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 [AHQR], 2013a). There are up to 1 million patient falls that result in nearly 11,000 deaths in the United States every year (Dupree, Campiz, and Musheno, 2014; Dupree, 2014). According to Fitzpatrick (2011), one quarter of hospitalized patients will suffer from injury due to a fall. The Centers for Medicare and Medicaid Services (CMS) classify patient falls as “never events” and do not reimburse hospitals for injuries acquired as a result of a patient falls that occur in the hospital. Increased costs due to additional treatment and longer hospitals stays are estimated to be 60% greater for patients who experience falls with injury than comparable patients without falls (Butcher, 2013). According to the Joint Commission, the “average increase in a hospital’s operational costs for a serious falls-related injury is more than $13,000 and the patient’s length of stay increases by an average of 6.27 days” (Butcher, 2013). By 2020, direct and indirect costs due to falls with injury are anticipated to reach almost $55 billion (Pearson and Coburn, 2011). Furthermore, falls are not only the most frequent adverse event documented by hospitals, but they are also the number one cause of hospital acquired injuries (NQMC, 2012). It is estimated that half of all hospital patients are at risk for falling and half of those patients experience falls with injury (Fitzpatrick, 2011).
Such staggering healthcare costs in conjunction with poor patient outcomes contributed to the National Quality Foundat...
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...ll prevention measures if they are denied by an autonomous patient. To further complicate matters, it can be argued that some fall prevention measures are detrimental to the patient. For some, dignity is lost if they are not allowed to use the toilet without being watched. Also, if high fall risk patients, such as the elderly, are not allowed to be mobile without assistance or being within arm’s reach of a hospital worker, patients may be vulnerable for losing their independence and capability for performing activities of daily living (ADLs). Just a few days of inactivity can convert a patient who should not walk alone to a patient who cannot walk alone. Consequently, nurses ethically must be able to walk the fine line between implementing fall prevention strategies and proactively protecting privacy, dignity, independence, and rehabilitation (Healy, 2011).
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