Introduction As a whole, fall injuries in hospital settings cost around $19 billion in the year of 2000. In 2020, the cost of falls is expected to cost over $54 billion (Hicks). The government deemed that since hospital falls were avoidable, they decided that they would no longer reimburse the expenses and instead the hospital would have to pay for the mistake by itself. With the cost of falls rising, it is even more important to bring to light the importance of fall prevention and safety. Optimum care and patient safety is a nurse’s main goal, and therefore, affects each and every nurse. With falls being such a critical part of a patient’s hospital stay as well as the nursing profession, nurses must perform adequate assessment and implementation
This research proposes a nurse-led rounding program in an acute care context, with an implementation based on the Iowa Model, to decrease patient falls. The Iowa Model's first stage is to determine the problem for the change in practice. The necessity to reduce patient falls is the trigger in this circumstance.
Significance of the Problem for Nursing: Prevention of falls in the elderly is an extremely important facet of nursing. Elderly falls often result in fractures, pain, decreased mobility, traumatic hemorrhages, as well as increased healthcare costs. Due to the increased prevalence of injuries acquired from elderly falls, increased risk of morbidity in the elderly experiencing falls, and the growing number of elderly patients, it is of vast importance that nurses research and incorporate evidence-based fall prevention practices to prevent falls in the elderly
Before this study, nurses were using general fall precautions for these patients at risk for falls and were not using fall prevention interventions specific for patient’s fall risk factors (Wilson et al., 2016). There were major themes and minor themes to go along with each major theme. There was a study before the fall prevention intervention practice that was described as a fall that occurs, either the patient is at a fall risk or the patient passed the fall risk assessment. Action was then taken by implementing general fall prevention practices for these patients that were shown as a risk. Before the study, one example of a general fall prevention practice was “We had
The second article that was reviewed came for National Guideline Clearing house (NGC, 2012). The methods used to analyze the evidence were review of published meta-analyses and systematic review. The major outcomes considered in the study were sensitivity, specificity, and reliability of screening tools, risk factors for falls and fall rates. There were numerous recommendations that were recommended to reduce and prevent falls among the elderly population. However the best practice in fall reduction includes falls risk assessment , visual identification of individuals at high risk for falls , falls risk directed interventions and standardized multifactorial education including visual tools for staff, families, and patients (NGC, 2012).
Change is inevitable not only in the hospital setting but also in all other organizations that put the safety of stakeholders at hand. It is, however, sometimes challenging to have all stakeholders adopting a proposed change since some individuals would rather stick to the old ways of doing things as opposed to trying out new interventions (Guse, Peterson, Christiansen, Mahoney, Laud, & Layde,, 2015). Nevertheless, positive change is essential, especially when such a change is expected to positively impact on the safety of patients (Johnson, Veneziano, Green, Howarth, Malast, Mastro, Moran, Mulligan, & Smith, 2011). The purpose of this paper is to critique the adoption of hourly rounding as a nursing intervention for preventing falls.
(Joint Commissions, 2014).It is important for nurses to explain how to use the call light to the elderly patients, and also to ask for help before getting out of bed. Vulnerable patients should be placed close to the nursing station for close monitoring. It is very important to educate health care workers on the approaches used to prevent falls. The measures used to prevent falls in the elderly could include; carrying out a risk assessment during admission, placing colorful stickers outside their doors, stopping the use of psychotropic medications, teaching them the best way to use their assistive device, placing their call light and belonging within their reach, placing their beds in the lowest position with brakes /wheels locked at all times, removing throw rugs from their surroundings, making sure that they are wearing non-skid shoes/socks before ambulating and also giving them their prescribed Vitamin D supplement as well as encouraging them on the use of their corrective glasses or hearing aids. It is very important to educate health care workers on the approaches used to prevent
Falls can result in a variety of critical outcomes that include broken bones, hospitalization, infections, fear of subsequent falls and loss of independence. Sadly, the majority of falls that occur in nursing homes and assisted living facilities
The clinical guidelines and literature for extensive fall prevention approach provides an in depth analysis that was difficult to understand clinical challenges of fall prevention. By using Roper et al (2000) model helps the healthcare professionals in identifying and assessing assess the individual requirement and what sort of on-going support is needed for improving. I believe that the nursing process environment must be based on at least one nursing model to properly examine and analyse the case
The clinical practice guidelines that were selected for this paper are from the National Guideline Clearinghouse and from International journal of nursing studies. The Hendrich Fall Risk Model was primarily developed as a predictive nursing assessment tool based on epidemiological research (NGC, 2011). The Guidelines were developed by the Hartford Institute for Geriatric Nursing the committee was however not stated. Authors were asked to sign confidentiality documents and all the authors agreed this. The research was conducted by hand searches of public literature and searches of electronic database.
Objective One During my clinical day three, I demonstrated entry-level competence in professional nursing practice in caring for patients with multiple and/or complex unmet human needs. I addressed safety needs, safety in medication administration, effective communication, and surveillance for my patients. First, I addressed safety needs my ensuring the appropriate safety measures were implemented for the patients. Some of the safety measures included, wearing non-skid socks, wearing a yellow armband which indicated fall risk, keeping the bed in lowest position, two side rails up, bed locked, and the call light within reach.
It also provided the use of critical thinking and clinical judgment on how to prevent falls, support, and be accountable for a client professionally. The practical knowledge I have learned helped me become aware of assessing and assisting a client. As a nurse, our job is to provide “safe, compassionate, competent and ethical care” (p.8) and collaborate as an interprofessional team to deliver safe care and prevent risks from happening while offering quality nursing care (CNA, 2017). I will always provide the professional care under the code of ethics to promote health and wellness for an older adult and prevent risks from happening. As well as following the plan of care, use communication strategies, be aware, acknowledge, and accommodate individuals with different diseases such as with dementia, to promote fall prevention strategies (RNAO, 2017).
The major strengths of this model “is its brevity, the inclusion of risky medication categories, and its focus on interventions for specific areas of risks” (Hendrich, 2017). Falls cause harm, both physical and psychologically. Regardless of age, falls can radically change a patients’ quality of life. As nurses, assessing, re-assessing, and educating our patients, plays a major role in fall prevention, especially those vulnerable to falls such as the elderly
A research study was conducted on reducing severe injury from falls in 2 veteran’s hospital medical-surgical units. The research study was done by Patricia A. Quigley, PhD, ARNP, CRRN and a team of RN’s. A large veteran’s hospital participated in a 1 year long collaborative project
According to the Agency for Healthcare Research and Quality, between 700,000 and 1,000,000 people in the United States fall in a hospital each year. According to our reports, 20 of these falls occurred in our hospital last year. Research has identified risk factors for falling in a hospital, such as impaired balance, history of falling, vertigo, orthostatic hypotension, altered mobility, visual impairment, the use of certain medications, etc. Patients who fall are more likely to feel hopeless, become less confident, become depressed and more isolated socially, experience a loss of physical functioning, a loss of quality of life, etc. This is an issue that must be resolved as soon as possible because the safety and well-being of the patients in this hospital should be a top priority.
I will also discuss on how this clinical situation could be done differently. Clinical scenario I was posted to a medical ward in National University Hospital for my clinical posting. There is a particular cubicle allocated for patients with very high risk of fall called the “Green eye cubicle “. Patients in that cubicle are usually confused or not compliant to fall precaution.