Patient Safety: Falls
Erica L. Ray
Baker University School of Nursing
The average cost for a fall with injury is about $14,000 ( joint commission 2015 p. 1). Falls are a prevalent problem in healthcare facilities. According to Hicks (2015) " A fall is defined as an unexpected descent from a standing, sitting, or supine position". Falls can happen to anyone at any time and the injuries can range from moderate to death. "Over 20% of people who fall suffer moderate-to-severe injuries, such as bruises, hip fractures, or head trauma" (Hicks 2015). Elderly adults are more susceptible to falls that result in serious injury due to the decrease of bone density and aging in general. No matter the extent
…show more content…
After a patient experiences first fall, they develop a fear of falling. Having a fear of falling may cause the patient to limit their activities such as mobility and decrease in physical mobility which could potentially increase the risk of the patient falling again. In the elderly the loss of independent living is a major concern. "Compared with individuals 65 to 74 years of age, individuals 75 years of age or older are four to five more times more likely to be admitted to a long-term health care facility for one year or longer after a fall" (Schimke 2014). The cost of a fall is enough to put a financial burden on the patient depending on the severity of the injuries obtained. Joint Commission (2015) states " In one study, a fall with injury added 6.3 days to the hospital stay". An increase in hospital stay increases health care costs due to needed other resources to supplement the fall such as inpatient/outpatient physical or occupation therapy and home health care or rehab care. "By 2020, the annual direct and indirect cost of fall injuries is projected to exceed $54 billon". A fall does not only affect the finances for the patient, it also affects the cost for insurance and facility. With an increase in falls health insurance will start to climb. Families of patients that suffer falls with injury also could be affected by having to take time off from work, providing care for a loved one, and/or trying to find …show more content…
Safety is responsibility of the whole healthcare team. Any patient who enters a hospital or healthcare facility should be screened for fall risk upon admittance. Hicks (2015) states " Patient falls are recognized as a quality improvement through nurse-led safety strategies. These strategies include screening upon admission and implementing fall prevention strategies specific to the facility and nurse discretion. In order for the nurse to be successful at doing this a facility needs to have a protocol and proper training on fall situations. Nurses start with orientating to new environment by showing patient how to use the call light, rounding at least every 2 hours, any type of alarm that is needed or even a patient sitter. A study was done using evidence based practice to implement a safety team. "Successful falls prevention strategies included staff education about the fall-injury risk assessment tool, post-fall assessments, alarm device usage, side effects of medications, hourly rounding, and offering toileting frequently" (Godlock et al 2016). The whole healthcare team has to be engaged for team effort in reducing falls. A fall safety team should include nurses, medication aides, and certified nurses assistants and a universal or facility protocol should be part of handbook and annual training should be done to keep everyone current on training and any new changes. Godlock
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
From the literature researched, the writer thinks that environmental modifications along with multifactorial interventions can make a difference for falls that an elderly can receive. Still, he thinks that there should be more research done on environmental assessment tools, flooring, and effective behavioral interventions. On his last thoughts, he believes that strategies should be patient focused and environmental modifications should be developed for that individual.
In health care, safety does not only pertain to the patient, but to all of the staff as well. Although this is important, it is critical that nurses are safe, since they usually interact with the patients the most. If a nurse does not follow correct safety and health practices, they may cause harm to the patient, which may end up in a lawsuit if the damage is bad enough. If safety measures are followed and nothing wrong happens, this saves the facility money and it could possibly gain money if the patients refer the facility to other potential customers. Every facility should have a policy pertaining to safety measures, and it should be reviewed as needed. One thing that nurses will need to know is how to properly use lifts and
Occupational therapy is a profession that is concerned with promoting the health and well-being with people of all ages. Health and well-being is usually a major issue concerning the elderly. The following paragraphs will provide examples of how occupational therapy (OT) can help rehabilitate the elderly after certain illnesses and injuries and provide information on the different settings for rehabilitation. Mackenzie, Clemson, and Roberts (2013) discuss how falls among the elderly can be life threatening, but intervention from an occupational therapist before a fall happens can save the hospitals time and save the elderly from becoming injured. Mackenzie, Clemson, and Roberts state that “falls are the leading cause of accidental injury or death among the older population”(p.60). To solve this problem they be...
A certified professional tai chi instructor will provide education and support to the staff. The staff will receive 8 hours of training, and for staff members seeking certification, a 3-day, 8-hour class will be provided. A video recording will also be available on the hospital intranet for those who need additional training. Trained tai chi staff will also be able to provide support. This program will be available to patients and as well as, their family members, and loved ones. Tai chi exercises can be done twice-weekly in the patient’s room for 30 minutes each session, or they may be practiced in our approved exercise room depending on the number of participants. I have reserved an exercise room in the inpatient rehabilitation unit for such use during this pilot program. The participants in this program will be identified based on their assessed falls score. Those with a high number will be asked to participate. All members of the program must be alert, oriented, and able to consent to this study. The limitations of this study such as a willingness to participate, general overall health status, will be addressed with the staff and participants. A further recommendation from their health care provider will be discussed when such limits pose
Patient safety is a major issue in health care, especially in the public sector. Studies show that as many as 10 patients get harmed daily as they receive care in stroke rehabilitation wards in hospitals in the United States alone. Patient safety refers to mechanisms for preventing patients from getting harmed as they receive health care services in hospitals. The issue of patient safety is usually associated with factors such as medication errors, wrong-site surgery, health care-acquired infections, falls, diagnostic errors, and readmissions. Patient safety can be improved through strategies such as improving communication within hospitals, increasing patient involvement, reporting adverse events, developing protocols and guidelines, proper management of human resources, educating health-care providers on the need for patient protection, and commitment of the leadership to the task. This paper talks about patient safety and how it can be improved in stroke rehabilitation wards of both public and private hospitals.
Fuller, G. (2000, April 1). Falls in the Elderly. American Family Physician, 61. Retrieved from http://www.aafp.org/afp/2000/0401/p2159.html
Sonu, P. & Manoj, M. (2014). Non-Target and Target-Oriented Functional Reach among elderly females at risk of falls. Indian Journal of Physiotherapy & Occupational Therapy. Vol,8,
When taking steps to analyze and apply intervention strategies for falls, we must examine the factors that cause these occurrences. There are numerous reasons that falls occur, such as intrinsic and or extrinsic risk factors. Intrinsic risk factors for falls may be due to changes that are part of the normal aging process and acute or chronic conditions. According to Zheng, Pan and Hua et al. (2013), about 35-45 percent of individuals who are usually older than 65 years and other 50 percent of the elderly individuals report cases of fall every year. Extrinsic factors are those related to physical environment such as lack of grab bars, poor condition of floor surfaces, inadequate or improper use of assistive devices (Currie). Patient falls is not an easy thing to eliminate. With many clinical challenges, there’s no easy answer to the challenges posed by patient falls; howe...
Falls and trauma is one out of the few complications in the United States that are no longer paid for by healthcare. This complication occurs mostly among the elderly population and is the common cause of injuries and fatalities. Falls and trauma can be eliminated using different prevention measures. Per the assignment instructions, this paper presents the cost of treatment, nursing measures to prevent complications and impact of non- reimbursement.
The main problem of falling is observed to be present among adults who are of more than fifty years of age. The problem lies in lack of physical ability and internal weakness among this population. Falling can lead to various injuries such as fractures, sprains, and permanent inability to move.
Falls are not a part of getting old. Falls can cause severe injury and two -thirds death; five percent require hospitalization (Center for Disease Control, n.d.). Falls are the leading cause of injury among older adults, falls are treated every thirteen seconds in the emergency department, and every twenty minutes someone dies from a fall. One out three older adults fall annually, and only half tell their doctor. (Healthy people 2020, n.d.). The Center for Disease Control (CDC) states falls are a threat to health and decrease the ability to remain independent (Center for Disease Control, n.d.). Falls create a burden for the caregiver, incur costs of emergency room, acute, rehabilitation and long-term care. The CDC states that 2015 total
The rate of errors and situations are seen as chances for improvement. A great degree of preventable adversative events and medical faults happen. They cause injury to patients and their loved ones. Events are possibly able to occur in all types of settings. Innovations and strategies have been created to identify hazards to progress patient and staff safety. Nurses are dominant to providing an atmosphere and values of safety. As an outcome, nurses are becoming safety leaders in the healthcare environment(Utrich&Kear,
One of the leading causes of hospitalization and mortality in older people is the fear of falling or falling itself. Falling accounts for on average more than 2.5 million injuries treated in emergency rooms every year. Not to mention every 20 min an older adult dies from a fall, accounting for over 21,000 deaths in a year on average. This can get very costly; it is estimated to hit a high of $67.7 billion by the year 2020. Falling or the fear of falling not only leads to physical harm but also leads to mental distress in the elderly. The fear of falling can lead to things such as depression, anxiety, social isolation or even decreased physical activity that can later cause muscular dystrophy. Analysis of studies of the risk factors
Incidents involving nursing home residents are expected to increase with global population on the rise. More than 13% of the U.S. population is over the age of 65. Some nursing homes fail to meet the safety standards on site and at the expense of employees. Patients falling are a common accident inside nursing homes and account for 87% of all elderly fractures. Nursing home falls can lead to immobilization, which leads to more complications and financial issues.