Risk And Implement Falls Prevention Measures

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.

Keywords: Clinical Supervision Patient Safety Quality of Care Nurses Risk of Fall Morse Fall Scale

assessments (PFAs) are essential to prevention of future falls and implementation of risk-reduction programs, particularly in institutional settings. The initial post fall assessment includes assessment of the patient for any obvious injuries and the provision of appropriate treatment. If the older adult cannot tell you about the circumstances of the fall, information should be obtained from staff or witnesses. The purpose of the PFA is to identify the underlying cause(s) of the fall and assist in implementing appropriate individualized risk-reduction interventions. Because complications of falls may not occur immediately, all patients should be observed for 48 hours after a fall. Standard “incident report” forms do not provide adequate post fall assessment information.” (Marquis & Huston, 2012)

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

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.

Quality improvement is referred to as “the use of data to monitor the outcomes for care processes and use improvement methods to design and test changes to continuously improve the quality and safety of health care” (Sherwood & Barnsteiner, 2012). Data is used as the reflection of quality care that is provided by nurses and presents whether or not improvement is needed. In order for nurses to be mindful of the care that they give, they must be taught a systematic process of defining problems, identifying possible causes of those problems, and methods for trying out new solutions to prevent those problems (Sherwood & Barnsteiner, 2012). Currently, quality improvement measures are being utilized throughout hospitals to reduce the risk of patient falls and fall injuries.

Minor (2009) explains the Memorial Hermann Texas Medical Center (MH-TMC) fall reduction committee reviewed the historical data related to fall within their facility and compared their data with the national data. Therefore, indicators used were patient fall rates, also the outcome indicators used were patient fall rates. Thereby, reviewed were the current data, recommendations, and current practice. Also, the utilization of the National Database of Nursing Quality Indicators (NDNQI) was completed for the external benchmarks. Also, completion of the national comparison of patient falls in other facilities. Also, internal benchmarks were utilized within the organization for the comparison different population risks, patient acuity levels,

Increased falls on a particular unit became a concern. The unit formed a fall prevention committee. This committee used evidence-based practice to create a plan and interventions to help reduce falls. The fall prevention committee then monitored trends in the fall prevention process, fall rates, medications, surgeries and disease comorbidities that were associated with fall. Implementing these techniques had a significate reduction of patient falls.

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).

Purpose: The purpose of this study is to determine if registered nurses are utilizing evidence-based practice fall-preventative strategies, such as modification of patient-specific risk factors and implementation of a proper physical training program, to reduce and prevent falls and injuries in the elderly population.

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

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

As expected, each criterion was implemented and improved resulting in fewer falls. Nurses without fall education were given a class regarding their hospital’s fall prevention strategies. Using JBI’s audit method, gaps were identified for fall prevention best practice and strategies were implemented to improve these