Search for Evidence: In collecting evidence for this project, the database Cinahl was used to extract articles from scholarly journals in the field of nursing. An initial general search was conducted using the combined terms “falls” and “scale” which yielded a handful of articles regarding fall assessment tool. A second search using the term “Morse fall” was conducted to broaden the scope of research, and we were able to make selections from these searches. The Science direct website also provided fast facts on the different falls assessment tools and interventions which were applied to this project. The phenomenon of falls has long been studied in order to develop policies and procedures to decrease the overall number of falls. Meta-analysis …show more content…
and Systematic reviews of literature published on fall risk assessment tool were plentiful, and one is featured in this project, Instruments for assessing the risk of falls in acute hospitalized patients: A systematic Review and Meta- Analysis ---- our Level 1 evidence. This review provided insight into the epidemiology of falls, fall risk assessment tools to prevent fall and an evaluation of accuracy of the instruments such as Morse Fall Scale, STRATIFY and Hndrich Scale for detecting fall risk.
This evidence proves to be of value to the health care industry because it provides a direct evidence of level of accuracy of the three different fall risk assessment tool and what nurses need to do for the tool to works best to prevent falls from occurring. A Meta-analysis, Fall Risk Tools in Hospitalized Adults —serves as Level 1 evidence. This study compared two fall risk assessment tool to determine which fall risk assessment tool is most accurate for assessing adults in the hospital setting. This study found the Morse Fall Scale to have a significantly Higher sensitivity in assessing patient risk of fall than the STRATIFY. A Systematic Review and Meta- Analysis, Design- Related Bias in Hospital Fall Risk Screening Tool Predictive Accuracy Evaluations---- also serves as Level 1 evidence. This journal published the results of a review on thirty- five publications on fall prevention and fall risk screening tools. The results concluded that while fall risk tools such as Morse Fall Scale and STRATIFY are imperative in evaluating patient fall risk, the nurse’s clinical judgment on their patient fall risk in addition to the Morse Fall Scale is …show more content…
significantly important. A Comparative Study --serves as Level IV evidence. Validity of Fall Risk Assessment Scales in Korean Hospital: This study compares Morse Fall Scale to John Hopkins Hospital Risk Assessment Tool (JHFRAT) and Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS).
The Morse Fall Scale was found to have the highest predictive validity for identifying patient at high risk for falls in comprising to John Hopkins Hospital Risk Assessment Tool (JHFRAT) and Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS). A cluster -randomized controlled trial--- serves as Level 1 evidence. Comparison of a fall risk assessment tool with nurse’s judgment alone: This study compares two falls risk assessment to and a nurse’s clinical judgment in assessing the patient risk of fall, the result shows that application of a fall risk assessment tool alone in nursing homes does not result in the better clinical outcome than reliance on nurse’s clinical judgment. This information was important to consider because a multi-focal approach to fall risk assessment is proven to be feasible, it will correctly identifies patients at risk of fall, and will help reduce in inpatient falls. Overall, there is much research available regarding the epidemiology of falls and fall assessment tool in accurately determine patient risk of fall, which results in an excellent opportunity to educate health care staff on effective
fall risk assessment tool. Summary of Evidence: Instruments for assessing the risk of falls in acute hospitalized patients: Systematic Review and Meta- Analysis (Level 1) This article reviewed several literatures on fall risk assessment scale and compared the Morse Fall Scale, the STRATIFY scale and Hendrich Fall Scale in their effectiveness in assessing the risk of fall in hospitalized patient. (Aranda, Morales, Canca, Barrero, Perez, Morales & Mora,2013). Fall Risk Tools in Hospitalized Adults: Meta-analysis (Level 1) This study compared two fall risk assessment tool to determine which fall risk assessment tool is most accurate for assessing adults in the hospital setting. This study found the Morse Fall Scale to have a significantly Higher sensitivity in assessing patient risk of fall than the STRATIFY. (Harrington, Luquire, Vish, Winter, Wilder, Houser, & Huanying, 2010). A Design- Related Bias in Hospital Fall Risk Screening Tool Predictive Accuracy Evaluations (Level 1) This journal published the results of a review on thirty- five publications on fall prevention and fall risk screening tools. The results concluded that while fall risk tools such as Morse Fall Scale and STRATIFY are imperative in evaluating patient fall risk, the nurse’s clinical judgment on their patient fall risk in addition to the Morse Fall Scale is significantly important. (Haines, Hill, Walsh, & Osborne, 2007). Comparison of a fall risk assessment tool with nurse’s judgment alone: A cluster -randomized controlled trial (Level 1) This study compares two falls risk assessment to a nurse’s clinical judgment in assessing the patient risk of fall, the result shows that application of a fall risk assessment tool alone in nursing homes does not result in the better clinical outcome than reliance on nurse’s clinical judgment. (Meyer, Köpke, Haastert, & Mühlhauser, 2009). Validity of Fall Risk Assessment Scales in Korean Hospital: A Comparative Study (Level IV) This study compares Morse Fall Scale to John Hopkins Hospital Risk Assessment Tool (JHFRAT) and Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS). The Morse Fall Scale was found to have the highest predictive validity for identifying patient at high risk for falls in comprising to John Hopkins Hospital Risk Assessment Tool (JHFRAT) and Bobath Memorial Hospital Fall Risk Assessment Scale (BMFRAS). (Kim, Kim, Choi, Kim, Park, Kim, & Song, 2011).
In over-all, 65 years and older suffer from many geriatric symptoms, due to psychotropic and anti-psychotropic medications, including Electroconvulsive therapy (ECT), mobility challenges, incontinence, poor balance, disorganization and confusion which all lead to high falls. According to a study in the International Journal of Geriatric Psychiatry, patients with the highest risk for falls presented with one or more of the following variables such as Parkinson’s syndrome, Dementia, female gender, mood stabilizers, cardiac arrhythmia, and ECT. Edmonson et. al established, “The Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) specific to the psychiatric, geriatric population and found initial testing of EPFRAT to have higher sensitivity in assessing fall risk in the geri-psych inpatient population” (Edmonson, Robinson, & Hughes, 2011). This project purpose is to investigate and explore whether an Edmonson Fall risk assessment Toll decreases patient falls in inpatient geri-psych units. Stakeholders and Change
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: assessment and interventions. Nursing Standard, 25(52), 50-55.
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,
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
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.
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
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
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. ...
Yates K. M., & Creech Tart. (2012). Acute care patient falls: evaluation of a revised fall
...chronic illnesses which makes people more at risk for falling. Unfortunately falls are very common in the elderly which makes the fall risk tool very important. Last but not least the depression scale is used a lot in the elderly because depression is a very common diagnosis. Elderly lose their loved ones, they have decreased social interactions, etc. By using these assessment tools they will make a person a better, accurate nurse.
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)
This student developed a sample Fall Risk Prevention Policy that the staff and unit Director could evaluate and then determine if it is one that would be beneficial to the unit. The Policy covers several concepts, listed as follows: fall definition, equipment needed, implementation, environmental considerations, patient and family education, patient education components, documentation, fall occurrence and post fall nursing and direct care staff. This would co-inside with the use of t...
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.
The Nursing Quality Council and the Professional Practice Council recognized this, and have implemented an evidence-based falls prevention team and program. Patient assessment using a universal falls protocol was implemented. Every patient is assessed for risk to fall using the ABC risk for injury assessment and the Morse fall scale. Reassessment of the patient’s risk to fall is completed on each shift, since a patient’s condition can change rapidly. Spoelstra et al.
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.