safety. Unfortunately falls will happen but there are methods that can be implemented to prevent falls. The necessity to decrease them is very imperative. Preventing falls needs the vigorous commitment of numerous people. To move towards the right direction, good prevention involves administrative values and effective practices that encourage cooperation and communication, in addition to specific knowledge.

Patients’ safety is a priority in today’s health care system. The Centers for Medicare and Medicaid Services announced that hospitals will no longer be reimbursed for certain nosocomial conditions, thus placing a great demand on healthcare systems to prevent hospital-acquired health related injuries such as falls (U.S. Department of Health and Human Services, 2008). Nosocomial conditions, such as falls are conditions that are preventable that occur in the clinical or hospital setting. A fall is an unexpected event in which the participant comes to rest on the ground, floor, or lower level (Amador & Loera, 2006). Fall related accidents, injuries and death remain a major problem among hospitalized patients. It is estimated that one out of three adult patients over the age of 65 will fall (CDC, 2014). Falls have detrimental effects and impact on patients’ health and outcome as well as hospitalizations costs. Falls have attributed to broken bones, fractured hips, fear of walking alone, brain trauma, and even death. In 2012, the direct medical costs of older adult falls were $30 billion (CDC, 2014). According to Tzeng, Yin, & Grunawalt (2008), even the length of stay is affected, with inpatient falls with injury resulting in a 7.5-day increase in total length of stay. The attributed cost of falls, increased in injuries and prolonged hospital stay have a great impact on Advanced Practice Nurses’ (APNs) practice. The focus of this paper is to discuss evidenced-based

Falling is a crucial issue among the hospitals. Even the hospitals make all the efforts to prevent falls, falls still occur frequently and some repeatedly. According to Currie (2008), approximately 700000 to 1000000 individuals fall in the united states hospitals each year. A fall in a health care organization is considered a never-event by Medicare and Medicaid services(CMS) (Cox et al., 2015). As the result, health care facilities are not reimbursed for hospitalized falls which increase the economic burden of hospitals.

Evidence based nursing practices are based upon an approach that holds evidence in the utmost regard. In order to provide better health care researchers rely on an objective approach to collect and analyze data that is used especially for decision making. By utilizing a qualitative approach to investigating the root causes of different issues, researchers can eliminate large amounts of bias from their recommendations that can be implemented in the decision making process. This analysis will briefly review some of the evidence based approaches that have been used in regards to determining the cause that result in patient falls when they are in professional care and some of the recommendations that have been made to prevent such situations from occurring.

Falls and fall related injuries are a common and significant health concern among inpatients, especially the elder population related to lack of fall prevention programs and lack of patient and nursing education. Patient falls contribute to unwanted hospital admissions, increase hospital stays, pain, severe injury or death (Demons & Duncan, 2014). Evidence suggests that falls contribute to functional decline, increased healthcare costs, and increase need for medical treatment including lengthy hospitalizations. Risk factors for falls range from environmental hazards to physical impairments and health diagnosis; therefore educating the nurse in appropriate falls prevention and interventions can considerably increase the health and safety of patients (Demons & Duncan, 2014).