The purpose of this paper was to correlate the relation between patient falls and implementation of STEEEP, safe, timely, effective, efficient, equitable, and patient-centered (Institute of Medicine, 2014). Safety was first addressed through assessment of patients to recognize those at an increased risk for falls and implementing interventions as outlined by hospital policy. The intervention must be timely in that it is implemented upon admission of the patient to the facility to ensure effectiveness. Following the hospital policy in regards to application of an armband for fall risk, identifiable socks, utilization of equipment such as bed alarms and appropriate signage provides a checklist to maintain efficiency of the prescribed interventions. Education about falls and its prevention assists patients in understanding the importance of alerting staff prior to ambulation to reduce the potential to fall. This includes the patient in the plan of care and provides patient-centered care.
Research suggests that reducing patient falls is difficult for many acute care facilities. Within a healthcare facility, the nurse to patient ratio, staff education level, and medications play is directly proportional to fall rate. Addressing these issues is pertinent in reducing falls among patients in acute care settings.
Leadership holds the responsibility for policy development and implementation to assist with fall reduction, while receiving treatment in an acute care facility. Additionally, leadership serves as a role model, to staff expectations, by exercising interventions that encompass high quality and safe patient care. With the implementation of STEEEP, the occurrence of patient falls may be reduced, meeting organizational and...
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...Jaecker, P. (2009). Medication use and increased risk of falls in hospitalized elderly patients: A retrospective, case-control study. Drugs & Aging, 26(10), 847-852. doi:10.2165/11317610-000000000-00000
Rosario, E. R., Kaplan, S. E., Khonsari, S., & Patterson, D. (2014). Predicting and assessing fall risk in an acute inpatient rehabilitation facility. Rehabilitation Nursing, 39(2), 86-93. doi:10.1002/rnj.114
Rush, K. L., Robey-Williams, C., Patton, L. M., Chamberlain, D., Bendyk, H., & Sparks, T. (2009). Patient falls: acute care nurses' experiences. Journal of Clinical Nursing, 18(3), 357-365. doi:10.1111/j.1365-2702.2007.02260.x
Vieira, E. R., Freund-Heritage, R., & da Costa, B. R. (2011). Risk factors for geriatric patient falls in rehabilitation hospital settings: A systematic review. Clinical Rehabilitation, 25(9), 788-799. doi:10.1177/0269215511400639
In over-all, 65 years and older suffer from many geriatric symptoms, due to psychotropic and anti-psychotropic medications, including Electroconvulsive therapy (ECT), mobility challenges, incontinence, poor balance, disorganization and confusion which all lead to high falls. According to a study in the International Journal of Geriatric Psychiatry, patients with the highest risk for falls presented with one or more of the following variables such as Parkinson’s syndrome, Dementia, female gender, mood stabilizers, cardiac arrhythmia, and ECT. Edmonson et. al established, “The Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) specific to the psychiatric, geriatric population and found initial testing of EPFRAT to have higher sensitivity in assessing fall risk in the geri-psych inpatient population” (Edmonson, Robinson, & Hughes, 2011). This project purpose is to investigate and explore whether an Edmonson Fall risk assessment Toll decreases patient falls in inpatient geri-psych units. Stakeholders and Change
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: assessment and interventions. Nursing Standard, 25(52), 50-55.
Falls in nursing homes residents are associated with morbidity, mortality, and healthcare costs. The centers for Medicare and Medicaid indicate falls as the quality indicator. (Leland, Gozalo, Teno, Mor, 2012). Factors such as new environment, medication, cognition, and non-compliance contribute to falls. A significant number of falls occur from wheelchairs. (Willy, 2013). Newly admitted residents to long-term care facilities are confused with the change. The new environment and the new unfamiliar faces increase the level of anxiety. Pain may also contribute to falls. In order to take tailor made preventative measures, fall risk factors for each resident should be evaluated periodically. Tools scoring risk factors can be utilized.
The nurse would firstly identify if Mrs Jones is at risk of falls by conducting a falls risk assessment using an evaluation tool such as the Peninsula Health Falls Risk Assessment Tool (FRAT) (ACSQHC, 2009). The falls risk assessment enables the nurse to identify any factors that may increase the risk of falls (ACSQHC, 2009). The falls risk assessment tool focuses on areas such as recent falls and past history of falls; psychological status for example, depression and anxiety; cognitive status; medications including diuretics, anti-hypertensives, anti-depressants, sedatives, anti-Parkinson’s and hypnotics; as well as taking into account any problems in relation to vision, mobility, behaviours, environment, nutrition, continence and activities
The National Patient Safety Goal (NPSG) for falls in long term care facilities is to identify which patients are at risk for falling and to take action to prevent falls for these residents. (NPSG.09.02.01). There are five elements of performance for NPSG: 1. Assess the risk for falls, 2. Implement interventions to reduce falls based on the resident’s assessed risk, 3. Educate staff on the fall reduction program in time frames determined by the organization, 4. Educate the resident and, as needed, the family on any individualized fall reduction strategies, and 5. Evaluate the effectiveness of all fall reduction activities, including assessment,
This document’s purpose is to assist nurses to identify elderly patients at risk for falls and to implement interventions to prevent or decrease the number of falls and fall related injuries (RNAO, 2005). The target population are elderly adults in acute or long-term care. The recommendations are to help practitioners and patients make effective healthcare decisions, support nurses by giving educational recommendations, and to guide organizations in providing an environment receptive to quality nursing care and ongoing evaluation of guideline implementation and outcomes. These guidelines stress and interdisciplinary approach with ongoing communication and take patient preferences into consideration.
A fall is an “untoward event which results in the patient coming to rest unintentionally on the ground” (Morris & Isaacs, 1980). When it comes to patient safety in health care, there isn’t any subject that takes precedence. Patient falls are a major cause for concern in the health industry, particularly in an acute-care setting such as a hospital where a patient’s mental and physical well being may already be compromised. Not only do patient falls increase the length of hospital stays, but it has a major impact on the economics of health care with adjusted medical costs related to falls averaging in the range of 30 billion dollars per year (Center for Disease Control [CDC], 2013). Patient falls are a common phenomenon seen most often in the elderly population. One out of three adults, aged 65 or older, fall each year (CDC, 2013). Complications of falls are quite critical in nature and are the leading cause of both fatal and nonfatal injuries including traumatic brain injuries and fractures. A huge solution to this problem focuses on prevention and education to those at risk. ...
Yates K. M., & Creech Tart. (2012). Acute care patient falls: evaluation of a revised fall
Based on the review of previous falls, the statistics indicate that falls and patient injuries have decreased from the previous year by ten percent. By utilizing evidence-based practice and synthesis of internal and external evidence the fall prevention program proved to be effective and results in increased patient safety and improved overall patient outcomes.
Fall prevention is one of the biggest safety concerns regarding geriatric and pediatric patients in a health care setting. Falls occur almost every day in hospitals and nursing home settings because of a variety of reasons, from weak bones and throw rugs to toys lying in the floor. Tumbles can have grave effects on a child because they tend to play and not pay attention to their surroundings which causes them to take a spill. The consequences can be even worse for an older adult that suffers a fall giving their age and health concerns, this gives the elderly a disadvantage when falls transpire. Most people can help prevent falls from occurring but OTs (Occupational Therapist) are an elite group of people with knowledge and skills that train,
Nurses play an important role to facilitate these programs successful. Fall can have happened to any patient’s at any age or due to physiological changes such as medications, medical conditions. It is very important that nurses to follow evidence- based fall prevention management initiative- purposeful rounding to reduce fall in hospital
Patient falls in the hospital is a serious issue and challenging problem that could lead to prolonged hospital stay, longer recovery time for patients, increased costs for hospitals, and a source of distress and anxiety for patients, nurses, and families. Patient falls can cause minor or major serious physical injury depending on the situation and the age of the client. In addition to the physical harms, patients can suffer from psychological injuries which make them lose their independence and confidence on themselves and build a lot of anger, distress and fears of falling.
It is the hope and the goal of many hospital staff to help to decrease the number of falls in the hospital setting. The hope is to establish a plan that will assist nursing staff to decrease the number of falls. Falls can be extremely harmful to the elderly. Preventing falls is a much need goal that will bring better outcomes for the patient and the hospital. Evaluation of the action plan will also be planned for so that revisions can be made as needed to decrease the amount of patient falls.
During the incident, I was shocked and never realize that this incident would ever happen to me. As all know, the incidence of patient falls will be the huge thing in every health care centre. I am worried if Madam Y experienced any complications, I might not be able to forgive myself. This critical incident made me feel sad, guilty and disappointed in myself. After this incident, I started to blame myself for the fall and this affected my nursing practice until the end of my shift. I still being uncomfortable and not confident on that day while performing my nursing skills and felt sad throughout the day. Even until now the incident still affect my daily routine of nursing care. I became more paranoid to patient and afraid it will happen
Patient falls is one of the commonest events within the healthcare facilities that affect the safety of the patients. Preventing falls among patients requires various methods. Recognition, evaluation, and preventing of patient falls are great challenges for healthcare workers in providing a safe environment in any healthcare setting. Hospitals have come together to understand the contributing factors of falls, and to decrease their occurrence and resulting injuries or death. Risk of falls among patients is considered as a safety indicator in healthcare institutions due to this. Falls and related injuries have consistently been associated with the quality of nursing care and are included as a nursing-quality indicator monitored by the American Nurses Association, National Database of Nursing Quality Indicators and by the National Quality Forum. (NCBI)