Fall Prevention in Hospitals
The purpose of this paper is to help educate my fellow healthcare colleagues on some of the current best practices available to aid in the reduction of patient falls in the hospital setting. Multidisciplinary education is not a new concept but can be an extremely effective approach especially when addressing such a complex and potentially deviating issue such as preventing patient falls. This approach allows for idea sharing and learning from other disciplines perspective all for the greater good of maintaining patient safety and team building while working together for a singular purpose our patients.
Problem Statement
The problem or patient falls is a very complicated and complex problem remaining one of the
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With such a large varying audience some will consider themselves as experts on this topic but the vast majority will be receptive to the possibility of learning additional information on this important patient safety topic.
Assessment of the Learners- Attitude toward Learning.
The planned audience for this training consists mostly of well-educated health care workers who are all lifelong learners and are well prepared to receive new or expanded teaching. Especially on a topic that can significantly improve the safety of their patients.
Learners Objectives-Short Term
The learners will be able to verbalize the definition of what is considered a patient fall after the completion of the training they will also be able to describe the major risk factors for their patients falling in a hospital setting. They will be able to identify the two most commonly used patient fall risk assessment tools and the rationale behind their scoring systems. The learners also are able to verbalize several methods to reduce patient falls in the hospital
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“A patient fall is defined as an unplanned descent to the floor with or without injury to the patient” (Agency for Healthcare Research and Quality, 2013). The most common risk factors patients falling in a hospital setting as identified by the Joint Commission after analyzing sentinel events. The common risk factors include the following: inadequate fall risk assessment, communication failures between provider and providers and family members. Lack of adherence to facility protocols and established safety procedures has also be attributed to falls. There has been demonstrated a link between, inadequate staff orientation, staff supervision, staffing levels and staff mix. Deficiencies in the physical environment have also been shown to contribute to falls. Lack of facility leadership in regards to promoting a culture of safety has also been shown as an unfortunate contributing factor to patient falls (Joint Commission,
Orlando Regional Healthcare, Education & Development. (2004). Patient Safety: Preventing Medical Errors. Retrieved on March 2014 from world wide web at http://www.orlandohealth.com/pdf%20folder/patient%20safety.pdf
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 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.
Falls can happen at any time and place in a hospital setting. It is a major patient safety issue causing injury, distress and even death. According to Debra Hain (2012), “In 2010, there were 2.35 million emergency room visits for non-fatal injuries in older adults with over 25% requiring hospitalization” (pg. 251). Falls can interrupt a person’s quality of life but also have a financial effect on the healthcare system (Hain, 2012). Falls are preventable and in order to reduce the rates for falls nurses must be more vigilant in their assessments to identify patients that are at risk, especially for those undergoing hemodialysis.
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
Falls are the leading cause of injuries, disabilities, and deaths among community-dwelling older adults (Moyer, 2012). According to the Center for Disease Control and Prevention (CDC, 2016), each year one out of three community-dwelling older adults aged 65 years or above falls at least once. There is a need to identify effective interventions pertinent to the primary-care setting to prevent falls among older adults living in the community. The guideline titled “Prevention of falls in community-dwelling older adults: U.S. Preventive Services Task Force recommendation statement” is focused on determining the effectiveness and harms of different fall-prevention interventions relevant to primary care for adults aged 65 years or above (Moyer,
Education is imperative in improving quality and safety in patient care. Nurse educators must now implement a curriculum that is designed to teach pre and post-license nursing students the skills, knowledge, and attitude that is necessary to ensure the safety of the patients. Obtaining knowledge in how to
Fall can lead to serious injuries and death which, increase the health care cost. Hence prevention of fall is an important public health issue in the hospital for patient safety. We had many falls incidents reported in our unit every month. Therefore, it is essential to implement prevention strategies through multidimensional approach by interdisciplinary team. Through the proposed fall management program, we can reduce fall rate drastically.
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.
Assessing the reason for the falls would be the first step in the plan. Is there any repetition of the reason behind the fall (Olrich, Kalman, & Nigolian, 2012)? For instance, is there frequent falls at a certain time of the day such as during shift change? Also it may be helpful to know if the fall was related to tethers such as IV poles or Foley catheters. It may also be a good idea to look at the type of patient who fell, is the patient reported to be confused at the time of the fall? Is there any history of dementia reported for the patient that fell? Once all the information is gathered then the pertinent information could be categorized into groups that would help to decipher the best plan of action to prevent falls. The plan would need to be written and approved by the nursing managers and may be put into place by the clinical leaders that are involved with the unit. Although each unit is different some of the ways to prevent falls are similar in all units in the hospital and a team should be formed that would use the inf...
The patient safety program in hospital setting is intended to reduce medical errors and hazardous conditions by assuring an environment that inspires error identification, reporting and prevention through education, system enhancement for any adverse occasions such that information about sentinel events that frequently occurs in health care are built in the system progressively for risk reduction. Through education component, proper and effective orientation and training that emphasizes clinical and non-clinical aspects of patient safety, including an inte...
...ches indicate how nurses can ensure prevention and mitigation of the problems experienced due to falls. There are various strategies that can be used to enhance the safety of individuals from falls. In order to be able to deal with these issues within the healthcare facilities, nurses must be involved in the effective policy making so that the risks of patient falling can be amicably dealt with. On the other hand, the nurses must be placed at the forefront of the implementation process of the designed interventions. Leaders must engage the nurses in applying the evidence-based therapies so that they can ensure good safety for the patients. Nurses are important in ensuring advocacy, education and the management of the facility environment. The nurses will therefore apply various necessary interventions that guarantee safe environments for the patients and the nurses.
Fall is sudden, unpredicted, unintentional occurrence resulting in-patient landing on ground or at lower level. Falls and fall related injuries incur cost for the patient as well as the health cares system. The fall has a significant impact in patient quality of life and usually fall has many reasons to happen. Thus, preventing falls among patients in healthcare settings requires a complex approach, and recognition, evaluation and prevention of patient falls are significant challenges. Falls are a common cause of injury and the leading cause of nonfatal injuries and trauma-related hospitalizations in the United States (Barton, 2009). Falls occur in all types of healthcare institutions and to all patient populations. Up to 12% of hospitalized patients fall at least once during their hospital stay (Kalisch, Tschannen, & Lee, 2012). It has been using different strategies in many hospitals to prevent or at least to decrease the incidence of fall. However, the number of falls in the hospitals increases at alarming rate in the nation. The hospitals try to implement more efficient intervention strategies, but the number fall increase instead of decrease. In fact, many interventions to prevent falls and fall-related injuries require organized support and effective implementation for specific at risk and vulnerable subpopulations, such as the frail elderly and those at risk for injury.