Implementing Fall-Safe Prevention Programs to Reduce Hospital Falls
Falls are hospital accidents affecting patients and ought to be mitigated through the adoption of effective strategies as they worsen a patient’s suffering and may even cause mortality. Hospital falls are common occurrences in most healthcare settings, affecting an average of 11% of all hospital patients with statistics indicating more than 10% of the patients who fall suffer injuries (Spetz, Brown, & Aydin, 2015). Most of the inpatients affected by hospital falls attribute the accidents to effects of medication, search for toilets and bathrooms, and unfamiliar environments (Pearson, 2011). This prompts the need for nurses and other hospital managers to institute efficient care mechanisms to help avoid instances of hospital falls.
Through the intervention of the environmental and universal fall prevention measures, nurses can help mitigate and even eliminate the prevalence of falls within hospital settings (Degelau et al., 2012). The fall-safe interventions targeting at eliminating all the fall risk factors helps ensure the current statistics of hospital falls drop drastically. It is, thus, important that nurses adopt a comprehensive plan targeting the elimination of falls through the implementation of universal and environmental intervention programs to help effectively reduce hospital fall prevalence in healthcare settings.
Change Model Overview
The John Hopkins Evidence Based Practice Process is crucial in the nursing profession as it helps provide universal guidelines on various issues and programs affecting the healthcare sector. Through the process, nurses get to know the universally accepted steps of implementing various programs to help assure of their success in the healthcare sector. The model, thus, provides accurate guidelines for the implementation of various change processes.
Practice Question
Step 1: Recruit Inter-Professional Team
To help implement the nursing intervention plan designed to implement the fall-safe prevention plan, the study will be facilitated with an inter-professional team comprised of four charge nurses, three physicians and a pharmacist. As the team leader, I will personally select the members of the inter-professional team to help me achieve the intervention plan objectives.
Step 2: Develop and Refine the EBP Question
Will implementing a Fall-safe Prevention Program be effective in reducing hospital falls?
Population. Hospital falls are a source of injuries to hospitalized patients and in some cases lead to the death of the affected patients. Falls are highly prevalent in hospital settings due to factors like confusion that result from the types of medicines consumed by patients, lack of proper orientation and guidance by hospitals staffs, in addition to the failure to make elaborate patient assessments (Wayland et al., 2010). The falls affect patients of all ages though researchers such as Tinetti and Kumar (2010) argue that elderly populations are the most affected by falls in hospital settings and beyond. In this case, the intervention program will be designed to help reduce falls among all in patients with no regard to the age bracket they belong to because of the desire to effectively reduce or eliminate all instances of hospital falls.
Intervention. Having identified hospital falls as a major cause of injuries and mortality in various healthcare settings involving hospitalized patients, it is important to ensure efficient intervention strategies to help mitigate the situation. As noted by Spetz et al. (2015), the hospital fall rate is abnormally high prompting the need for urgent fall-safe intervention programs to help considerably reduce the hospital fall statistics. The universal intervention program can help effectively reduce the hospital fall statistics (Degelau et al., 2012). Through the universal intervention program, all the stakeholders involved in this project will help institute fall preventive mechanisms designed to help all patients avoid falling irrespective of their age or gender. Through this intervention program, the stakeholders will familiarize the patients with the hospital environment upon admission, show them the washrooms, and take proper assessment to ascertain whether they are able to move around on their own or with staff support.
The stakeholders will also ensure the floor of the hospital are not slippery while additionally ensuring the patient basic needs like slippers are placed within reach. For who assessed and found not strong enough to move around unsupported, the hospital staffs will be on standby to help them get to the washrooms and back to their beds. Through the universal intervention plan, the nurses will also be scheduled to undertake annual refresher courses to help ensure they familiarize themselves with the hospital fall risk factors to help ensure high quality service delivery and effective mitigation of hospital falls.
The inter-professional team will operate in schedule in the allocated study intervention wards for a period of three months as shall be designed with the group leader with the support of all the team members. The project team will help ensure all aspects of universal intervention process are adopted to help ensure best results at the completion of the fall-safe intervention program. The team leader will ensure daily inspection of all the intervention mechanisms such as dry floors, firm grip slippers, escort to bathrooms, patient assessment and prompt providence of personal effects to help assure the success of the project.
Control. The intervention program adopted in this project is all inclusive as it operates with the help of a well co-ordinate inter-professional team who work closely with the admitted patients to help ensure their safety and reduce fall rates. In ordinary circumstances, the handling of the welfare of admitted patients is considered a preserve of only the nurses, who at times get overworked and suffer from burnout. Therefore, this particular intervention program is better designed to yield quality and convincing results with regard to what can best be done to help reduce the prevalence of hospital falls in healthcare settings in the United States and beyond.
Outcome. This fall-safe intervention program aims to help drastically reduce the incidences of hospital falls in the United States and beyond using a universal intervention program supported by a strong inter-professional team. This intervention programs expects to register very low or no hospital falls throughout the intervention period given the fact that the selected inter-professional team will always be there to help answer to the calls and welfare needs of patients in the intervention ward at all times. Thus, the universal nursing intervention program will highly help mitigate the challenges of hospital falls in healthcare settings.
Step 3: Define the Scope of the EBP
Hospital falls worsen the condition of the affected victims and in most occasions result in injury and even death (Pearson, 2011). Spetz et al. (2015) posit that an average of 11% of all hospitalized patients fall, a high statistic that requires urgent intervention to help bring it down. The patients who suffer from falls suffer the resultant consequences on a short term or long-term basis depending on the nature of impact created by the falls on the victims. Thus, the need to intervene to help reduce the rates of hospital falls.
Steps4 and 5: Determine Responsibility of Team Members
The selected inter-professional team is very important for the success of this project because they are the people with direct impact on the welfare of the hospitalized patients. The nurses are mandated with the patients’ care role while the physicians guide their treatment and examine them to monitor their progress. The pharmacists on their part are concerned with the provision of drugs to the patients. To help mitigate the prevalence of falls, the professional input of all this professionals is important in helping ensure the welfare of all in patients as per the guidelines of the intervention program.
Evidence
Steps 6 and 7: Conduct Internal/External Search for Evidence and Appraisal of Evidence
This study is based on quality resources, comprised of qualitative studies, quantitative studies, and quality improvement data. The studies provide a detailed overview of the issues concerning falls among hospitalized patients in the United States and beyond.
Steps 8and9: Summarize the Evidence
Researchers search as Spetz et al. (2015) and Wayland et al. (2010) in their scholarly analysis of the costs, prevalence, and incidences of hospital falls note that falls have been costly to patients as they exaggerate the patients’ suffering while in some cases causing mortality. Pearson (2011) writes an elaborate document detailing the causes of hospital falls and their resultant effects on the welfare of patients. The article notes that falls increase the patients’ suffering and thus recommends that strategies be adopted to help mitigate the incidences of hospital falls. Heslop and Lu (2014) wrote a scholarly article outlining the increased prevalence of hospital falls in among hospitalized patients and recommend that nurses should step in a more involved role to help reduce the falls prevalence in hospital settings.
Step 10: Develop Recommendations for Change Based on Evidence
Based on the available evidence with regard to the high prevalence of falls within hospitals settings, it would be important for hospitals to institute measures to help curb hospital falls. Hospital managements should adopt fall-safe intervention programs such as the universal intervention programs to help ensure high quality care to patients that can help avoid falls. Additionally, for daily analysis of patients’ welfare and recovery progress to help in identifying those at the risk of falling.
Translation
Steps 11, 12, and 13, 14: Action Plan
The Universal intervention plan will be used in this study to help reduce the hospital fall incidence rates. To help achieve this objective, the plan will be implemented through a series of steps through a three month intervention period. First, the researcher will select the hospital and ward for the study. The research will then draw data form through which information on the welfare and number of patient falls will be documented throughout the three months study period. An inter-professional team within the hospital settings comprising of four nurses, three physicians, and a pharmacist will then be selected. The team will be guided on what is expected of them throughout the intervention period in addition to guiding them on how to fill the data form. The collected data will then be analyzed at the end of the exercise and compared with that of other wards with no universal intervention to help compare the statistics and know which program is best suited in reducing the hospital falls. The collected data will be presented in tables and graphs for easy understanding and comparison with other periods.
Steps 15 and 16: Evaluating Outcomes and Reporting Outcomes
Drastic reduction or elimination of hospital falls will be the desired outcome of this intervention program. The outcomes will be measured through an analysis of the documented information regarding the number of falls experienced within the intervention period. The data will be reported in the form of tables and graphs to the stakeholders to help enhance their understanding.
Steps 17: Identify Next Steps
On a larger scale, the universal intervention program would be implemented with the help of the local hospital management authorities that will help advice hospital managements on how best to reduce hospital falls with the help of an inter-professional team using the universal intervention program. Local policy makers would help ensure the implementation becomes mandatory across all hospitals in the region.
Step 18: Disseminate Findings
Within the organization, it is crucial to communicate the information by pinning posters containing the findings across all notice boards within the organization. On a larger scale, compiling an article on the findings and printing it in a reputable nursing journal would help reach more stakeholders in the nursing sector.
Conclusion
There is a high prevalence of hospital falls across different healthcare settings in the United States and beyond. The falls cause injuries and even mortalities to the affected patients and the effects can be felt either in the short-term or in the long-term. To help avoid the hospital falls, it is important that hospital managements institute effective preventive measures that can help patients from falling during their hospital stay. The use of the universal hospital-fall intervention programs is one of the most effective ways of reducing and mitigating the incidences of hospital falls in healthcare settings. Through this intervention program, an analysis will be made with regard to the efficiency of using the universal intervention program in helping mitigate the prevalence of hospital falls.
References
Degelau, J., Belz, M., Bungum, L., Flavin, P.L., Harper, C., Leys, K., Lundquist, L. & Webb, B. (2012). Prevention of falls (acute care). Institute for Clinical Systems Improvement, 3(2012), 1-44. Retrieved from https://www.icsi.org/_asset/dcn15z/falls-interactive0412.pdf
Heslop, L. & Lu, S. (2014). Nursing-sensitive indicators: A concept analysis. Journal of Advanced Nursing, 70(11), 2469–2482. doi: 10.1111/jan.12503
Pearson, K. (2011). Evidence-based falls prevention in critical access hospitals. Policy Brief, 24(2011), 1-35. Retrieved from http://www.flexmonitoring.org/wp-content/uploads/2013/07/PolicyBrief24_Falls-Prevention.pdf
Spetz, J., Brown, D. & Aydin, C. (2015). The economics of preventing hospital falls. Journal of Nursing Administration, 45(1), 50-57. doi:10.1097/NNA.0000000000000154
Tinetti, M. E., & Kumar, C. (2010). The patient who falls: “It’s always a trade-off.” JAMA: The Journal of the American Medical Association, 303(3), 258–266. doi:10.1001/jama.2009.2024
Wayland, L., Holt, L., Sewell, S., Bird, J. & Edelman, L. (2010). Reducing the patient fall rate in a rural health system. J Healthc Qual, 32(2), 9-15. doi:10.1111/j.1945-1474.2009.00068.x
