Statistics/Facts
Prevention of falls for hospitalized patients is a cause of concernfor many hospitals. Accidental falls are the most prevalent incidents recorded in hospitals resulting to difficulty in 2 percent of hospital stays. The level of falls for United States hospitals ranges from 3.3 to 11.5 falls per 1000 patient days (Bouldin et al. 2013 p. 13). Falls rates in hospitals vary from unit to unit with medical units recording the highest rates (Bouldin et al. 2013 p. 13). The authors conducted a research to give data on fall statistics in United States hospitals. The author’s utilized data from the National Database of Nursing Quality Indicators gathered between July 1, 2006 and September 30, 2008 to determine the commonness of falls happening in general wards and surgical units. The data was conducted after an observation from 6,100 units in 1,263 hospitals in the United States (Bouldin et al. 2013 p. 13). The results of the study indicated that more than 315,817 falls happened in the research period; out of the total injuries, 82,332 caused an injury. The fall and injury levels were higher in medical units than surgical units. However, falls and injuries decreased during the two years and three months study period.
How Falls Happen In Hospitals
Certain factors contribute to sustaining falls in a hospital; they include an aging population, nurse shortages, and inefficient work environments for caregivers, rising patient acuity and failure of hospital leadership. Patient falls don’t happen due to intrinsic factors such as illnesses rather patient falls happen due to several factors (Abreu et al. 2012 p. 597). Most patients often feel disoriented or confused and they might not realize where they are need to utilize the nurse call button before attempting to walk. Other patients stubbornly feel that they do not require help and will attempt to get out of the hospital bed when they do not have the strength to walk alone. Bed-exit alarms are used to alert staff to emergencies such as getting out of bed (Abreu et al. 2012 p. 597). A common mishap that might occur in hospitals is when the bed-exit alarm is accidently not reset consequently exposing patients to risks (Abreu et al. 2012 p. 597).
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Causes
There are certain factors that cause falls for hospitalized patients; some of the reasons include chronic health conditions, physical and mental impairments, illnesses that affect body balance and failing bed alarms (Hempel et al. 2013 p. 483). Chronic illnesses such as hypertension, dementia, and blood pressure cause dizziness. Failing vision and muscle weakness cause the patients to hit objects that might result to falls. Illnesses such as labyrinthitis that affect the fragile balance regulating parts of the ear might contribute to falls (Hempel et al. 2013 p. 483). Hospital personnel often fail to conduct assessments on high risk fall patients when they enter the hospital hence exposing the patients to risk.
Risks
The outcomes of falls for hospitalized patients can be quite dangerous. The authors of the article utilized for this section conducted a study on patients who had experienced a previous fall for a 26 month period from 16 general medical wards and surgical units (Mion et al. 2012 p. 408). Falls are particularly dangerous for older adults due to the increased risk of morbidity and mortality. That fact is particularly disturbing since elder patients make up more than one third of hospital admissions. High medical costs for liability, longer hospital stays and care are associated with falls. Additionally, the Center for Medicare and Medicaid Services terminated payments to hospitals for the cost of treating injuries (Mion et al. 2012 p. 408).
Nursing Interventions
There are nursing interventions that may be used in the prevention of falls for hospitalized patients. It is important for nurses not to make an assumption that all patients have the same fall risk. It is important for nurses to conduct a fall risk evaluation by designing and implementing an individualized plan of care for preventing falls (Mion et al. 2012 p. 408). That could be conducted by screening patients for risk factors utilizing a valid risk tool. The assessment could be followed up with a comprehensive nursing and interdisciplinary evaluation such as fall history, function, cognitive and physical assessment. The fall risk assessment is performed through the use of team approach and assessing the risk factors found. Fall risk factors can be alleviated while others can be compensated. The fall risk assessment also involves interacting with the patients to discuss their concerns about falling (Mion et al. 2012 p. 408). It is important to ensure that patients use proper footwear to prevent the feet from sliding. The use of nonskid socks to prevent sliding or well-fitting shoes for ambulation. Fall surveillance systems help nurses to track patients before a fall through observation or alarms. Cameras allow for observation while alarms on the bed allow patients to notify nurses when they need to move. Bed alarms alert the nursing staff when a patient needs help; they allow for timely response to avoid falls.
Falls for hospitalized patients is serious concern for many hospitals and staff. A study conducted on 6100 hospitals revealed that more than 315,817 falls occurred during the study period; out of the total injuries, 82,332 resulted in injury. The factors that lead to falls in hospitalized patients include an aging population, nurse shortages, and inefficient work environments for caregivers, rising patient acuity and failure of hospital leadership. Falls are particularly dangerous for elder patients due to the increased risk of mortality and morbidity. Other risks of falls include high costs, increased hospital stays and liability costs. Some of the nursing interventions utilized to prevent falls include fall risk assessment, use of proper footwear and utilization of fall surveillance systems.
References
Abreu, C., Mendes, A., Monteiro, J., & Santos, F. R. (2012). Falls in hospital settings: a longitudinal study. Revista latino-americana de enfermagem , 20 (3), 597-603.
Bouldin, E. D., Andresen, E. M., Dunton, N. E., Simon, M., Waters, T. M., Liu, M., ... & Shorr, R. I. (2013). Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of patient safety , 9 (1), 13
Hempel, S., Newberry, S., Wang, Z., Booth, M., Shanman, R., Johnsen, B., ... & Ganz, D. A. (2013). Hospital fall prevention: a systematic review of implementation, components, adherence, and effectiveness. Journal of the American Geriatrics Society , 61 (4), 483-494.
Mion, L. C., Chandler, A. M., Waters, T. M., Dietrich, M. S., Kessler, L. A., Miller, S. T., & Shorr, R. I. (2012). Is it possible to identify risks for injurious falls in hospitalized patients?. The Joint Commission Journal on Quality and Patient Safety , 38 (9), 408-AP3.
