Patient Falls

Preventing Patient Falls in Inpatient Hospital Settings Introduction For the most part, hospitals are places where one comes for healing and it is place where our clients should feel safe and away from harm. Nurses have an important role as a patient advocate and are to provide all clients with safe, compassionate, and quality care at all times. Nonetheless, the hospital can also be a dangerous place for inpatients. It is a foreign environment to clients and there may be alterations in their medical condition in regards to their physical and/or mental status.

With this said, there is a need to improve upon how we care for our clients, especially those who are at most risk for various incidents. Background Certain facilities have dedicated efforts such as research and quality improvement teams to prevent incidents, yet patient falls still make up the largest category of reported incidents in hospitals (The Joint Commission, 2007). As nurses, we see fall prevention programs such as using fall risk assessment tools to determine how many our patients are at risk for falls.

In the inpatient setting, nurses also implement bed alarms and encourage “fall risk” clients to use the call light especially while getting up and out of bed. Although these tools ensure some security for our clients, it is not enough as it does not fully protect our patient population. This problem is significant to nursing as it compromises the safety and well-being of our clients, affects the length of stay, and also affects finances for both the patient and the hospital. So the question is: how can we promote safer hospital stays and prevent inpatient falls? Method This exploratory study used a qualitative research design that was conducted in one acute, medical adult unit (32 beds) in a Michigan medical center. The clinical nurses who currently work in the study unit were recruited for interviews. ” (Tzeng, 2008) These participants were asked for their input regarding how and why patient falls occur in the hospital setting according to their perspective, and to think of ways to implement new regulations and ways to prevent inpatient falls. (Tzeng, 2008) It would be ideal to create a fall prevention team that includes current staff who are directly involved n the care of clients. This team would include physicians, former or current staff nurses, assisting personnel, and other healthcare members since they all spend time at the patients’ bedside, and they may have insight into areas of improvement that others may not see. An interdisciplinary effort would be an overall better approach when dealing with precautions that would affect the facility’s policy and procedure changed in the facility. (Hughes, 2007) All of the members input about healthcare improvement may be highly constructive and would greatly benefit safety goals.

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The Joint Commission emphasizes that a better physical design of facilities may also lead to improved healthcare outcomes such as fewer patient falls. (Joint Commission, 2007) Results “The primary root causes of fatal falls as reported by healthcare organizations involved inadequate staff communication, incomplete orientation and training, incomplete patient assessment and reassessment, environmental issues, incomplete care planning, unavailable or delayed care provision, and inadequate organizational culture of safety. (Joint Commission, 2007) If a client is high-fall-risk, implementing continuous observation by bringing in a sitter for the patient would be best. If there are patients that are demented or confused, it may be ideal to inform and educate the family to visit and care for them as much as possible so that it provides the client with a familiar environment. If there are bed alarms set for certain patients, maybe it is best to group these patients closer to nurses station so the responsible nurse to could hear the alarms better and react faster.

Other findings include communicating changes in the patients’ behavior and conditions to oncoming nurses during shift change. Educating the family is always beneficial, so that they know about details such as non-slip socks, the importance of keeping the side rails up, and using the call light in concerns. Considering all over-the-counter and prescription drugs the client is taking is important, as well as considering the physical environment and thoroughly assessing and re-assessing clients for any physical and mental changes.

Ensuring that the client’s room and restroom are clean, dry, and free of clutter should also be a concern. For nurses especially, we should not also rely on housekeeping or the aides. If we could go out our way, just for a few minutes, this may just be enough sometimes to keep our patients out of harm’s way. Ethical Considerations People with autonomy have the freedom to choose between multitudes of options. (Burkhardt & Nathaniel, 2008) Autonomy is the ability to freely choose amongst a variety of options that would have certain effects on a person’s life.

Most of the clients that seek healthcare are independent in caring for themselves or formerly independent in self-care. At times, nurses encounter clients who seem to be stubborn or not enthused with the idea that now at a certain time of their life, they are not able to do things completely by themselves. Their autonomy has now been compromised by medical or other conditions they have. Nurses encounter problems with certain people who do not call for help or have healthcare personnel assist them when they really are at risk for falls and other injuries.

If a problem such as this arises, clients should be made aware that nurses and aides are always willing to help even if it is just a trip to the restroom. Clients should be re-assured that they are not being bothersome and ask for assistance at any time during their patient stay. This is how nurses should promote beneficence and ensure trust amongst our patient population. Conclusion Ensuring client safety should be the main concern for nurses and healthcare professionals. Although the Joint Commission has addressed problems with client falls, there is always room for improvement.

Nurses should be known as bedside leaders because out of the rest of the interdisciplinary team, we know our patients the best and they are our priority. References Burkhardt, M. A. , & Nathaniel, A. K. (2008). Ethics and Issues in Contemporary Nursing (3rd ed. , pp. 452-453). Clifton Park, NY: Delmar Cengage Learning. Hart-Hughes, S. , Quigley, P. , Palacios, P. , Bulat, T. , & Scott, S. (2007 ). An Interdisciplinary Approach to Reducing Fall Risks and Falls. Journal of Rehabilitation, 70(4), 46-51.

Retrieved February 9, 2012, from CINAHL Plus with Full Text. Joint Commission, The. (2007). National Patient Safety Goals — Facts about the 2007 National Patient Safety Goals. Retrieved February 7, 2012, from http://www. jointcommission. org/PatientSafety/NationalPatientSafetyGoals/07_npsg_facts. htm Tzeng, H. , & Yin, C. (2008, June). Nurses' Solutions to Prevent Inpatient FallsHospital Settings [Electronic version]. Nursing Economics, 26(3), 179-187. Retrieved February 9, 2012, from CINAHL Plus with Full Text.

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