Safety is a very important topic in the hospital settings. Hospitals are constantly trying to improve the safety of their patients. One important safety issue is “reduce the risk of patient harm resulting from falls” (Zerwekh & Garneau, 2015, p. 509). Working in a hospital myself, I remember discussing patient fall risks daily. As a CNA, I was always communicating with my nurses about which patients were major fall risks and how many people were needed for safe transport. In fact “inpatient falls were the most common type of safety incident” (Visvanathan, et al., 2017). A lot of times, falls have serious consequences for the patient and results in further health issues. It is noted “fall rates in hospitals remain unacceptably high especially in wards where there are a large number of older people including those with cognitive impairment” (Visvanathan, et al., 2017). I remember from working as a CNA, the elderly and patients with cognitive deficits were our biggest concern when it came to fall risk. The Joint Commission is also concerned about fall risks because “falls in hospitals have been reported to result in approximately doubling of hospitalization costs” (Visvanathan, et al., 2017). Increasing costs and most likely hospital stays are a huge concern not only for financial reasons, but the health and well being of the patient. …show more content…
The more patients each nurse and CNA has, the less time spent with each patient. In fact, “many falls occur at night when nurse staffing levels are lowest” (Visvanathan, et al., 2017). When the patient is not being checked up on frequently, this increases the chance of the patients trying to get up by themselves, which increases their fall risk. The more times the nurse checks up on their patients, most likely their needs will be met and this will decrease the risk of
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.
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.
7). In an article by Rosalina Butao, RN, MSN, “Hitting Two Birds With One Bullet: Bedside Shift Reporting; “bedside reporting solidifies compliance to the Joint Commission’s 2009 National Patient Safety Goals: improve the accuracy of patient identification, improve communication among caregivers and encourage patient’s active involvement in their own care” all of which improves patient safety (Butao, 2010 p. S50). In a synthesis of literature by Sherman, et al., (2013), patient benefits include the patient being more knowledgeable and involved in their health care, improved the relationship between the nurse and patient, also improving patient satisfaction, as well as patient safety thus decreasing the number of falls, and increasing discharge times (p. 310). Bedside reporting allows the patient and family the opportunity to intervene during
Fall can lead to serious injuries and death which, increase the health care cost. Hence prevention of fall is an important public health issue in the hospital for patient safety. We had many falls incidents reported in our unit every month. Therefore, it is essential to implement prevention strategies through multidimensional approach by interdisciplinary team. Through the proposed fall management program, we can reduce fall rate drastically.
In the case of nurse staffing, the more nurses there are the better outcome of patient safety. When there enough staff to handle the number of patients, there is a better quality of care that can be provided. The nurses would be able to focus on the patients, monitor the conditions closely, performs assessments as they should, and administer medications on time. There will be a reduction in errors, patient complications, mortality, nurse fatigue and nurse burnout (Curtan, 2016). While improving patient satisfaction and nurse job satisfaction. This allows the principle of non-maleficence, do no harm, to be carried out correctly. A study mentioned in Scientific America showed that after California passed a law in 2014 to regulate hospital staffing and set a minimum of nurse to patient ratios, there was an improvement in patient care. Including lower rates of post-surgery infection, falls and other micro emergencies in hospitals (Jacobson,
Patient falls were reduced by 24%-80% when hourly rounding occurred (Mitchell et al., 2014). Most falls occur in the hospital setting are caused when a patient is trying to get to the bathroom or bedside commode and ambulating on their own (Tucker, Bieber, Attlesey-Pries, Olson, & Dierkhising, 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. Pressure ulcers were reduced by 56%. Hourly rounding can help address the issue of turning patients every two hours to reduce the risk of developing a presence of a pressure ulcer (Ford, 2014).
Does nurse to patient staffing ratios make a difference in health care? Studies have proven that increasing the nurse to patient ratio has decreased falls and aggressive behavior. Another positive effect is the improvement of range of motion, quality of care, and patient satisfaction (Shin & Hyun, 2015). However, knowing this information does not change the fact of nursing shortages and overworked nurses. The nurse to patient ratio has been a subject of conflict amongst nurses, employers, and the United States Government.
In the novel, Among the Hidden. Margaret Peterson Haddix, follows a chilling tale about a boy named “Luke Garner” who lives on a quiet, remote farm in the woods. Although Luke seems like an ordinary boy, that is far from the truth. You see, in this story, we learn that there is a law prohibiting families from having two children (due to famine and overpopulation).
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)
Fall prevention needs to be the target of many hospitals. Falls occur each year in hospitals and can be detrimental to the patient, especially the elderly patient (Peel, Travers, Bell, & Smith, 2010). Falls can lead to broken bones, longer stays in the hospital and potentially can lead to death. Falls are expensive to both the patient and the hospital (Trepanier & Hilsenbeck, 2014). This paper would like to take a look at a strategic action plan that would help to prevent falls. This plan of action will includes organizational changes that are geared towards fall prevention. The second part of this paper will include an evaluation plan that is designed to measure and monitor the plan.