Change Proposal: Fall Prevention Management

Change Proposal
Name
Institution / Affiliation
Background
Falls are a key health risk and the second primary cause of unplanned injury death and hospitalization across the world. Annually, over 646,000 people across the globe lose their lives to falls with 80% of the falls happening in low and middle-income countries (Phelan et al., 2016). Adults with the age of above 65 years are more prone to falls (Quigley & White, 2013) For instance, in the United States every second every day an older adult suffers a fall leading to an injury or death. Other health risk factors include; cognitive deficits, chronic conditions, medications, behavioral choices, sensory deficits, alcohol and drug abuse, strength and balance deficits (Shever et al., 2011). In hospitals, falls are attributed to prolonged stay in hospitals, poor outcomes as well as readmissions. Falls prevention emphasizes on improving education and training, operative research, creating active guidelines to reduce the risk as well as developing safer surroundings (Quigley & White, 2013).
Problem statement
Globally, falls and injuries among inpatients in medical-surgical facilities are a significant health concern which prolongs patients’ recovery as well as increasing healthcare costs and liability. For example, patients suffering from falls incur an additional 6-12 days of hospital time and an excess of $13,316 than their counterparts. Moreover, hospital-related falls are a predominant and severe threat to patients’ safety (Quigley & White, 2013). Normally, in healthcare facilities, accidental falls are the most common fatalities accounting for 2% of prolonged hospital stays. In the United States, for example, hospital falls range from 3.3 and 12 per 1000 patients every day with over 25% of falls resulting into injury and 2% leading to stark breakages (Singer & Tucker, 2014). Nevertheless, the rate of falls is considered to vary by the type of medical unit. For instance, neurology, medicine and neurosurgery units are reported to have the highest fall rates compared to other units such as medical and intensive care units which have relatively lower fall rates (King et al., 2016). Normally, surgical procedures cause severe side effects that may alter patient’s mobility as well as frequent toileting which in turn increases the vulnerability to falls.
Purpose of the change proposal
Falls and injuries are frequently reported among adults in inpatients settings. Consequently, they lead to increased healthcare costs, reduced patients safety, prolonged patients stay in hospitals, increased federal health expenditure caused by falls, there is need to develop prevention strategies that address this challenge (Slade et al., 2017). Currently, many hospital managements are adopting nursing interventions such as increased accessibility to patient personal items, call bell system, appropriate reorientation strategies, safety rounds, use of walking aids among patients, increased education and training about fall risk to patients and caregivers, early and regular mobilization to reduce falls and injuries for inpatients in surgical facilities (Phelan et al., 2016). Therefore, the change proposal focuses to create more awareness on the effectiveness of nursing safety rounds in the prevention and management of falls and injuries.
PICOT question
How effective is nursing safety rounds in inpatients and medical-surgical units in controlling healthcare costs, maintaining patients’ safety as well as minimizing the patients stays in hospital as compared to the absence of the intervention?
Literature review
Falls prevention and management have been identified to be essential to patients’ outcomes in inpatients and medical-surgical units (Quigley & White 2013). According to, nurse’s safety workarounds have demonstrated to increase the safety culture in health facilities. Typically, it is considered that nurses have the best opportunity in reducing falls and injury due to their all-time presence as well as consistent contact with patients in the inpatient and surgical units (King et al., 2016; Slade, et al., 2017). (Quigley, 2013), maintained that conducting environmental rounds helps nurses identify and modify fall and injury risk factors.
Similarly, Phelan et al. (2016) found that nursing rounds is a structure...