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Prevention of falls in hospitals
Fall safety in hospitals
Fall prevention in older adults research paper outline
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Falls prevention of hospitalized older adults in acute medical Units: Evidence based nursing interventions. Introduction 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... ... middle of paper ... ... Practice 25(2), 127- 152. Tucker S. J., Bieber P. L., Attlesey-Pries J. M., Olson M. E.& Dierkhising R. A. (2012). Outcomes and Challenges in Implementing Hourly Rounds to Reduce Falls in Orthopedic Units. Worldviews On Evidence-Based Nursing 9(1), 18-29 Tzeng H. & Yin C. (2010) Nurses' response time to call lights and fall occurrences. MEDSURG Nursing 19(5), 266-272. Yates K. M., & Creech Tart. (2012). Acute care patient falls: evaluation of a revised fall prevention program following comparative analysis of psychiatric and medical patient falls. Applied Nursing Research 25(2), 68-74. World Health Organisation(2012) WHo Global report on falls Prevention in older Age. Available from http://www.who.int/ageing/publications/Falls_prevention [accessed on 09/11/2013].
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
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: assessment and interventions. Nursing Standard, 25(52), 50-55.
Patients expect instant response to call lights due to today’s technological advancements. This can negatively impact nurse stress and cause contempt toward the patient. However, the expectation to respond promptly improves safety and encourages frequent rounding. Also, aiming for high patient satisfaction scores on the HCAHPS/Press Ganey by fulfilling patient requests can overshadow safe, efficient, and necessary healthcare. Although patient satisfaction is important, ultimately, the patient’s health takes precedence over satisfying patient and family requests, especially when those requests are unnecessary, harmful, or take away from the plan of care (Junewicz & Youngner, 2015). The HCAHPS/Press Ganey survey focuses on the patient’s perception of care. The problem with this aspect of the survey is that the first and foremost goal of nurses should not be to increase a patient’s score based on perception. According to an article in Health Facilities Management, the nurse’s top priority is to provide the safest, most quality care possible for patients with the resources they are given (Hurst, 2013). Once this has been accomplished, the nurse can then help the patient realize that the most
For those who need hospital admission, the focus should be on anticipated discharge date, clear clinical criteria needed for admission in the right ward, and the right team for timely assessment (Royal College of Physicians 2012a; Emergency Care Intensive Support Team 2011; British Geriatrics Society 2012b). In my case study, the patient was admitted to the specialised ward for fracture neck of femur patients only and the need to consider why he had a fall at home certainly needs some thought.
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
Nurses hate it when patients are constantly turning their call lights on. The nurse feels like they are continuously in and out of that room for every little thing. Patients hate it when they wait a long time for someone to show up after pressing their call light. The patient begins to feel that they are not being take care of well and are being ignored. Patient satisfaction surveys state that one of the top complaints from patients were call lights not being answered in a timely manner. There has been evidence to prove that if facilities implement hourly rounding into their daily routine patient satisfaction goes up and call light use is greatly reduced. It is also proven if patient satisfaction goes up more nurses are satisfied with their job performance and can take care of their patients better.
Hospitalized patients are often hooked up to monitoring devices such as heart monitors, which monitor the electric activity of the heart, or connected to a physiological monitor so their vital signs are constantly being measured. These monitors are intended to continuously assess the patients’ status, and alarm if the patients’ status drops below what is considered normal. The increased use of monitoring devices has created a new phenomenon known as alarm fatigue. According to the ECRI institute (2011), “alarm fatigue occurs when the sheer number of alarms overwhelms staff and they become desensitized to the alarms resulting in delayed alarm response and missed alarms-often resulting in patient harm or even death.” Alarm fatigue has become a major problem within the nursing community and has already had a negative impact on patient safety. Due to the adverse effects alarm fatigue is having on quality patient care, there has been a call to action to find solutions that may deter alarm fatigue. Evidence-based practices involving quality improvement initiatives have been put into effect. The problem has also gained national attention from such institutions as the Food and Drug Administration (FDA) and The Joint Commission (TJC).
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).
As technology advances and medical aid becomes readily available it is no wonder that the elderly within our communities are living longer. Unfortunately this poses a serious issue for health professionals as elderly are becoming more prevalently injured, presenting with complications of higher severity than their younger counterparts (Ng et al., 2002). This essay will discuss the epidemiology, assessment and presentation of an elderly patient suffering from a traumatic injury. It will also examine the considerations specific to the elderly in terms of management, and ethical and cultural differences.
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. ...
While nurses are working on a floor there are many different machines that have alarms such as IV pumps, ventilator machines, ECG’s, vital machines, call lights, and pagers. New nurses have shown a lack of response efforts to combat these alarms from a proposed desensitization and sensory overload of the alarm noise (Cvach, 2012). This is a patient safety concern due to what the alarms purpose is which in turn leads to varying amounts of potentially severe consqeunces if not answered promptly. Between 2009 and 2012 the joint commission stated that there were 80 patient deaths, 13 permanent losses of function, and 5 events that led to extended hospital stays (Horkan, 2014). It is important for nurses to recognize alarm fatigue and find interventions to help keep patients from being injured.
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)
In the world there is an alarming trend where what seems to be harmless accidents take the lives of thousands of people every year. However, the loss of life and human potential is unacceptable. These unintentional injury deaths take on a myriad of forms that are brought out by the World Health Organization (WHO) and the U.S. Department of Health and Human Services (HHS). With the guidelines provided by these organizations Public Health Nurses (PHN) can help develop and execute strategies in an effort to decrease the lives lost to unintentional injuries.
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.