NR NR452 Evidence Based RUA : Preventing Falls in Hospitals- A Continuing Priority for Patient Safety

Introduction

Despite the overwhelming focus on COVID-19, the importance of preventing falls within hospital settings remains a critical patient safety goal, as highlighted by The Joint Commission (JACHO). The Joint Commission plays a significant role in establishing standards for patient care and safety, and hospitals place great importance on achieving accreditation and certification from this body. Accreditation not only demonstrates a hospital’s commitment to quality care but also instills confidence in the community that they will receive competent and safe care (The Joint Commission, n.d.). Patient falls, particularly those resulting in serious injury or death, are categorized as “sentinel events,” meaning they are preventable occurrences that should never happen. Although falls are deemed “never events,” they still occur in hospital settings, making fall prevention a paramount concern for healthcare providers. This essay aims to explore the importance of fall prevention in hospitals, propose a solution, and discuss the associated barriers and benefits.

Importance of Fall Prevention

On average, between 1.3 and 8.9 falls occur per 1,000 patients in hospitals, a statistic that might seem modest at first glance. However, patient falls are one of the most frequently reported adverse events in hospitals, accounting for approximately 70% of inpatient incidents (Ashok & Khyathi, 2019). This issue is not just a matter of patient safety but also has significant financial implications for hospitals. Each fall leads to an average increase of $4,200 in healthcare costs due to extended hospital stays, the need for additional skilled nursing staff, and other related expenses. These funds, which could have been used to purchase personal protective equipment (PPE), upgrade hospital facilities, or provide staff raises, are instead consumed by the aftermath of preventable falls.

Moreover, the financial strain is exacerbated by the ongoing COVID-19 pandemic, which has further stretched hospital resources in the United States. However, beyond the financial implications, the ethical responsibility of preventing falls cannot be overlooked. The patient, along with their family, remains at the heart of this issue. Serious injuries resulting from falls, such as fractures and subdural hematomas, can lead to significant suffering and even death—outcomes that are entirely preventable with proper care and safety measures (Ashok & Khyathi, 2019).

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Proposed Solution: A Multidisciplinary Approach to Fall Prevention

To address the issue of falls in hospitals, a multidisciplinary approach is essential. This involves the collaboration of healthcare professionals, including nurses, physicians, physical therapists, and occupational therapists, who can collectively develop and implement effective fall prevention strategies. A proposed solution is the adoption of a comprehensive fall prevention program that integrates risk assessment tools, patient education, environmental modifications, and staff training.

Risk Assessment Tools: One of the key components of the fall prevention program is the use of standardized risk assessment tools, such as the Morse Fall Scale or the Hendrich II Fall Risk Model. These tools help healthcare providers identify patients at high risk of falling and tailor interventions accordingly. For example, patients identified as high-risk may require more frequent monitoring, the use of bed alarms, or the application of non-slip footwear.

Patient Education: Educating patients and their families about the risks of falls and the measures they can take to prevent them is another critical aspect of the program. Patients should be encouraged to ask for assistance when moving around, use mobility aids as needed, and ensure that their hospital room is free from hazards such as loose rugs or cluttered pathways.

Environmental Modifications: Making changes to the hospital environment is also crucial in reducing the risk of falls. This includes ensuring adequate lighting in patient rooms and hallways, installing handrails in bathrooms and corridors, and keeping frequently used items within easy reach of the patient. Regular environmental checks by staff can help identify and rectify potential hazards before they lead to an incident.

Staff Training: Ongoing training for hospital staff is essential to the success of any fall prevention program. Staff should be trained to recognize fall risks, properly use fall prevention equipment, and respond appropriately in the event of a fall. Additionally, fostering a culture of safety within the hospital, where staff feel empowered to speak up about potential fall risks, is vital.

Barriers and Benefits

Implementing a comprehensive fall prevention program is not without its challenges. Two primary barriers include staff knowledge and lack of motivation. Many healthcare workers may not be fully aware of the latest fall prevention strategies or may lack the motivation to consistently apply these practices. This is particularly true in high-stress environments where the immediate demands of patient care may take precedence over preventive measures.

However, the benefits of such a program are substantial for both the healthcare team and patients. For the healthcare team, a successful fall prevention program can lead to reduced workload associated with managing fall-related injuries, increased job satisfaction from providing high-quality care, and improved patient outcomes. For patients, the benefits are even more significant—reduced risk of injury, shorter hospital stays, and a lower likelihood of complications arising from falls.

Conclusion

Preventing falls in hospitals remains a critical issue in patient safety, despite the recent focus on the COVID-19 pandemic. The Joint Commission continues to emphasize fall prevention as a key safety goal, with patient falls being classified as sentinel events due to their preventability. The implementation of a comprehensive, multidisciplinary fall prevention program can significantly reduce the incidence of falls in hospitals, thereby improving patient outcomes and reducing healthcare costs. While challenges such as staff knowledge and motivation exist, the benefits of such a program far outweigh the barriers. By prioritizing fall prevention, hospitals can ensure that they provide the safest possible environment for their patients.

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References

Ashok, P., & Khyathi, R. (2019). Fall prevention strategies in healthcare: Evidence-based practices and guidelines. Journal of Nursing and Healthcare, 8(3), 120-125. Retrieved from https://www.journalofnursingandhealthcare.com/

The Joint Commission. (n.d.). Facts about patient safety. The Joint Commission. Retrieved from https://www.jointcommission.org/

National Council of State Boards of Nursing. (2019). NCLEX-RN examination: Test plan for the National Council Licensure Examination for Registered Nurses. Retrieved from https://www.ncsbn.org/nclex.htm