Fall And Middle Range Theory

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,

Patient falls in hospitals are a critical problem and are used as a standard metric of nursing care quality. According to the Joint Commission, thousands of patients fall in hospitals each year. Approximately 30-50% of falls result in injuries and prolonged hospital stays. Any patient in a hospital is at risk for falling and certain measures should be in place to prevent this. Preventing falls and injuries are not only important for the patient, but also for their families, the hospital, health care team, and insurance companies. It is estimated the average cost of a hospital admission due to a fall is $20,000 and by 2030, an estimated $54 billion will be spent on health care costs due to falls. The purpose of this paper is to explore the risk factors of falls in hospitals and interventions used to combat this problem.

Capan, K., & Lynch, B. (2007). Reports from the field: patient safety. a hospital fall assessment and intervention project. Journal of Clinical Outcomes Management: JCOM, 14(3), 155-160.

The purpose of this research paper was to examine the latest research and evidence-based practices related to inpatient falls. Falls among the elderly within a hospital setting has increased within the last decade. Inpatient falls have become the second leading cause of death, causing longer hospital stays and indirect costs for the hospital. The research reviewed multiple studies, which discussed the causes of inpatient falls. A few causes included nurses and staff not knowledgeable of current hospital practices, lack of individualized plan of care, and lack of training related to falls. The findings assisted the writer to revise the current fall policy and procedure for Arrowhead Regional Medical Center (ARMC). A fall reduction program

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues,

The Centers for Medicare and Medicaid Services (CMS) has identified eight adverse conditions, and inpatient injurious falls continues to be the most common adverse condition (as cited in Tzeng, Hu & Yin, 2016). The inpatient falls in the “US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (as cited in Bouldin et al, 2013, p.13). Roughly 25% of patients are injured when they fall (Bouldin et al, 2013). Since 2005, the USA’s National Patient Safety Goal listed fall prevention as a goal (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014). Since 2008, hospitals no longer receive payments from CMS for health care cost connected to inpatient falls (Bouldin et al, 2013). CMS views inpatient injurious falls as injuries that should never occur (Bouldin et al., 2013). There is no doubt that quality improvement must continue to address inpatient injurious falls. Preventing falls and implementing interventions to lower the rates of falls is a major concern for hospitals and must be included in any quality improvement measure.

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues, and difficulty with activities of daily living all of which are factors linked to falling. Contributing causes of nursing home falls include walking or gait issues, environmental hazards such as wet

Falls are the second most common adverse event within health care institutions following medication errors, and an estimated 30% of hospital-based falls result in serious injury. The severity of this problem led the Joint Commission to make reducing the risk of patient injuries from falls a national patient safety goal for hospitals in 2009 (AHRQ, 2006). Falls are a leading cause of hospital-acquired injury and frequently prolong and complicate hospital stays and result in poor quality of life, increased costs, and unanticipated admissions to long-term care facilities.

Patient falls have been a long debated healthcare issue throughout time and measured as a nursing sensitive issue. The National Quality Forum (NQF) has endorsed patient falls with an injury with the steward of the American Nurses Association (NFQ: Quality Positioning Systems, 2014). All patient falls are documented per 1,000 patient days via the measurement description (NQF: Quality Positioning Systems, 2014). The target population that accounts for the total number of patient falls is in the medical-surgical, step-down, critical care, critical access, surgical, medical and adult rehabilitation units (NQF: Quality Positioning Systems, 2014). The Center for Control and Disease (CDC) has reported that every seventeen seconds, an elderly patient will have a fall in a hospital (Hill & Fauerbach, 2014). The majority of falls are associated with patients ambulating from a bed, chair, or toilet without the proper assistance (Shorr, Chandler, Mion, Waters Liu Daniels, et al., 2012). There is a new regulation published by the Center for Medicaid Services. It states that injuries acquired through a fall in an organization will be held responsible for those medical costs (Hill & Fauerbach, 2014). In fact, in 2010, there was approximately $30B in hospital costs related to patient falls (Hill & Fauerbach, 2014). With the increasing number of patient falls in acute care settings and the change of healthcare coverage, does the use of bed alarms reduce the risk of falls of

This paper will discuss about fall prevention, which is one of the major issue leading to mortality and morbidity in health care setting (ACSQHC 2012, p. 6). The five peer reviewed articles related to the fall prevention will be used.

A fall can make wide spread consequences on the health service or can be affected seriously by the increased health care utilization. Among the fallers approximately 30% of falls result in physical injury leading to extensive hospitalization with significant hospital expenses (Tzeng & Yin 2010). Preventive care phases can support health services to regulate the spare expenditure to a greater extend. A fall in hospital consequently affects the nursing staff, which lead to impaired job satisfaction, additional work load and startling time consume. As the front line of care, nurses can prevent falls and reduce fall injury rates in acute care unit with available resources (Dykes et al. 2013). This literature review aims to assess the efficiency of planned interventions to reduce the incidence of falls in acute medical units. The discussions of the main findings of the review as well as the recommendations for further research are revealed to conclude this study.

he incidence of falls has a large impact in healthcare today, including legal, ethical, economical and safety implications, for patients, healthcare organizations and the community. Adhering to standards of care, and preventing falls assist the nurse, organization and patient in avoiding legal implications from falls. Protecting the patient's’ well-being, providing autonomy, and freedom are ethical obligations the nurse must consider when taking care of patients. Financial implications for falls can be devastating to the patient, as well as the organization and community. The safety of the patient is our number one goal in healthcare, and reducing fall incidence will not only improve patient safety, but it will improve healthcare as a whole.

If patient safety is the most important issue in Health Care facilities then how come hospital inpatient falls continue to be the most reported of all accidental falls (Tzeng & Yin, 2009)? Throughout the years, hospitals continue to make changes to decrease the risk of accidents and increase the quality of patient safety. With research studies and improvements made, patient falls still hold the largest portion of reported incidents in hospitals (Tzeng, & Yin, 2008). According to Tzeng & Yin (2008), “fall prevention programs apparently do not effectively reduce inpatient fall rates because of human factors and ergonomics in a hospital environment (p.179, para. 2). The two studies reviewed in this paper were performed with the hopes of

As we age, our bodies tend to weaken and we become more susceptible to disease and illness. When we have a disease, this causes us to become weakened and we will have a higher chance having a fall, which is America’s highest unintentional killer in hospitals. The definition of a fall is an unintentional change in body position that results in the patient’s body coming to rest on the floor or ground (Ignatavicius & Workman, 2016). At one point in our lives, we all have taken a stumble or two, possibly injuring ourselves or worse, but as we get older, our chances of falling increase dramatically. Aging is inevitable and we will all have injuries and illnesses that increase our chances of having a

In conclusion of using the following fall management series of KDH hospital and after the successful implementation in two months of research in 2002, the nursing staff is well trained, documentation of fall risk management has been published and readily available for the staff, they now have a standard continuity of approach. The present statistic still does not show much improvement during the few months of pre- testing but is has been improved after a few more months.