Research Summary and Ethical Considerations of “Factors Associated with Falls in Hospital Adults Patients”
Introduction
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.
Background of study
Falls can be categorized into unanticipated physiologic, anticipated physiologic, accidental or intentional (as cited in Cox et al., 2015). Furthermore, the causes of inpatient falls include patients’ intrinsic and extrinsic risk factors as well as organizational or workforce factors (Cox et al., 2015). The methods of fall prevention are tailored to patients’ unique intrinsic or extrinsic risks; however, fall prevention tactics are not created for individual, they are used in various patient population (Cox et al., 2015). Moreover, the scale from the fall risk assessment tools, for example: Morse Falls Risk Assessment Scale and the Hendrich I Falls Risk Assessment Scale and, do not specify the type of fall for individual, making it hard to design or direct fall prevention approaches
A patient who is admitted to a facility may be alert, oriented, and independent in ambulation. Add on intravenous (IV) tubing attached to a pole, a telemetry monitor, a foley catheter, and new medications for the patient. This patient now has fall risk factors. The purpose of this paper is to describe and evaluate change in preventing falls in the hospital setting.
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,
As a nurse we want to ensure that our patients receive a high quality of care. Patients should feel safe and satisfied while hospitalized. Many hospitals are continually looking for answers and implementation to significantly reduce the inpatient fall incidents. According to Bechdel et al (2014), the top priority of health care organizations nationwide is to reduce and eliminate falls within the clinical care settings. One of the serious problems in acute care hospital is the patient’s fall. The unfamiliar environment, acute and co-morbid illnesses, prolonged bedrest, polypharmacy, and the placement of tubes and catheters are common challenges that place patients at risk of falling. Most of the falls that I have encountered while working involves
Current literature has exposed many risk factors for falls. There are both intrinsic risk factors and extrinsic risk factors. Intrinsic risk factors include changes that come with age, such as gait issues, urinary incontinence, and fear of falling. Extrinsic risk factors include those that are related to the physical environment such as improper use of assistive devices and poor floor surfaces. No matter the type of risk factor, it is crucial to conduct a risk assessment when trying to prevent falls from occurring. Pearson and Coburn (2011) found that identifying risk factor for falls will help identify appropriate prevention strategies. Fall risk assessments help determine Talk about
Problem: Patient falls have long been a common and serious problem in hospitals across the nation, causing
Many of these inpatient falls can be prevented when following the proper fall prevention measures. Not only does patient safety make preventing falls a priority but the financial impact these falls have on an institution make it a priority as well.
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.
Nurses help to ensure patient safety, which includes preventing falls and fall-related injuries (Quigley, Neily, Watson, Wright, & Strobel, 2017). The general population is at risk for falls and fall-related injuries, more specifically the elderly, 65 and over (Quigley, Neily, Watson, Wright, & Strobel, 2017). Patient falls are one of the top events for hospitals and long-term care facilities due to loss of physical function or cognition (Quigley, Neily, Watson, Wright, & Strobel, 2017). Fall-related injuries are a serious health issue for the elderly population (Quigley, Neily, Watson, Wright, & Strobel, 2017). Nurses make a major contribution to patient safety by assessing fall risk and designing patient-specific fall prevention
As the United States population is advancing in age, the amount of patient falls and medical costs are estimated to increase. Approximately 700,000 patients fall per year in the hospital, which one-third of those falls could have been prevented (AHRQ, 2012). Prolonged hospital stays related to fall injuries is very costly. In 2013, a total of $34 billion dollars was paid due to falls by patients and insurance companies (CDC, 2015). Examples of injuries that can occur as a result of falls are fractures, lacerations, or internal bleeding (AHRQ, 2012). Studies also show
“In the United Sates, unintentional falls are the most common cause of nonfatal injuries for people older than 65 years (Hughes, 2008).” This illustrates a problem that requires addressing. “Rates of falls vary across hospitals and units however, the highest rates are found in neuroscience (6.12-8.83/1000 patient days) and medical (3.48-6.12 falls/1000 patient days) units” (Mion, 2014). Older adults are usually those most affected and their falls are
Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control
Fall risk assessments tools, which help to identify those patients at risk of falling, play a vital role in reducing the number of falls. The basis for this assessment is that if patients at high fall risk can be
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization
Risk factors for falls are categorized by intrinsic or extrinsic (Tzeng, & Yin, 2009). According to Tzeng and Yin (2008), intrinsic factors, referring to the patient themselves, are related to their health status and possibly associated with age-related changes: previous falls, reduced vision, unsteady gait, musculoskeletal system deficits, mental status deficits, acute illness, and chronic illness. Extrinsic factors are involved in the patient’s environment, including medications, lack of support equipment, furniture, bathroom designs, small patient rooms, poor lighting, and improper use of and inadequate assistive devices. Tzeng & Yin (2008; 2009) focused on the extrinsic risk factors for the basis of their studies.
Internet Citation: Tool 3H: Morse Fall Scale for Identifying Fall Risk Factors. Content last reviewed January 2013. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/systems/hospital/fallpxtoolkit/fallpxtk-tool3h.html