The Patient Safety Concern And Quality Improvement Issue ( State And National Context )

The Center for Disease Control (CDC) reported that more than one third of adults 65 and older fall each year. Half of the elderly people, who fall, do so repeatedly. Aside from the health problems related to falls, nearly $20 billion of direct medical costs are associated with fatal and non-fatal falls (Larson & Bergmann, 2008).

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

In 2000, direct cost of fall among older adults cost the U.S. health care system over $19 billion dollars. In 2002, Medicare paid an average cost per fall between $9,103 and $13,457. In addition to direct cost related to nursing home care, rehabilitation, and doctor’s office visit, hospitalization, insurance process and prescription drugs. Indirect costs including long term effects such as lost time from work, household duties, disability, and reduced quality of life. According to CDC, by 2020, indirect and direct costs of injuries related to fall are estimated to reach $54.8 billion dollars. According to Centers for Disease Control and Prevention (2015), over the past decade the death rates from falls among older women and men have risen sharply. In 2013, about 25,500 older adults died from accidental fall injuries. Men are more likely than women to die from fall injuries. After taking age into account, the fall death rate is approximately 40% higher for men than for

Intervening falls can reduce the financial burdens attributed to patient falls in hospitals and other healthcare settings are among the most serious risk management issues facing the healthcare industry.

Hospital falls are extremely common. In a study that was conducted to describe the epidemiological nature of hospital falls, they found that that about 183 of 1,300 patients fell during the period of study. Hospital falls are more common in the elderly where the average age of the patients who had fallen was found to be 63.4%. Many of the falls were unassisted (79%) and they had occurred while the patients were in their own rooms (85%). Generally, the number of falls in hospitals ranges from 2.3-7 falls per 1,000 patient-days and it was found that 30% of the falls that happen in hospitals result in injury with 4-6% leading to serious injuries ADDIN EN.CITE Hitcho20041043(Hitcho et al., 2004)1043104317Eileen B HitchoMelissa J KraussStanley BirgeWilliam Claiborne DunaganIrene FischerShirley JohnsonPatricia A NastEileen CostantinouVictoria J FraserCharacteristics and Circumstances of Falls in a Hospital Setting: A Prospective AnalysisJournal of General Internal MedicineJournal of General Internal Medicine732-7391972004( HYPERLINK l "_ENREF_2" o "Hitcho, 2004 #1043" Hitcho et al., 2004). Some of the serious injuries include subdural hematomas, fractures, excessive bleeding and in some extreme cases, death ADDIN EN.CITE Belechri20021044(Belechri, Petridou, & Trichopoulos, 2002)1044104417Belechri, M.Petridou, E.Trichopoulos, D.Bunk versus Conventional Beds: A Comparative Assessment of Fall Injury RiskJournal of Epidemiology and

Falling is the leading cause of death due to injury for persons 65 years of age or older (CDC, 2012). This problem is so prevalent, that one third of all adults in this age group will fall each year in the United States. In addition to being a leading cause of death for this age group, emergency departments treated 2.3 million and admitted 663,000 older adults in 2010 due to fall-related injuries. The direct medical costs for fall-related injuries during the same reporting period were estimated to be $30 billion.

It is estimated that 1 in 3 adults over 65 years of age will fall each year (Stanford Health Care, 2016). By the time seniors reach 80 years, the risk of falling is 1 in 2 persons (Stanford Health Care, 2016). Broken bones mean more medicine, doctors’ visits, and surgeries, increasing healthcare costs to both individuals and the medical system (Jang, M. S., Lee, Y. S., & Kim, J. T. (2014). In 2013, the cost for treating fall-related injuries was more than $34 billion in the U.S. (NCSL, 20116). That money pays for the 2.5 million emergency room visits, for 700,000 hospitalizations, and toward the 25,000 deaths per year as a result of falls (NCSL, 20116).

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.

They also focus on the increased cost that is spent on patients falls. They estimate that falls may increase their cost by anywhere between $16,500 to $27,000 dollars depending on the severity of the injury (Quigley & White, 2013). When patients fall in the healthcare setting, whether in the hospital or a long term care facility, that in turns drives up the health care costs and can eventually lead to losing their accreditations or reimbursements from insurances. That is why the key to decreasing patient falls is focusing on prevention.

According to the CDC (2015), the unintentional falls are the leading cause of both nonfatal injuries and fatal injuries requiring emergency treatment in adults and older adults. Moreover, the consequence of falls leads to more hospital admission, disability, and deaths than any other type of trauma (CDC, 2015). Furthermore, the CDC reported the cost of falls that fall-related injuries are among the 20 most expensive medical conditions, and the Medicare pays for around 78% of the costs of falls (CDC, 2014). Therefore, the unintentional fall-related injury caused by unsafe environments may be the vital health issue in that

Falls in acute care settings frequently occur regardless of the prevention measures used to eliminate the risk of falling and sometimes lead to fractures, hematomas, head injuries, and spinal cord. It can also lead to a decrease in confidence, independence, and mobility in elderly. However, to prevent a fall, risk factors must be accurately assessed in a hospital setting, in which the patient’s risk assessment information can translate into an action plan if this protocol is applied. Fall has a tremendous impact on the patient, but implementing an accurate assessment will help reduce the risk of falling and the hospital cost. These are just some potential results that could happen, and these results would be generalizable to the study population

Falls are the leading cause of unintentional fatal and non-fatal injuries in older adults from the ages of 65 and older. This major health concern results in more than 2.8 million injuries treated in emergency departments, over 800,000 hospitalizations and more than 27,000 deaths a year in the U.S alone (National Council On Aging, 2016). Not only do these falls result in injury, loss of independence, and death, but they have also created economic burdens among heath care systems and individuals. With a growing number of persons over the age of 65, along with extended life expectancies, injuries and costs are expected to increase. A statistic provided by the National Institute on Health recorded that in 2010 an estimated 524 million people were age 65 or older, which was about 8% of the world’s population at the time, and by 2050, this number is expected to nearly triple to about 1.5 billion, representing 16% of the world’s population (National Institute on Aging, 2016).

The in-patient hospital setting has an estimated 700,000-1,000,000 falls annually, with one third of these falls being preventable (Bock, 2017). There are also repercussions from the falls such reimbursement costs for treatment of falls, which can range from $7,000-$30,000 and the cost of legal claims (Bock, 2017). The use of sitters as a fall prevention intervention has received various reviews on the actual efficiency and rate of success (Bock, 2017). However, the annual cost of sitters has been reported to be $1,000,000 (Bock, 2017). Although the welfare of the patient is the number one priority of the facility, there should be more options for the staff in order to prevent the astronomical cost of delegating sitters. Currently, there is no best practice for implementation of fall prevention interventions (Bock,

Studies show that adults of ages 65 and above account for 80 % falls in acute care setting (Rheaume, 2015). A variety of factors predispose this group of vulnerable population to falls and include: age, urinary incontinence, impaired mobility and vision, orthostatic hypotension, history of falls, mental status changes, and acute illness. Falls can result in increased hospital cost, injury or even worse, death. The study focused on six case reviews on patients between the ages of 64 and 87, who sustained falls while hospitalized (Rheaume, 2015).

Hello Mary. I agree there is a need for increased fall education and patient safety awareness of staff. We play a vital role in patient safety and quality improvement. I believe that being a nurse is a constant learning, we learn as we practice. Nursing research helps us to bring forth more efficient nursing care. According to Beck and Polit, it is important to emphasize the clinical nursing research to guide nursing practice and to improve the health and quality of life of our patients (2012). Unfamiliar environment, illnesses, and treatment increase the risk of the patient for falls. We are restraint free in our long-term care unit. Staffs are always looking for alternatives to prevent falls such as medication changes, alarms, 1:1 sitter,