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Patient Falls

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Patient Falls

Patient falls undermine the quality of healthcare outcomes. Nurses are responsible

for ensuring patient safety because they are the majority of healthcare providers.

Healthcare professionals strive to enhance and maintain patient safety and create a safe

healthcare environment. However, healthcare environments are complex, and

maintaining the required level of safety for patients can be quite challenging. Safety

improvement plans and Quality improvement (QI) measures are effective healthcare

interventions that ensure fall incidents are effectively reduced. Nurses are most

significant in identifying and eradicating patient fall risk factors and incorporating

solutions from scholarly evidence to improve patient outcomes. Sound knowledge of

acquiring and utilizing evidence from scientific journals and other published and peer-

reviewed works is critical to improving patient care.

Elements Of A Successful Quality Improvement Initiative

A successful quality improvement plan comprises a problem, goal, aim, and

measures taken to solve the problem effectively. According to AHRQ (2023), there are

between 700,000 and 1,000,000 fall incidents annually in hospitals in the United States.

A third of these fall incidents are preventable by managing underlying patient and

environmental risk factors. Managing patient risk factors and developing and optimizing

the healthcare environment's physical design can prevent falls. A sustainable fall

prevention program would significantly improve the quality of healthcare outcomes since

falls can adversely affect the quality of patient care outcomes. Patient injuries, fractures,

internal bleeding lacerations, and psychological burdens can result in increased

healthcare utilization and costs.

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Factors Leading To Patient Safety Risks

Patient falls are a greater challenge to patient safety in hospitals. Patient falls

significantly increase healthcare costs and prolong patient stays in hospitals. A study by

Najafpour et al. (2019) investigated the risk factors associated with patient falls in

hospital settings. The study employed a nested case-control methodology on case 185

patients and 1141 control with respect to the identified patient and environmental risk

factors. The study findings show that the treatment length and type significantly impacted

patient fall incidents. For example, according to Najafpour et al. (2019), patients on

sedative drugs, chemotherapy, benzodiazepines, anticonvulsants, and ACE inhibitors

were at high risk of patient falls (OR= 1.01, CI= 0.32 to 0.73).

Another patient-related risk factors were visual acuity (OR = 6.93, CI=4.22 t0

11.38). Other patient-related factors assessed were patient balance conditions, urinary

inconsistency, manual transfer aid, and cancers. These patient factors were found to have

greater odds of patient falls, presenting a significant risk to patient safety. Other factors

assessed, such as patient-to-nurse ratio, patient fall history, and stroke, were not

associated with patent falls (Najafpour et al., 2019). The study concludes that patient-

related factors and medication history should be considered when developing fall-

prevention interventions. Moreover, modifiable risk factors such as the provision of

manual transfer aid, vision impairment, regular toilet programs, drug modification, and

diabetes management should be considered when developing fall prevention

interventions (Najafpour et al., 2019).

Best practice evidence-based solutions.

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Nurses play a significant role in enhancing patient safety through fall prevention.

Managing risk factors for falls can greatly improve the efficiency of patient falls strategy

(Najafpour et al., 2019). LeLaurin and Shorr's (2019) study proposes using alarms to

prevent patient falls. According to LeLaurin and Shorr (2019), installing alarms can alert

nurses when patients wake up and attempt to leave their beds without assistance. Patients

at greater risk due to medication or treatment can be assisted to leave their beds without

leading to patient fall incidents.

Additionally, sitters can be recommended as companion specialists to help

monitor the patients to prevent patient fall incidents. However, sitters can be costly and

ineffective at providing cost-effective fall prevention strategies. LeLaurin and Shorr's

(2019) study further emphasizes the importance of patient education on fall prevention.

When combined with physician follow-up, patient education can lead to better and

quality care outcomes.

The hospital environment plays a significant role in patient safety. LeLaurin and

Shorr (2019) suggest that environmental modification can improve patient safety by

eliminating patient fall incidents. Environmental risk factors include high beds, steep

staircases, slippery floors, and indoor air conditioning (Lenzen et al., 2020). According to

Lenzen et al. (2020), enhancing the healthcare environment to improve patient safety can

significantly improve healthcare outcomes by reducing patient fall incidents. Improving

the heights of beds and providing support rails for patients on convulsive, sedatives,

chemotherapy, and other medication that interfere with patient balance can improve the

hospital environment to facilitate patient safety. By providing less slippery floors, fall

incidents are likely to be reduced.

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Role Of Nurses In Coordinated Care, Improving Quality, And Reducing Costs

Nurses play a significant role in care coordination to prevent risk factors

associated with patient falls. Nurses can respond fast and effectively to fall prevention

alarms to prevent fall incidents. Care coordination is critical to fall prevention because it

eliminates the risks associated with fall incidents. Nurses and other healthcare

professionals can provide more effective fall prevention solutions by fostering

interprofessional collaboration. Interprofessional collaboration in nursing and other

multidisciplinary coordination provides useful information about the best ways to prevent

patient falls. Care coordination improves care quality and safety, preventing unnecessary

healthcare costs from patient falls.

Stakeholders

Developing effective fall prevention interventions requires effective collaboration

and teamwork. Nurse leaders and hospital management teams play significant roles in

facilitating the implementation of proposed solutions through resource allocation and

management. Additionally, they ensure that the right and safe protocols according to the

set nursing standards are strictly adhered to. Collaborating with medical engineers is

essential for promoting safe beds with proper alarm installation hence improving patient

safety. Nurses are essential for ensuring that the patients and their families experience

better quality care outcomes.

Conclusion

Patient falls result in injuries that can significantly prolong patient hospitalization and

lead to significant healthcare costs. However, patient falls are preventable. Developing

effective fall prevention strategies requires using evidence from scholarly journals, care
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coordination, and interprofessional collaboration to provide the necessary information to

implement effective and efficient solutions for preventing patient falls. Installing alarm

systems, improving the healthcare environment, and coordinating care can improve

patient care outcomes by preventing patient falls.

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References

AHRQ (2023, March). Preventing falls in Hospitals.

https://ahrq.gov/patient-safety/settings/hospoital/fall-prevention/toolkit/

index.html#

LeLaurin, J., H., & Shorr, R., I., (2019). Preventing falls in Hospitalized patients. State of

the science. Clinics in Geriatric Medicine. 35(2). 273-283.

https://doi.org/10.1016/j.cger.2019.01.007

Lenzen, M., Malik, A., Li, M., Fry, J., Weisz, H., Pichler, P. P., ... & Pencheon, D.

(2020). The environmental footprint of health care: a global assessment. The

Lancet Planetary Health, 4(7), e271-e279. https://doi.org/10.1016/S2542-

5196(20)30121-2

Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M., (2019). Risk factors for falls in

hospitals: A prospective Nested Case-Control Study. International Journal of

Health Policy and Management, 8(5), 300-306.

https://doi.org/10.15171/ijhpm.2019.11