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Falls in a hospital setting have a negative impact on patient outcomes. Due to age-related changes, elderly individuals are more susceptible to falls. At the same time, they are more likely to suffer serious consequences of a fall ranging from severe injuries to death. It is also noteworthy that the occurrence of falls negatively impacts the economic aspect of a healthcare facility functioning. The current paper proposes an evidence-based solution and outlines the expected outcomes of its implementation.
Identification of Clinical Problem
Patient falls negatively impact patients’ quality of life and have been associated with increased risk of sickness and injury, increased mortality, inability to perform routine activities without aid, and depression (Stenhagen, Ekström, Nordell, & Elmståhl, 2014). According to the current consensus, the hospital environment contains several crucial factors that contribute to fall occurrence, with environment-based issues such as cluttered and slippery surfaces, multiple drug therapies, and coexistence of chronic conditions being the leading causes (Jones & Whitaker, 2011).
Due to the existence of the vulnerability, patients also require extended treatment and, by extension, prolonged hospital stay. For the healthcare facility, such a scenario results in additional expenses. The falls also have an indirect negative impact on nursing performance, primarily due to the need for care following a fall.
Combined with nurse shortage, the extensive care disproportionately increases the nurses’ workload, resulting in the decline of quality of nursing care and decreased patient satisfaction. Importantly, the issue in question is preventable. The most effective approaches to fall reduction are intensive and regular physical therapy, sufficient understanding and awareness on the issue among the personnel, and adequate health screening (Matchar et al., 2017). The responsibility for the prevention of falls lies mainly within the nursing staff.
Evidence-Based Solution
In order to resolve the issue, it is recommended to introduce seamless staff training interventions in order to improve the quality and consistency of quality delivery of fall prevention strategies in the hospital setting. Simultaneously, relevant and accessible information on the strategies used to prevent falls should be delivered to the patients in recurring educational sessions and events. The topics that need to be covered in the proposed sessions include the performance of hourly checklists, utilization of ambulation assistance, recurring fall assessments, and an establishment of communication channels between the nursing personnel and patients, among others.
The multidisciplinary nature of the nursing intervention is expected to ensure consistency of results and a more reliable improvement across the setting (Healey & Darowski, 2012). The intervention is suggested to be in the form of brief in-services conducted on a quarterly basis. Each session would need to be tied to a specific narrow topic and delivered with maximal time efficiency to prevent excessive load on nursing staff. Importantly, the intervention is expected to enhance patients’ capacity for self-care and, by extension, make them less dependent on nursing staff, thus improving the overall level of patient care.
It is also worth mentioning that the proposed intervention is consistent with the specific health care agency since it will contribute to the efficiency of the current fall prevention protocol. The expected change in nursing practice associated with the proposed intervention is the increased awareness of the effective fall prevention strategies and more consistent use of the current components of a protocol, such as a bedside reporting and the application of interventions corresponding to the results of the fall assessment tool.
Conclusion
Prevention of falls among the elderly is an important issue both from a clinical perspective and as a determinant of the quality of care. The proposed solution will enhance the efficiency of the existing fall prevention protocol, actualize relevant knowledge among nursing personnel, and increase patient satisfaction. Finally, the format of the intervention is consistent with the current limitations of the setting and is expected to result in positive nursing practice change.
References
Healey, F., & Darowski, A. (2012). Older patients and falls in the hospital. Clinical Risk, 18(5), 170-176.
Jones, D., & Whitaker, T. (2011). Preventing falls in older people: Assessment and interventions. Nursing Standard, 25(52), 50-55. Web.
Matchar, D., Duncan, P., Lien, C.T., Ong, M. E., Lee, M., Sim, R., & Eom, K. (2017). The steps to avoid falls in the elderly (safe) study. Innovation in Aging,1(1), 267- 275. Web.
Steinhagen, M., Ekström, H., Nordell, E., & Elmståhl, S. (2014). Accidental falls, health-related quality of life, and life satisfaction: A prospective study of the general elderly population. Archives of Gerontology and Geriatrics, 58(1), 95-100. Web.
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