Fall is the most common cause of injuries of all ages in the hospital. Late last year, our unit has had an alarming patient’s fall incidence. Although, fall preventions were implemented such as fall education, use of mobility aid, and bed/chair alarm activation did not reduce the incidence of falls in our unit. As a nurse my top priority is my patient’s safety. Nobody wants someone to fall. Also, we do not want our patients injured. Nor do we want to risk injury ourselves, when we have to get them up from the floor and safely back to bed. Injuries from a fall can impact patient can lead to complications, loss of independent function and even death.
“Nursing research represents a systematic search for the knowledge needed to provide high-quality
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According to Blais and Hayes (2011), “Qualitative research investigates phenomena through narrative data that describe the phenomena in an in-depth and holistic fashion” (page 191). When the occurrence of falls was reviewed, 4 out 6 of the patients were trying to get to the bathroom or the bedside commode. Most of them are elderly, has mental status deficit and with unsteady gait, and on IV antibiotic. In our unit, we use the 4Ps in hourly rounds (pain, potty, position, and proximity) to be more effective another P (pump) was added. Pump includes the IV, tube feeding, and oxygen tubing. Nurses must examine contributing factors to prevent falls. Our performance improvement chair person was also involved in investigating and reviewing the problem. Additionally, her responsibility is to ensure that staff has the proper knowledge regarding fall preventions. The ability of the staff to prevent falls and injury is dependent upon having in place a standard process of care, which includes assessing the risk of falls, implementing multidisciplinary interventions designed to reduce risk, and evaluating falling episodes. Team members will re-evaluate plans of care to determine the effectiveness of the fall
Problem Description A geriatric-psychiatric unit, is an inpatient hospital unit which treats elderly people who suffer from medical and emotional or psychological disorders. It deserves more attention to the fall
Beneficence is the principle of working in someone's best interest, in this sense, preventing harm from falls by promoting safety. Nonmaleficence allows the nursing staff opportunities to avoid actually causing harm again by, promoting safety to better integrate ethical principles into our practice. Many interventions are implemented with safety as the priority; yet, there are times when autonomy supersedes safety, for instance, patients who are cognitively with it stands on their choices and eventually ends up overestimate there limits. Today in long-term care facility bed alarm usage is considered to be a restrain and was discontinue because it was said to be the cause of most falls due to fear when activated. Purposeful rounding and maintaining toileting programs and other interventions applied to all patients, such as universal fall precautions would encourage independence in older adults at the same time respect patient’s values, wishes, and choices. One of the most difficult ethical dilemmas that arise for nurses and related health care providers is finding the balance between promoting independence and autonomy for seniors by not interfering with their life goals, but by trying to act responsibly and promote health and
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.
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
Most falls occur in the hospital setting when the patient is trying to get to the bathroom or bedside commode and ambulating on their own. (Tucker et al., 2012) With hourly rounding the nurse can help address elimination needs for the patient and help assist the patient to the bedside commode or the bathroom. With hourly rounding on patient this can help address the issue of marinating turning patients every two to help reduce the presence of a pressure ulcer and reduce pressure ulcers rate up to 56% (Ford,
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.
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.
Nurses play an important role to facilitate these programs successful. Fall can have happened to any patient’s at any age or due to physiological changes such as medications, medical conditions. It is very important that nurses to follow evidence- based fall prevention management initiative- purposeful rounding to reduce fall in hospital
The Quality and Education for Nurses (QSEN) project has set several goals for future nurses to meet in terms of knowledge, skills, and attitude (KSAs), one of which is safety (2014). The definition of safety according to QSEN is minimizing risk of harm to patients through system effectiveness and individual performance (QSEN, 2014). Since falls are such a huge occurrence in health care, preventing falls is critical for patient safety. The Joint Commission (2011) has also noted fall prevention as a National Safety Patient Goal (NPSG) 09.02.01 requiring hospitals to reduce the risk of harm resulting from falls.
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...
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)
“Passive, accommodating and unemotional”. These are just some of the many stereotypical terms used to describe “The Orient”, or “The Other”. As Edward Said claims in his fairly objective view on Orientalism, there is a common misconception that exists in the minds of Westerners in which the Eastern Orients are childlike, irrational and ignorant, while the Westerners are more civilized and educated, which makes it their duty to shelter and educate other races. This superiority complex, as well as the gendered representation and ratialization of Asian and Western identities, is revealed in John Luther Long’s captivating play Madame Butterfly. However, this dichotomy between the East and West is put into question in Henry Hwang’s M. Butterfly, which also depicts the negative stereotypes and ideologies associated with the Asian culture, while also emphasizing how gender roles of men and women can become reversed. David Henry Hwang’s utilization of literary devices in the forms of foils and irony is used as a means to successfully critique John Luther Long’s Madame Butterfly, as well as to affirm the dominant belief system during the 1960’s to 1980’s, which encompasses the intersectionality of race, class and, particularly, gender.
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.
During the incident, I was shocked and never realize that this incident would ever happen to me. As all know, the incidence of patient falls will be the huge thing in every health care centre. I am worried if Madam Y experienced any complications, I might not be able to forgive myself. This critical incident made me feel sad, guilty and disappointed in myself. After this incident, I started to blame myself for the fall and this affected my nursing practice until the end of my shift. I still being uncomfortable and not confident on that day while performing my nursing skills and felt sad throughout the day. Even until now the incident still affect my daily routine of nursing care. I became more paranoid to patient and afraid it will happen
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.