Prevention of Falls in Hospitalized Older Adults Essay

Title: Are Registered Nurses Utilizing Evidence-Based Fall-Preventative Strategies to Reduce and Prevent Falls and Injuries in the Elderly Population

Patient falls in hospitals continue to be a major and costly problem. The definition of a patient fall is an unplanned descent to the floor, assisted or unassisted, with or without injury to the patient. The authors of this article wanted to investigate the effect “missed nursing care” has on patient fall rates and patient outcomes. The authors also looked at hospital staffing as it relates to patient falls and nursing staff having enough time to carry out all nursing responsibilities.

Fall prevention is a vital aspect of a nurse’s job in the hospital. In this article, it explains hospitals having fall risk assessment tools, but many of them have not implemented interventions to mitigate patient-specific fall risk to these tools. The research problem addressed even though fall prevention should be modified to the individuals risk factors. Hospitals have not implement the use of fall prevention intervention to targeted patient with specific risk factors. Each patient is an individual and may have different risk factors than the patient in the next bed. The gaps in knowledge for fall risk patient are medical personnel don’t consider patient specific fall risk factors in the hospital setting. This study understands little research

During hospitalizations, falls are amongst the highest preventable consistent adverse events. Preventing such undesirable events, enhances patient overall experience, as well as increased trust in the health care professional team (Fragata, 2011). The importance of fall prevention lies with the many serious unfavorable health outcomes it can pose on the patient. Falls have the potential increase length of hospital stay, limit mobility, independence, but can ultimately lead to health deterioration, including death. Worldwide, falls are the second leading cause of accidental death. In addition to the life-threatening health and safety risks falls have to the patient, it also as a financial impact,

Several national and global campaigns already exist that provide tips and resources for fall prevention. However, statistics continue to demonstrate that falls continue to remain a serious problem in the elderly community. No one can argue that education is the best defense against falls. Nor can they argue that national efforts are not needed. Despite these national campaigns, falls

As a nurse we want to ensure that our patients receive a high quality of care. Patients should feel safe and satisfied while hospitalized. Many hospitals are continually looking for answers and implementation to significantly reduce the inpatient fall incidents. According to Bechdel et al (2014), the top priority of health care organizations nationwide is to reduce and eliminate falls within the clinical care settings. One of the serious problems in acute care hospital is the patient’s fall. The unfamiliar environment, acute and co-morbid illnesses, prolonged bedrest, polypharmacy, and the placement of tubes and catheters are common challenges that place patients at risk of falling. Most of the falls that I have encountered while working involves

Falls can have an overwhelming effect on legal, economical, ethical, and political situations. Many questions arise as to how to keep patients safe when they are at risk for falls. “A fall is described as a sudden, unintentional, downward movement of the body to the ground or other surface; when a patient falls, he or she is at risk of serious injury, disability, and possibly death” Huey-Ming, 2012). Falls happen during the day, afternoon, at night and do not subside do to the amount of staff. Falls happen when patients are ambulating, transferring, getting up without assistance, reaching for personal items, along with many different reasons. It is our job and duty as health care professionals to ensure patients remain safe during their hospital stay. As we learned in my previous literature review, patients that have had previous falls tend to fall more than those who do not, falls will increase the patients stay when there is or isn’t an injury obtained.

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Falls are considered a leading cause of mortality and injury among older adults and majority of the falls occurs while hospitalized. One would think being in the hospital would be one of the safest places for older adults as far as fall prevention is concern due to the fact that hospitals provide staffing around the clock for patients but more and more falls have been occurring in the hospital especially in the older adult population. Fall is an unintended descent to the ground. It raises public and family care liability; it also decreases patient’s functioning because it causes pain and suffering, and increases medical costs (Saverino et al, 2015). The Center for Disease Control

Falls among hospitalized patients are a primary concern for all associated health care providers, and different factors contribute to fall during hospitalization. The setting the writer is going to address is hospitalized patients in acute and long term care setting of which the writer has worked both as a floor nurse, and as a nurse manager. The causes of falls in hospital are many, and maybe due to intrinsic factors which is related to the patient’s health status such as confusion, or extrinsic factors which is related environmental obstacles like medical equipment, and also the organizational or workforce factors.

The procedures were conducted using the format of questionnaires. The questions on the questionnaire were based on these four main areas: cause of falls, nursing staffs intervention in fall prevention, routines of documentation and report, and experiences and reactions of nursing staff related to fall incidents. The 64 questions were distributed into four different categories of people. The four different categories are registered nurse, enrolled nurses, unskilled nurses’ aid and other professions (Struksness et al., 2011, p.3 ). Out of the 64 questions, 7 were background questions. The other 57 questions were distributed among the four main areas of fall. 28

Falls are a big concern for all employees in a hospital setting daily. The worst thing that can happen to a patient while being hospitalized is a fall, or a major fall, that could result in skin damage (i.e. wounds, skin tears, or abrasions), a fracture or break, thus limiting their independence. This student’s goal was to develop a way to educate staff members in ways they can help reduce the number of falls that occur. Developing a sample Fall Risk Prevention Policy as well as a Staff in-service on fall risk and Prevention achieved this goal.

Approximately 30% to 40% of people older than age 65 fall at least once a year. Of those who fall, 5% to 10% will sustain a head injury, a fracture, or laceration.” (Capetuzi) Elders falling is one of the fastest rising problems in the United States and it is responsible for many hospitalizations. Not only are falls dangerous but they are also costly to the victim and their family. A fall can increase an elder’s dependence and make it much more likely that they will sustain another fall. Elders who fall and are not tended to immediately can suffer from pressure damage and hypothermia. In addition to physical harm, fall victims have reported having less confidence, as well as a greater limitation of activities following a fall.

Patients’ safety is a priority in today’s health care system. The Centers for Medicare and Medicaid Services announced that hospitals will no longer be reimbursed for certain nosocomial conditions, thus placing a great demand on healthcare systems to prevent hospital-acquired health related injuries such as falls (U.S. Department of Health and Human Services, 2008). Nosocomial conditions, such as falls are conditions that are preventable that occur in the clinical or hospital setting. A fall is an unexpected event in which the participant comes to rest on the ground, floor, or lower level (Amador & Loera, 2006). Fall related accidents, injuries and death remain a major problem among hospitalized patients. It is estimated that one out of three adult patients over the age of 65 will fall (CDC, 2014). Falls have detrimental effects and impact on patients’ health and outcome as well as hospitalizations costs. Falls have attributed to broken bones, fractured hips, fear of walking alone, brain trauma, and even death. In 2012, the direct medical costs of older adult falls were $30 billion (CDC, 2014). According to Tzeng, Yin, & Grunawalt (2008), even the length of stay is affected, with inpatient falls with injury resulting in a 7.5-day increase in total length of stay. The attributed cost of falls, increased in injuries and prolonged hospital stay have a great impact on Advanced Practice Nurses’ (APNs) practice. The focus of this paper is to discuss evidenced-based

Although several national and professional organizations have developed evidence-based guidelines that set forth strategies for reducing falls,10,11 consistency in implementation of these strategies has been limited. Findings from 188 medical-surgical units in 48 hospitals across the United States found that risk-specific interventions (such as ambulation and medication management) are not being implemented consistently.12 This finding is in line with our research where we have identified that elements of nursing care are being regularly missed in acute care hospitals. We have conducted 3 studies of missed nursing care, the first being a qualitative focus group study on 5 patient units,13 the second a quantitative study in 3 hospitals,14 and the third, an expansion of the 3-hospital study in 10 hospitals with diverse characteristics (eg, size, teaching status).15 The results of these studies showed that a substantial amount of standard required nursing care is being left undone and that the patterns of missed care are similar across hospitals. Ambulation of patients 3 times per day (or as ordered) was the most frequently reported element of missed nursing care with 76% of nurses reporting this action being frequently or always missed. Similarly, Callen and colleagues16 found that 73% of patients did not walk during their