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Fall prevention in hospitals study
Patient falls are a major safety issue in health care facilities as they can significantly delay patient recovery
Patient falls are a major safety issue in health care facilities as they can significantly delay patient recovery
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As population ages in all developing nations, impacts of falls remaining a huge problem for social and healthcare systems (Oliver, 2009). According to National Institute on Aging (NIA), in 2006 almost 500 million people worldwide were aged 65 or older. That number projected to reach 1 billion by 2030 with most rapid increases in developing countries. Because older adults are fastest growing segment of the United States population the problem is only going to get worth. An estimated 25% to 39% of adults aged 65 years or older fall each year (Keskin et al., 2008). Falls accounted for a leading cause of injuries, hospitalizations and death among elderly. Besides, people who sustained a fall within a past year will be more prone to recurrent falls. Recurrent falls impact person’s independence, quality of life, ability to take care of oneself. It also increases the amount of healthcare dollars spent on treatment of fall related injuries. Like with any disease, fall prevention is the best treatment. This literature review focuses mainly on community-dwelling adults, but also includes information about long-term care and hospital inpatient categories.
Assessment tools for fall risks
Timed GUG test measures mobility in people who are able to walk on their own with or without assistive devices. Person is being asked to sit back in the chair with arms on arms rest. On command the test subject gets up from the chair, walks 10 feet, turns around and sits back in the chair. Test administered 3 times and the result is the mean time. Person considered freely mobile if the test performed under 10 seconds, mostly independent with test results < 20 seconds, and mobility impaired for anything >20 seconds (Podsiadlo & Richardson, 1991).
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...stitute on Aging. (2005, February). Tai Chi for older people reduces falls, may help maintain strength. Journal of Gerontology and Biomedical Science. 60 (2), 187-194.
Oliver, D. Older people who fall: Why they matter and what you can do. British Journal of Community Nursing. 12(11), 500-507.
Podsiadlo, D., Richardson, S. (1991). The timed ‘Up and Go’ test: A test of basic functional mobility for frail elderly persons. Journal of American Geriatric Society. 39, 142-148
Tzeng, H.M., Yin, C.Y. (2009, August). Inpatient falls: The impact of family and personal caregivers. Applied Nursing Research. 22(3). Retrieved from http://www.nursingconsult.com/das/article/body/202545845-2/jorg=journal&source
Wood-Dauphinee, S., Berg, K., Bravo, G., Williams, J. (1997). The Balance Scale: Responding to clinically meaningful changes. Canadian Journal of Rehabilitation. 10, 35-50
The key objective of the project is to produce a report on fall among the geriatric population, which will help to improve an awareness and knowledge of the importance of lessens falls in elderly and encourage action to lower falls and related
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.
Fatigue, decreased mobility and impaired balance from the rheumatoid and osteoarthritis pain also increases the risk of falls (Stanmore et al., 2013). Age related changes such as sarcopenia causes muscle tone and strength to decrease, especially in the lower limbs and as a result, balance and gait become impaired (Culross, 2008). These factors significantly influence the risk of falls and also affect the ability to carry out daily activities therefore, with a physiotherapists assistance, the nurse could introduce a personalised exercise regime to enhance muscle tone and strength (Culross, 2008). According to Neuberger et al (1997), exercise lessens fatigue and improves muscle tone and balance in older people. Recommending an exercise programme for Mrs Jones that incorporates strength training exercises and aerobics, could potentially improve muscle tone and strength and as a result improve mobility, balance and lessen the risk of falls (Bird, Pittaway, Cuisick, Rattray & Ahuja, 2013). The nurse could also suggest safety precautions such as advising Mrs Jones to use a mobility aid (Gooberman-Hill & Ebrahim,
The prevention of falls in the long term care facility is one of the most important interventions the health care team can do to ensure the safety of loved ones under their care. According to the Summary Data of Sentinel Events Reviewed by the Joint Commission (2016), there were 806 falls between 2004-2015 with 95 of those occurring in 2015 . As health care providers, we have a responsibility to incorporate interventions that will help protect the patient while under our care. Interventions as simple as ensuring the use of a gait belt by any team member that transfers the patient, to making sure all team members are aware of the medications that can make certain patients more of a fall risk, will help in the prevention of falls.
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.
Wolf, S. L., Barnhart, H. X., Kutner, N. G., McNeely, E., Cooler, C., Xu, T. (1996). Reducing fraility and falls in older persons: an investigation of Tai Chi and computerized balance training. Journal of American Geriatrics Society, 44, 489-497.
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. ...
A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization (Swartzell et al. 2013). Because the multi-etiological factors contribute to the incidence and severity of falls in older society, each cause should be addressed or alleviated to prevent patient’s injuries during their hospital stay (Titler et al. 2011). Therefore, nursing interventions play a pivotal role in preventing patient injury related to hospital falls (Johnson et al. 2011). Unfortunately, the danger of falling rises with age and enormously affect one third of older people with ravages varying from minimal injury to incapacities, which may lead to premature death (Johnson et al. 2011). In addition, to the detrimental impacts on patient falls consequently affect the patient’s family members, care providers, and the health organization emotionally as well as financially (Ang et al. 2011). Even though falls in hospital affect young as well as older patients, the aged groups are more likely to get injured than the youth (Boltz et al. 2013). Devastating problems, which resulted from the falls, can c...
Preventing fall in the nursing facilites Introduction/ Background Fall is one of the major issues in nursing facilities. Of the 1.6 million residents in U.S. nursing facilities, approximately half fall annually (AHRQ, 2012). Those who fall will have the tendency to fall again. Falls in older patients can change their quality of life. Because people who fall are terrified of falling again that can affect their daily activities.
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.
Darby, S. Marr, J. Crump, A Scurfield, M (1999) Older People, Nursing & Mental Health. Oxford: Buterworth-Heinemann.
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)
The article An Expanded Framework to Determine Physical Activity and Falls Risks Among Diverse Older Adults discusses that the risk of falling can be due to a lack of motivation to stay physically activity. This can add importance to reasons why Activity Theory is so important in the aging population. This article explored ways to motivate older adults to stay active.