NPSG: Fall Prevention
Theresa Montgomery
Rasmussen College
This paper is being submitted on August 28th, 2016 for Julie Deane’s NUR2115 Fundamentals in Nursing course.
A fall can happen to anyone no matter age, gender, or race, but there is a population that is more at risk compared to anyone and that is the elderly. A fall for an elderly person can be very detrimental for them and for the facility that they reside in. Long-term care facilities see more falls than any other facility. The Joint Commission has many different safety goals in place in order to help protect the clients that seek help, goal nine is fall prevention in long term care facilities (The Joint Commission, 2016) The elderly population is going
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When an elderly person falls and has an injury it can take them twice as long or even longer to heal compared to a healthy adult. Fractures are the most common injury after falls for the elderly (Jung, Shin, & Kim, 2014, p. 526). This can affect them in negative ways. If they end up being immobile it can result in bedsores. They can end up being afraid of falling again so they might refuse to get up. They can even suffer from depression after the injury. A major issues for long-term care facilities is being understaffed. The amount of work that is put on the staff in some situations is almost unbearable. When there isn’t enough staff the risk for a fall goes up even more. The call lights do not get answered fast enough and the client cannot wait they will try to get up on their own. If they are not able to do this the can end up falling. The client is not the only one that can have a negative effect from the fall, there can be a huge impact on the facility when it comes to cost. In some long term care settings clients are able to go home or they go to another facility if the client is injured it results in them staying at that facility longer. The facility ends up absorbing most of the cost, and they have to wait for that bed to open in order to make any money …show more content…
The main thing is protecting the client from injury. Nursing is focused on the client and what the client needs. If the client is in a long term care facility that need to be protected from things like falls. For the most part each facility has some form of fall program in place. These fall programs focus on a rating system. Throughout the system they look at things like cognitive capabilities, physical capabilities, the client’s gait, if they use any assistive devices and so on. Each of these categories have a number next to them, and if the client score high it means they are a high fall risk (Jung, Shin, & Kim, 2014, p. 529). This helps the nurse because they are able to focus a little bit more attention on that person. They are able to put things in place like frequent checks or making sure the client isn’t left alone. This not only protects the patient, but it protects the facility, and it protects the nurse. There has been other research done in order to prevent falls. There was a study done in Japan, where the clients were able to exercise their lower extremities. There was strengthening, stretching, toe exercises, and proprioception for the neuromuscular aspect (Kato, Izumi, Hiramatsu, & Shogenji, 2006, p. 109). These little exercises improved balance and mobility along with a decrease in the number of falls (Kato, Izumi, Hiramatsu, & Shogenji, 2006, p.110). This could be
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.
Risk factors for falls in older people in nursing homes and hospitals. A systematic review and meta-analysis. Archives of gerontology & geriatrics, 56(3), 407-415. doi:10.1016/j.archger.2012.12.006
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,
Registered Nurses’ Association of Ontario (RNAO). (2005). Prevention of falls and fall injuries in the older adult. Retrieved from http://rnao.ca/sites/rnao-ca/files/Prevention_of_Falls_and_Fall_Injuries_in_the_Older_Adult.pdf
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.
Elderly patients require far more resources medically than younger patients with the same mechanism of injury (Dinh, Roncal, Byrne, & Petchell, 2013), and it is likely due to the deterioration of the body’s systems that come with age. As seen in Fig. 1, the two major causes of death for both sexes from age 65 – 84 are road traffic collisions (RTC) or falls. Figure 1 - The. Major causes of death due to unintentional injury between 2000-2002 (Retrieved from http://www.moh.govt.nz/moh.nsf/pagesmh/5795/$File/older-peoples-health-chart-book-2006-new.pdf).
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. ...
Define Nursing Nursing is a knowledge-based profession within the health care sector that focuses on the overall care of individuals. According to The American College of Nurse Practitioners (ACNP), “defines nurse practitioners as registered nurses who have received graduate-level nursing education and clinical training, which enables them to provide a wide range of preventative and acute health care services to individuals of all ages. They deliver high-quality, cost effective care, often performing physical examinations, ordering tests, making diagnoses, and prescribing and managing medication and therapies”. Nurse Practitioners are able to specialize in a particular area, such as family and adult practice, pediatrics, and women’s health; and refer patients to other specialists when necessary. Some nurse practitioners work under the supervision of a physician while others run their own practices.
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...
Nursing Nursing is a profession within the health care field. Nursing mainly focuses on personal, family as well as community care in ensuring they maintain and recover their health (Aiken et al., 647). Nurses can be distinguished from other providers of health care by their training, practice, and the approach towards patient care. Nursing involves the diversity of practice with practice scopes and prescriber authority levels. Traditionally, nurses provided health care under the supervision of physicians, but currently nurses are being observed as care providers.
Everyday in this world, elderly, adults, teens or children become ill or get into accidents and need medical attention. Whether these elderly, adults, teens or children are taken to a hospital, pediatrician, specialist, or clinic, a doctor and a nurse will tend to them. The nurse plays a role that is just as important as the doctor. Nurses work very closely with the families as part of the caring process. Every member of the family plays a role in different ways. The nurses are there to help the patient as well as the family step through the illness or injury. They provide information for the prevention of future illness and injury, and help to comfort the patient and his/her family. It is vital that a nurse understands that to be a nurse, you need a certain personality and understanding of the field.
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.
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...
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...