Problem Statement
Breimaier, Halfens & Lohrmann (2015) described that falls are a very common accident in the hospital, especially in the elder, people are 65year old or over. In addition, the evidence showed approximately 30% of the elder suffer a fall each year (as cited in Breimaier et al., 2014). According to Heinze, Halfens & Dassen (2007), 3.2%- 37% of inpatients fell and it depended on the department. Moreover, not all the fall prevention measure was taken to prevent fall-related injuries. Since all the research-based recommendations are not adopted and carried out, the potential positive effects of fall prevention on patient health outcomes cannot be realized. Inter-/national clinical practice guideline (CPGs) was created with scientific knowledge and one of them is the fall evidence-based guideline (the authors named it as Falls CPG) The Falls CPG was informed and delivered in all hospital setting. However, the fall prevention guideline was not applied in routine nursing practice. Therefore, the authors wanted to assess the effectiveness of implementation of CPG.
Furthermore, Breimaier et al. (2015) also addressed the financial issue in the research. As implementing a guideline, consider the cost and resources, as well as the effects of the implementation of the current budget-constrained health care system, was also important. Therefore, in this research, authors also counted the required time of application the CPG into the nursing practice.
Purpose and
Purpose: The purpose of this study is to determine if registered nurses are utilizing evidence-base standards of practice to recommend multi-factorial preventive fall programs to prevent falls in the elderly to prevent injury and preserve their quality of life.
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 are one of the major patient safety problems that every facility encounter on a day to day basis. An aging patient population, combined with multiple diagnosis and medications are prime contributing factors for patient fall. Other contributing factors are shortage of nursing and auxiliary staff, ineffective work environment and shortage of appropriate equipment. According to the Joint Commission around 30-50 percent of the falls happening in the hospitals have resulted in injury to the patients. Since Joint Commission started keeping records of fall from 1995 to 2012, it has been reported that there were 659 fall related death or permanent disability, which were voluntarily reported as a
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.
This work has significance because staff and patient education can help prevent falls. Specific interventions decrease falls. Nurses have a responsibility to their patients and their facility to be competent and confident in their abilities to do all that they can to prevent falls. Facilities have the responsibility to provide the tools and the training that is required to carry out fall prevention
The nursing process has been improved along the way, from Orlando’s original four step process in the late 1950’s, then, a separate step of a nursing diagnosis was added. As to the American Nurses Association Scope and Practice (2nd Edition, 2010), there was another important step of expected outcomes to identify patient goals. So, as the nursing process has been re-evaluated and improved the patient is re-evaluated and improved by the improved nursing process-problem solver. My fall prevention project has revealed to me and my readers there are vast numbers of risk factors that are involved in falls including medications, nutrition, cultures (beliefs), mental status and a history of falls. The nursing process has been and will always be used
Each year, one out of three elderly people fall (U.S. Centers for Disease Control and Prevention [CDC], 2015). The CDC (2015) also reports that once an individual has fallen, the chance that they will fall again doubles. Falls also contribute to an increase in direct medical costs. The CDC (2015) states, “Direct medical costs for fall injuries are thirty-four billion dollars annually. Hospital costs account for two-thirds of the total.” The amount of elderly people who fall each year along with the economic costs that result from falls indicates that preventing patient falls remains an important goal for healthcare workers including nurses. Nurses can use the nursing process—assessment, diagnosis, planning, intervention, and evaluation—to prevent patient falls and meet the fall prevention standards set by various regulating bodies.
The Center for Disease Control and Prevention (2016) informs us that “health care providers play a major role in fall prevention.” The care of our elders is entrust to all employees, every team member is value and fall prevention is not a concern of only the nursing staff. Therefore, as we embarked on this quality improvement endeavor our entire interdisciplinary team (IDT) met and brainstormed to develop a preventative plan to ensure safety. The fall policy was revised from the standard event reporting guidelines to to a more detailed and specific protocol. This protocol was in addition to the normal assessment, vital signs, mandate paperwork, and the procedures of notify the physician and the responsible party. The new ground rules laid out step by step guidelines. All staff members was informed about our concern with the increase rate of falls, the goal to reduce this number and the role they play in achieving this goal. “Every health care provider should be proactive in evaluating he risk of falls in their elderly patients” (Schimke & Schimke, 2014, p. 228). Therefore, a rallying of the troops is always necessary to assure we are all on board and moving in the same direction. Also, meetings of this nature reduces resistance from the direct caregivers. As well as, provides supports to the supervisors as they enforce and oversee the changes in our procedures. According to Osuji et al,
Current nursing practices are based on strict standards and requirements issued by The Center for Medicare and Medicaid Services (CMC) and The Joint Commission on Accreditation of Healthcare Organizations (JCAHO). The CMS requires facilities to provide a safe environment for care and failure to do so risks losing Medicare Medicaid funding. In fact, facilities no longer receive payments for treating injuries caused by in-hospital falls. The JCAHO National Patient Safety Goal (NPSG) requires nursing home to reduce the risk of patient harm resulting from falls and to implement a falls-reduction program. The NPSG has been upgraded to a standard that requires facilities to assess and manage the patient’s risks for falls and implement interventions to reduce falls based on this assessment. The current nursing practice for fall interventions begins with assessment. Patients are assessed and reassessed to identify and address any risks factors including underlying medical or medication conditions. Risk Assessment Tools for predicting falls score each category identified as a potential risk. For example, categories include Medication, Activity/Mobility, Elimination, Previous Falls, Length of Stay, Mental Status, and Age all can influence the
Falls are highly common amongst the elderly, particularly those who lack mobility, are in hospital, or are living in a nursing home. When an elderly person falls, their activities of daily living may be impacted due to injuries sustained from the fall. It is essential that precautions are put in place to prevent falls in all settings. This essay will discuss the statistics surrounding falls, prevention strategies, and the impacts of a fall on a patient’s ability to complete activities of daily living.
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.
For my project I choose that of fall prevention. I choose this because it is one of the many preventable sources of mortality and morbidity. I have seen many of my patients prematurely have to be placed in a nursing home due to complications from a fall when many of them could have been prevented.
According to the Joint Commission Resources-JCR (2005), there is no universally accepted definition of a fall. Thus several definitions have been floated over time in an attempt to define the same. One such definition of a fall is "an untoward event that results in the patient or resident coming to rest unintentionally on the ground or another lower surface" (Joint Commission Resources, 2005). Falls are regarded common causes of injury at every age. However, it is important to note that for seniors, falls can have serious consequences. This is more so the case given that a fall can bring about pain, trauma, or even death. With that in mind, the primary purpose of this program remains the reduction of falls and hence the aversion of related injuries amongst the concerned patients. Of key importance remains the identification of patients who appear to be at high risk of falling. This way, appropriate strategies can be developed to reduce the injuries related to inpatient falls.
Many of the bathroom accidents in our country happen to older adults, and often result in fall injuries. Fall injuries cause broken bones, head contusions, and lead to extended hospital visits. The fall risk is higher if you have a history of falls.
Falls are the leading cause of medical complications in health care facilities in the United States. Statistics from The Joint Commission shows that hundreds of thousands of patients fall in hospitals every year, with 30-50% of those falls resulting in injury (“Preventing falls and fall-related injuries,” 2015). Furthermore, the consequences of falls are that injured patients will require longer hospital stay leading to an increase in healthcare costs (“Preventing falls and fall-related injuries,” 2015). To prevent falls, health care facilities have implemented evidence-based intervention strategies such as fall risk assessment tools and faster call light response time.