PICOT Assignment Falls and Fall Injuries in Hospitals

PICOT: Falls and Fall Injuries in Hospitals
Name
Institution of Affiliation
Date
PICOT: Falls and Fall Injuries in Hospitals
Problem
Falls and injuries resulting from falls are among the most prevalent problems in the healthcare setting among the elderly population. However, falls are not exclusively for the elderly as they can happen to any patient within the hospital depending on factors such as undergoing surgery, diagnostic testing conditions and medication conditions which weaken the body or lead to confusion among the patients. In the 2015 Sentinel Alert database it indicates that every year there are hundreds of cases of falls that occur in hospitals and 30-50% of these cases result to injuries and some lead to death. The cases of falls in hospitals also have cost implications as some of the patients get admitted to the wards resulting to longer patient stay which increases the cost of medical care CITATION NHI17 \l 1033 (NHIS, 2017). Some of the factors that the Sentinel report recognizes which result to falls include inadequate assessment, communication failures, lack of adherence to protocols and safety practices , inadequate staff orientation, supervision, staffing levels or skill mix, deficiencies in the physical environment and lack of leadership CITATION The15 \l 1033 (The Joint Commission, 2015). There is need to handle fall cases in hospitals in order to meet the objective of achieving positive patient outcome using achievable minimal costs possible.
Intervention
Arguably there are several strategies that can be implemented in an effort to prevent falls. As indicated above there are several factors that result to the occurrence of cases of falls in a hospital setting. In a 2013, systematic review on strategies that have been deployed for fall prevention in hospital setting the authors have concluded that the majority of the articles that they reviewed had more than one strategy implementedCITATION eta13 \l 1033 (Sussane, et al., 2013). Therefore, to fully handle the problem it will require a multifaceted strategy as one strategy cannot cover all the factors identified above. However, these strategies should be designed in a manner that it is relevant to the patients’ healthcare needs and also the nature of the hospital environment. The goal of these strategies should not be defined as purely to prevent falls from happening but to ensure patient safety within the healthcare system.
The universal fall prevention strategy is the most appropriate in prevent falls occurrence in a hospital. This strategy is referred to as the universal strategy because it applies to all patients regardless of the type of falls that may occur. The universal fall prevention strategy has several strategies that should be taken into consideration. However, it’s up to the hospital management to determine the ones to emphasize most depending on the nature of their hospital environment and the kind of patients they are handling.
The Institute for Clinical Systems Improvement provides some of the key strategies that should be implemented in a hospital setting as a way of preventing fall cases. Firstly is to familiarize the patient with the hospital environment. In this case the patient should be able to understand the environment where they are well and this familiarization can be done on the first day the patient is admitted to the hospital. The patient’s possessions should be kept within their reach and this is achieved by ensuring that the patients have a small wardrobe just right next to the bed where they sleep. Have handrails in the patient’s bathrooms, rooms and the hallway so that they can hold onto them when they are walking in the bathroom or in the hallway. The patient’s bed should be put in a lower position when they are resting and also rose whenever they are getting out of bed and the hospital bed brakes should be locked when the patient is in bed. For those patients who use the wheelchair it should be locked in position when they are not in use. Always have the patient wear a nonslip footwear when they are walking within the hospital and the floor should be tidy free of cluttered equipment on the floor. Have adequate lighting within the patient care and keep the place clean and free of water and other liquid spills CITATION Age17 \l 1033 (Agency for Healthcare Research, 2017).
Comparison
Other fall prevention programs that have been commonly applied in a hospital care setting include the medical staff education strategy. In a 2008 study by Krauss et. Al on interventions to prevent falls in a teaching hospital with an objective of evaluate interventions to prevent falls in the hospitals, the researchers carried a quasi-experiment among the nursing staff and patients. A pre interventions score was averagely at 72% among the nursing staff. With the continued training the staff improved and their score was rated at 94% after the training. Notably their knowledge on the fall prevention interventions had increased as compared to the beginning. The testing and evaluation of the intervention was carried within a period of five months. In this strategy the authors concluded that the staff training strategy was effective within the training period. The authors concluded that this intervention could not be sustained and recommended for continuous training program to refresh the knowledge among the nursing staff and th...