Fall Prevention Strategies in Nursing Practice

Reducing the amount of harm and errors to patient can help improve patient safety. We as nurses are required to comply with the principles of patient safety so that the patient safety goal can be achieved. Why is it that most hospitals hammer on the point that we should make sure that beds are in the lowest position, locked, side rails are up *2 or *3, call light is in reach and every patient has non-skid footwear. All these precautions are not in place just for fun, but they are all in place for the safety of our patients. So, if an institution has it main goal to be the patient safety, improved patient outcomes will be achieved. A lot of falls seen on our units has taken the turn for worst, which is why I choose to write about falls in this research essay.

Most of the falls are seen in the elderly and then sometimes seen within the middle aged. I remember one time a middle-aged man who was on our unit for a TAVR (tricuspid aortic valve repair) work up ended up falling after his procedure. So, this man had his procedure and all post TAVR patients are at a high risk for pauses in their EKG’s. Since these patient’s are at a higher risk for pauses it makes them a high fall risk patient. He was constipated after his procedure due to the pain medicine and he wanted some privacy to use the toilet. He was on the toilet for a while and whiles he was on the toilet one of his pacemaker leads failed and he ended up falling on the floor once he tried to get up. This patient ended up with a neck fracture that needed surgery which the hospital was charged for. His life was never the same again after this incident. Imagine the impact this would have on his family.

I chose this clinical guideline because I think we as nurses are responsible for keeping our patients’ safe. By keeping patients safe I mean we need to keep all patients free of any additional injuries throughout their stay in the hospital. Research from recent studies shows that there are many strategies which can help reduce the number of falls in a healthcare setting.

The participants included both males and females with an average age of 73years. It included people from Cologne, Valencia, Sydney and Sregan. Purpose The purpose of the study was to increase older adults’ motivation in participating and using the iStoppFalls prevention measures. Research design A combination of qualitative and quantitative data was used in this study. Also, descriptive analyses were conducted. Sample studied Some participants used iStoppFalls program through the TV set for 16 weeks and others did the same exercise and setup for 24 weeks. I don’t think the instruments used to measure the variable were reliable because the long term like the 24 weeks requires long term evaluations.

The results of the study suggested that the iStoppFalls system has good usability, user experience and user acceptance.

I think the limitation to this study was the sample size because I think the sample size of this study was too small to allow for detailed statistical analysis in terms of user acceptance. Level of Evidence and Justification for Level. I think the level evidence in this research suggest that elderly people at a higher risk for falls.

Are Findings Valid?

I think that the findings of this research are valid in the sense that the results of the study suggested that the iStoppFalls system has good usability, user experience and user acceptance.

The importance of the findings helps us link the iStoppFalls system to the elderly fall rate.

The project was conducted on a six-bed pediatric and pediatric intensive care unit staffed only by registered nurses (RNs) in a mid-size hospital in the southeastern United States. Purpose The purpose of this project was to implement a pediatric fall prevention program and policy on an inpatient pediatric unit with a goal to decrease pediatric falls.

This QI project had multiple initial components that involved evaluating the problem of falls. This included existing fall risk data at the project site and the development of a policy and subsequent plan for fall prevention where nothing specifically designed for pediatrics was previously in place. Sample studied The project included all patients, newborn to 18 years of age, admitted to the six-bed pediatric unit, including both general pediatric patients and pediatric intensive care patients.

There were no falls on the pediatric unit between January and June 2016, resulting in the fall rate per 1, 000 patient days at 0%, compared with a 4. 5% per 1, 000 days for the unit between January and June 2015.

The program and policy were not accepted hospital wide. Level of Evidence and Justification for Level. I think this is going to be a level 1 because of evidence for a systematic review of all relevant RCT’s were used.

I think the findings are valid because no falls between January and June are the best results a hospital can have.

These findings are very relevant to strategies to prevent falls.

408 beds divided in 13 adult medical surgical rehab unit.

The purpose was to help detect patterns that was related to unassisted falls. It was also to establish a process in maintaining consistency of identifying risk factors and develop appropriate solutions. Research design Data was collected from the internal reporting system with analysis of all falls. Sample studied The sample involved were divided into two groups which were; one group below 65years and the other group was above 65 years. The age group below 65 years accounted for an average of 20% more admissions than those over 65years.

Patient education was effective and showed steady improvement as patients became more compliable to the fall prevention strategies.

One limitation that was identified was family members. Some family members take measures into their own hands and by deactivating bed alarms and helping patients out of bed to the bathroom or into the chair.

Because patients were compliable to fall prevention strategies. Therefore, the best practice for keeping our patients safe is going to be using the Morse fall risk assessment on every patient that is being admitted into the hospital. So anyone with a Morse fall score greater than 35 must be on high fall risk precautions. Every patient on the floor must be under general fall precautions which includes locked bed, bed in lowest position, non-skid footwear and so on. Patients with a Morse fall score greater 35 will be under high fall risk precaution; this includes all general fall risk precautions but with a yellow non-skid sock, yellow fall risk armband and bed alarm activated.

I believe high fall risk precautions should be implemented for patients who are at a high risk for fall because it will reduce the number of falls, hence providing patient safety. The nursing actions will include the nurse educating the patient about the purpose of the yellow socks, yellow armband and bed alarm. Some patients will refuse the alarm but, in this case, it is the duty of the nurse to convince the patient as to why we need to implement these measures, so the patient could understand.

I would suggest that modules about safety should be assigned to every employee so that they can complete the education and get to know the plan on patient safety. Also, a one hour always safe class can be assigned to every employee to attend. Some barriers will be encountered for sure. For instance, some employees might not do the modules and they will expire. Managers and unit educators can prevent situations like these by keeping track of people who have done the modules and attended the class. They can also email out friendly reminders to those who haven’t completed it yet. Daily reminders can be added to the daily huddle for the unit.

In conclusion, this has been a very interesting essay for me to write because safety is a big issue in almost every healthcare facility. We as nurses should take our time and asses each and every patient to determine their risk for falls, so the necessary fall precautionary measures can be put in place.