Priority Patient Analysis Paper

Mariam background is 60 year old lady admitted with left sided weakness and facial droop. Once confirmed stroke using the Recognition of Stroke in the Emergency Room (ROSIER) scale. Catangui (2015) states ROSIER scale is used to distinguish whether the patient is having a stroke or stroke mimics e.g. seizures or brain tumours. Computed tomography CT brain showed ischemic stroke. Ischaemic stroke is lack of sufficient blood supply to perfuse the brain/ cerebral tissue due to narrowing or blocked arteries in the brain (Morrison, 2014). According to Stroke Association (2015) statics shows that 1520000 strokes occur in the United Kingdom.

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

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.

Answering the call light (also called call bell a handheld like that is attached to the patient room wall, above the headboard of the bed) in a timely manner by the nursing staff in hospital setting is necessary to prevent falls that can harm, prolonged stays, and unnecessarily increase the cost of healthcare. However, researches concerning call light uses as it relates to patient safety, patient-care management and patient satisfaction are limited (Meade et al. 2006). Patients and their families emphasize that nurses should monitor patients constantly and provide assistance and answer a call light in a timely manner (Yoder, 2011). Note that the falls may be caused by several factors such as

In addition, high risk participants received education relating to falls which involved nurses instructing participants not to get out of bed without assistance, to press the call-bell for assistance and how to use the call-bell. As part of this study protocol, participants in the intervention group received usual care which include: fall risk assessment, placing the call-bell, TV remote control, eyeglasses, dentures, and hearing aids within the patient’s reach. Other interventions that have been used were bed and chair alarms, bed was in the lowest position at all time except when care was being provided and bed brakes were locked at all times. The patient’s elimination needs were scheduled every two hours, bedside commode was provided for frequent elimination needs, the patient was not left unattended while on bedside commode or in the bathroom. For a safe bathroom environment toilets was raised, toilet seats were secure, and handrails was strong enough to support patients, and patient was also instructed to pull the call light if feeling dizzy or in need of any assistance . Furthermore, the room temperature was

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 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.

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

Inform and educate patients and /or family members regarding a plan of care to prevent falls.

The evidence indicated that age, narcotic/sedative use, and overnight shift significantly and independently predicted the likelihood of a fall during the hospitalization (Cox et al., 2015). Moreover, cardiovascular comorbidities, neuro/musculoskeletal disease, evening shift, implementation of fall prevention strategies, and a higher RN-to-unlicensed assistive personnel (UAP) staffing ratio (RN/UAP) were significantly and independently associated with a decreased likelihood of a fall during the hospitalization. Additionally, the initiation of fall prevention strategies following a prescribed fall prevention protocol was found to decrease the likelihood of fall occurrence (Cox et al., 2015). From the evidence of the study, results can indicate that evidence-based fall prevention intervention can be effective modalities that can decrease fall occurrence for inpatients and the presence of RNs is indispensable to fall prevention setting (Cox et al., 2015).

This article’s main research problem was that most fall prevention programs depicted in hospitals were not as successful as desired. Despite implementation of the programs, hospitals still had a high rate of falls and/or injuries related to falls within their units. The purpose of this particular study was to solve this problem and examine the contribution of the response time to a patient’s call light and the fall related injuries in adult, in-patient facilities.

A potential program was identified and implemented practice an all-inclusive evidence-based fall prevention management program during hospitalization among the elderly adults (Hitcho et al., 2004). The project was implemented because of the multidisciplinary approaches in patient care delivery required to prevent falls (Kelsey, Procter-Gray, Hannan, & Wenjun, 2012). Fall prevention comprises of different components, some routine while others tailored to the individual and patient specific fall risk classification and assessment (Nitz & Johnston, 2014). Fall prevention mandates an active commitment and participation of many disciplines including the nurse in providing

Falls can have an overwhelming effect on legal, economical, ethical, and political situations. Many questions arise as to how to keep patients safe when they are at risk for falls. “A fall is described as a sudden, unintentional, downward movement of the body to the ground or other surface; when a patient falls, he or she is at risk of serious injury, disability, and possibly death” Huey-Ming, 2012). Falls happen during the day, afternoon, at night and do not subside do to the amount of staff. Falls happen when patients are ambulating, transferring, getting up without assistance, reaching for personal items, along with many different reasons. It is our job and duty as health care professionals to ensure patients remain safe during their hospital stay. As we learned in my previous literature review, patients that have had previous falls tend to fall more than those who do not, falls will increase the patients stay when there is or isn’t an injury obtained.

1. Choose one patient (new mother, newborn, or pregnant/laboring woman) and identify the priority problem. What did you contribute toward resolving or easing the problem?