Patient Safety Initiatives in the Hospital Setting

During hourly rounds assess the patients pain level and take necessary intervention to alleviate pain, reposition patients who need assistance and make sure that urinals and call light and telephone are within reach of the patient. Taking care of these needs in a timely manner will make the patient comfortable, which will reduce anxiety and stress levels in the patient and reduce the risk of falls. The nurse should always make sure that the environment is safe for the patient by keeping the area clutter free. Comfort measures like tightening the wrinkled bed, giving warm blanket, changing moist dressings or repositioning the tubes or other objects that bothering the patient can enhance their comfort level Monitor high risk patients with delirium, dementia, hypotension, medications, and other conditions which can increase the risk of fall. Providing safety companions for continuous observation and to help the patients will reduce the number of falls. Nurses should educate and encourage patients to use the call light and phone to call for help. Provide patients with appropriate assistive devices like cane, walker as needed to keep them steady. I believe the concept in this theory of comfort can be utilized to reduce the occurrence of falls in health care settings.

“The primary root causes of fatal falls as reported by healthcare organizations involved inadequate staff communication, incomplete orientation and training, incomplete patient assessment and reassessment, environmental issues, incomplete care planning, unavailable or delayed care provision, and inadequate organizational culture of safety.” (Joint Commission, 2007) If a client is high-fall-risk, implementing continuous observation by bringing in a sitter for the patient would be best. If there are patients that are demented or confused, it

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.

Hourly rounding, also known as “intentional” or “comfort” rounding is essentially when the nurse or tech routinely checks on a patient at scheduled times to anticipate individual needs prior to the activation of the call bell alarm (Harrington et al., 2012). In a recent study, authors imply that hourly rounding is an effective process for improving patient satisfaction and clinical outcomes (Brosey and March, 2015). I feel that the implementation of hourly rounding will improve multiple aspects of care, including patient and nurse

Dr. Linda Aiken is the leading researcher in nursing staffing rates within the United States (Kerfoot & Douglas, 2013). She suggests that each state follows California’s example of conducting research to determine a minimum staffing ratio and making it a law (Kerfoot & Douglas, 2013). The California legislation enhanced nurse staffing in hospitals across the state and improved the patient care results of millions of patients (Kerfoot & Douglas, 2013). After the bill went into effect, job satisfaction increased, and the nursing shortage ended (Kerfoot & Douglas, 2013).

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

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.

Hourly rounding can be defined as proactive nursing intervention, at regular intervals in order to ensure patients needs have been met. Nurses attending to patients’ comfort, safety and

L. Holtz, a registered nurse (RN), mentions even with the use of tab alarms, residents still experience falls (personal communication, February 3, 2017). When a resident is first admitted into long term care, they undergo various assessments. One assessment is the Morse Fall Scale (MFS). The MFS is a rapid and simple method of assessing a patient’s likelihood of falling. It consists of six variables that include: history of falling, secondary diagnosis, ambulatory aid, intravenous (IV)/Heparin lock, gait/transferring, and mental status. There are three risk levels based on scoring: no risk, low risk, and high risk. L. Holtz pointed out interventions for high risk residents would include: tab alarms, floor alarms, and lower beds (personal communication, February 3, 2017). She also mentioned each resident is identified as a fall risk by a falling star poster which is attached to their name tag outside their door (L. Holtz, personal communication, February 3, 2017). Other interventions to reduce the occurrence of falls include: regular toileting, clutter-free areas, and well lighted area. Efforts and interventions are placed to assure the safety of the residents. However, even when these interventions are in place, falls still

The method used was a quasi-experimental study on two medical-surgical units at the same hospital and similar in size. The results of the study confirmed the results of the study that was duplicated. Hourly rounding did prevent patient falls, increase patient satisfaction, and decrease the usage of the call bell. Thus, nursing leadership must emphasize and educate nursing staff on the importance of hourly rounding and ensure that it is done

Patient safety one of the driving forces of healthcare. Patient safety is defined as, “ the absence of preventable harm to a patient during the process of healthcare or as the prevention of errors and adverse events caused by the provision of healthcare rather than the patient’s underlying disease process. (Kangasniemi, Vaismoradi, Jasper, &Turunen, 2013)”. It was just as important in the past as it is day. Our healthcare field continues to strive to make improvement toward safer care for patients across the country.

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

Nurses always gives their best to provide better patient care for prevent the disease and promote the health. With the hourly rounding, they can prevent the falls, but sometime nurses can’t give hourly rounding because of shortage of nurses and this problem put the patient at high risk of fall. The best solution is maintaining the proper staff and talked with the manager or supervisor for help. Nurses needs to evaluate and provide safe environment around the patient. On admission ask the patient of previous number of falls. Discussion with patients and families about fall prevention measures for patient safety. During patient care nurses can use of tools visually such as, yellow socks, yellow tag, and magnets on patient locater board. Unfortunately,

Now, I am aware about the significance of safety measures to avoid falls and have been applying the measures to promote safety to the patients. “Injury preventation is a major concern for older adult. For some, vision is limited, reflexes are slowed, or bone are brittle “(Kozier et al, 2014). It clearly depicts the facts that falls is a major problem in elderly and health care professional need to apply each and every possible safety measures in the health care facility to minimise the incident of fall. It is clear that the bed rails will provide support and act as a barrier that prevents older adults from falling out of bed. In long term care disorder of gait and balance is the main problem of fall for older people. Because of that older

Hourly rounding is a continuing challenge for hospitals across the United States. What’s effective about this method is that it has brought some positive changes to some Health care facilities. There are three factors that have been constantly tested to improve patient care. These factors are: 1) fall rates 2) call light usage and 3) overall patient satisfaction.