Patient Falls: A Case Study

This outcome reduces potential injury of fall in a primary care setting and a hospitalization, prevents additional financial strain on patients and their families by protecting the patients’ healing process and reducing unwarranted hospitalization and the length of staying in the hospital. The outcome can also benefit staff and the health care facility by preventing unnecessary staff burnout and injury, and reducing cost spending in providing unwarranted care that reduces profit and increase

he incidence of falls has a large impact in healthcare today, including legal, ethical, economical and safety implications, for patients, healthcare organizations and the community. Adhering to standards of care, and preventing falls assist the nurse, organization and patient in avoiding legal implications from falls. Protecting the patient's’ well-being, providing autonomy, and freedom are ethical obligations the nurse must consider when taking care of patients. Financial implications for falls can be devastating to the patient, as well as the organization and community. The safety of the patient is our number one goal in healthcare, and reducing fall incidence will not only improve patient safety, but it will improve healthcare as a whole.

Since healthcare organizations throughout the country strive for positive patient outcomes and patient satisfaction, preventing falls among patients in healthcare settings remains a nursing staff priority. Unfortunately, fall prevention is not a new problem. Nurses face the challenge of recognizing patients who may be at high risk for falls and intervening to prevent falls on a daily basis. To identify areas for improvement in fall prevention, a thorough review of the organizational function of the medical unit at Rex Healthcare in Raleigh, North Carolina, utilizing Roussel’s Evaluating Organizational Function Tool was completed (2013, fig 7-51). Interestingly, even with great effort from nursing staff to prevent falls, they appear to continue to occur on the medical unit. Therefore, the purpose of this paper is to review current literature to identify whether or not an association has been found between the rate of falls and hourly rounding.

Falls among elderly individuals have continued to be a major challenge for health care providers. Individuals hospitalized for falls incur a higher health cost compared to other hospitalized patients. Despite efforts to reduce the number of falls through the use of some strategies, fall rates continue to be high in hospitals. According to Massachusetts Department of Public Health, and a recent summary performed by the Bureau of Health Care Safety and Quality (2011), Massachusetts acute care hospitals reported 57% of serious reportable events as environmental; 98% of those serious events were attributed to patient falls (Nientimp & Peterson, 2012). There is limited research that supports the idea that hourly rounding performed by nurses has an impact on reducing patient falls (Lascom, 2015).

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, and difficulty with activities of daily living all of which are factors linked to falling. Contributing causes of nursing home falls include walking or gait issues, environmental hazards such as wet

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

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.

At the center of a successful falls prevention program is an organizational culture that values safety for both patients and associates. Creating a culture of safety is one of the key interventions that reduce harm for patients in a heath care setting (Quigley & White, 2013). If a health care organization fails to protect patients from harm, there are both legal and financial implications. In the effort to prevent harm to patients and hospital acquired injuries, the Centers for Medicare and Medicaid Services (CMS) introduced pay-for-performance and the value-based purchasing program in 2008. These non-payment programs, withhold payments to organizations that report hospital acquired injuries such as falls (Rheaume & Fruh, 2015). A reduction is reimbursements leaves a health care organization vulnerable to financial instability. A lack of financial resources can lead to staffing reductions and lack of investment in patient safety interventions; both have been shown to lead to poor patient outcomes (Trepanier & Hilsenbeck, 2014).

In this assignment I will be explaining three different approaches to health education. I will also be giving examples of each approach being used and lastly I will also be explaining the role of the health educators in these approaches. The three approaches I will be talking about are as follows; social marketing approach, two way communication and community development approach.

The Centers for Medicare and Medicaid Services (CMS) has identified eight adverse conditions, and inpatient injurious falls continues to be the most common adverse condition (as cited in Tzeng, Hu & Yin, 2016). The inpatient falls in the “US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (as cited in Bouldin et al, 2013, p.13). Roughly 25% of patients are injured when they fall (Bouldin et al, 2013). Since 2005, the USA’s National Patient Safety Goal listed fall prevention as a goal (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014). Since 2008, hospitals no longer receive payments from CMS for health care cost connected to inpatient falls (Bouldin et al, 2013). CMS views inpatient injurious falls as injuries that should never occur (Bouldin et al., 2013). There is no doubt that quality improvement must continue to address inpatient injurious falls. Preventing falls and implementing interventions to lower the rates of falls is a major concern for hospitals and must be included in any quality improvement measure.

Patient falls have been a long debated healthcare issue throughout time and measured as a nursing sensitive issue. The National Quality Forum (NQF) has endorsed patient falls with an injury with the steward of the American Nurses Association (NFQ: Quality Positioning Systems, 2014). All patient falls are documented per 1,000 patient days via the measurement description (NQF: Quality Positioning Systems, 2014). The target population that accounts for the total number of patient falls is in the medical-surgical, step-down, critical care, critical access, surgical, medical and adult rehabilitation units (NQF: Quality Positioning Systems, 2014). The Center for Control and Disease (CDC) has reported that every seventeen seconds, an elderly patient will have a fall in a hospital (Hill & Fauerbach, 2014). The majority of falls are associated with patients ambulating from a bed, chair, or toilet without the proper assistance (Shorr, Chandler, Mion, Waters Liu Daniels, et al., 2012). There is a new regulation published by the Center for Medicaid Services. It states that injuries acquired through a fall in an organization will be held responsible for those medical costs (Hill & Fauerbach, 2014). In fact, in 2010, there was approximately $30B in hospital costs related to patient falls (Hill & Fauerbach, 2014). With the increasing number of patient falls in acute care settings and the change of healthcare coverage, does the use of bed alarms reduce the risk of falls of

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.

After watching my mother who is a nurse for the NHS for the most part of my life, the way she shows full devotion to her work and her dedication, made me realise in my few years in college that I have had a passion for science especially in the medical field and heath. This was later reinforced by my frequent visits to the hospital which gave me the invaluable chance to talk to some medical professionals, which helped me reaffirm and come to a natural choice in healthcare. So why did I choose this course?

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

The American employment laws are designed to foster human dignity and in the process provide employees with various tangible benefits. It is therefore expected for employees to be on the forefront in supporting and adhering to them. Likewise if an organization applies effectively these laws, it can benefit massively from dynamic, healthy, motivated, and productive employees. It therefore goes without saying that managers, just like employees, should promote these laws and thus ensures the organization conforms to them. Generally these laws govern the workplace actions of employers and employees. It ensures a fruitful and legally conducive environment and relationship exists between these two parties, and within employees