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Fall prevention in hospitals paper
Annotated bibliography on falls in health facilities setting
Patient falls are a major safety issue in health care facilities as they can significantly delay patient recovery
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Fall Prevention Introduction 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 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. ... ... middle of paper ... ...rcury on Cardiovascular and Central Nervous Systems. Journal of Biomedical Biotechnolgy, v.2012, 2012:949048. Biodiversity Research Institute. (2012). Global Mercury Hotspots. Retrieved from http://www.ipen.org/hgmonitoring/pdfs/ipen-bri-report-global-hg-hostpots-2013-01-09.pdf United States Environmental Protection Agency. (2013). Mercury. Retrieved from http://www.epa.gov/hg/ United States Environmental Protection Agency. (2013). Mercury, Where You Live. Retrieved from http://www.epa.gov/hg/whereyoulive.htm University of Minnesota. (2012). The Adverse Health Effects of Mercury. Retrieved from http://enhs.umn.edu/current/5103_spring2003/mercury/merchealtheffects.html World Health Organization. (2013). Mercury and Health. Retrieved from http://www.who.int/mediacentre/factsheets/fs361/en/
Safety competency is essential for high-quality care in the medical field. Nurses play an important role in setting the bar for quality healthcare services through patient safety mediation and strategies. The QSEN definition of safety is that it “minimizes risk of harm to patients and providers through both system effectiveness and individual performance.” This papers primary purpose is to review and better understand the importance of safety knowledge, skills, and attitude within nursing education, nursing practice, and nursing research. It will provide essential information that links health care quality to overall patient safety.
Nurses are key components in health care. Their role in today’s healthcare system goes beyond bedside care, making them the last line of defense to prevent negative patient outcomes (Sherwood & Zomorodi, 2014). As part of the interdisciplinary team, nurses have the responsibility to provide the safest care while maintaining quality. In order to meet this two healthcare system demands, the Quality and Safety Education for Nurses (QSEN) project defined six competencies to be used as a framework for future and current nurses (Sherwood & Zomorodi, 2014). These competencies cover all areas of nursing practice: patient-centered care, teamwork and collaboration, evidence-based practice, quality
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.
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
Nursingtimes.net. (2012) Scottish Patient Safety Programme Extended., Available: ProQuest Nursing and Allied Health Source [Accessed: 14th April 2014]
Today it is a requirement of the Joint Commission for all healthcare facilities to have a fall-prevention program in place. Facilities are also required to conduct an ongoing evaluation of the program (Hubbartt, Davis & Kautz, 2013). Most prevention programs include the use of a bed alarm, but can bed alarms alone prevent falls? This paper will investigate the use of a bed alarm being used as the only tool to prevent falls. It is often found that even when a bed alarm is sounded the patient has already fallen before any nursing personal can get into the room. This paper will also investigate the use of other prevention measures that can be used independently or in conjunction with bed alarms to work toward decreasing the number of falls and the related change theory that would work best to implement this change in practice. Nurses are leaders and should always be working to identifying and changing problems that appear to be evident with keeping in mind the best interest of the patient, their families, and the nursing staff.
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...
Nurses are pivotal in hospital efforts to improve quality because they are in the best position to affect the care patients receive during their hospitalization. Data collection and analysis is the core of quality improvement assisting in understanding how the system work, identifying potential areas in need for improvement, monitoring the effectiveness of change and outcome. Nurses are also the eyes and ears of the hospital to positively influence patient outcome. For example, nurses are the ones catching medication errors, falls, and identifying barriers to delivering care. In this nurse’s facility, in order to minimize patient falls the hospital implemented a falls risk assessment tool called, “The Humpty Dumpty Scale” upon admission
Safety is responsibility of the whole healthcare team. Any patient who enters a hospital or healthcare facility should be screened for fall risk upon admittance. Hicks (2015) states " Patient falls are recognized as a quality improvement through nurse-led safety strategies. These strategies include screening upon admission and implementing fall prevention strategies specific to the facility and nurse discretion. In order for the nurse to be successful at doing this a facility needs to have a protocol and proper training on fall situations. Nurses start with orientating to new environment by showing patient how to use the call light, rounding at least every 2 hours, any type of alarm that is needed or even a patient sitter. A study was done using evidence based practice to implement a safety team. "Successful falls prevention strategies included staff education about the fall-injury risk assessment tool, post-fall assessments, alarm device usage, side effects of medications, hourly rounding, and offering toileting frequently" (Godlock et al 2016). The whole healthcare team has to be engaged for team effort in reducing falls. A fall safety team should include nurses, medication aides, and certified nurses assistants and a universal or facility protocol should be part of handbook and annual training should be done to keep everyone current on training and any new changes. Godlock
“Staff in the med-surg unit are told that they must now educate all patients and families on falls prevention on admission and document it, regardless of the patient’s reason for or severity of admission, and along with everything else that they are asked to do with patients when admitted”(Scenario 3).
In the geriatric population, falls remain one of the most common cause of nonfatal injuries. In the article “Fall Prevention for Older Adults” three kinds of falls are described: anticipated physiological falls, unanticipated physiological falls, and accidental falls. Anticipated physiological falls “occur among people who are at a high risk for falling.” (Lyons, 2004). For the resident BK, this is the type of fall she experiences. BK is at a high risk for falling. In the last six months, she has fallen three times. In her most recent fall on Sept. 25, 2015, she was in her room being assisted with dressing before breakfast. While she was holding her walker, she lost her balance and fell backward. This fall didn’t result in her losing consciousness, and at the time, didn’t cause her any
Going to hospital as a patient can be quite daunting. Thus, it is the expectation that medical personnel, including nurses, will endeavour to ensure the patient has a safe and comfortable stay whilst receiving safe quality care. Hence patient centred care (PCC) defined by the Quality and Safety Education for Nurses (QSEN) model as “the recognition of the patient as the source of control and full partner in providing compassionate and coordinate care, based on respect for patients’ preferences, values and needs” (QSEN 2005, as cited in Hinds, 2013) is fundamentally vital to ensuring the patient experiences a safe stay in hospital. What must be remembered is that not only should nurses aim to be safe for the patients but for themselves as well. The safety of nurses from workplace-induced injuries and illnesses is extrem...
Events of falls not only impact the patients and their families, but the hospital as well. To the patients, a fall causes injuries that lead to mortality, morbidity, and early nursing home placement (Kim, et al., 2007). In addition, the Center for Disease Control and Prevention (CDC) reported that 20% of patients who fell,