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The problem of falling patients in the hospital analyzed in this work requires immediate practical intervention. This issue is the visible result of an overall lack of patient safety in the hospital. The solution to this problem seems to be subservient to each separate employee of the hospital, rather, it requires a plan and an in-depth understanding of the problem. In the process of analysis, the problem of patient security is presented in a historical context and is proven to have its own practical methods of solution. Based on a strategy of evidence-based medicine and drawing theoretical material into action, this sequential problem-solving program will be proposed. In order to establish whether the strategy proposed for implementation is successful, special tests will be offered.
Any practice used in such serious professional fields of activity as medicine and nursing definitely requires a knowledge base as a source of recommendations. Practical medical assistance cannot but be based on a cumulative database, theoretical constructions based on carefully collected statistics. Before prescribing a particular medicine, course of therapy, or the use of medical practices, it is required to focus on the existing evidence of the effectiveness of the decision made. Guided by fundamental ethical principles, such as patient non-harm and patient care, physicians and nurses should be able to use the concept of evidence-based medical practice.
The problem of this issue is obvious since the falls of patients result in injuries of varying degrees of significance and, in general, are a tragic burden of hospitals, especially institutions of the geriatric direction. Touching upon the history of this issue, one cannot fail to note the statistics according to which every hundredth patient falling in the United States dies as a result of this accident (LeLaurin & Shorr, 2017).
Falls are so common that 250,000 people in the United States are injured in this way every year (LeLaurin & Shorr, 2017). Emphasizing the need for its solution, it should be noted that at the moment, in medicine, there is a relatively large gap in the study of falling patients. The calculations and developments that scientists offer are for the most part theoretical and their real effectiveness in real life remains largely unproven.
The evidence-based practice relies on the principle that any independent step of a practicing physician should be based on existing factual material proving the necessity or possibility of a particular practice. It is a scientific direction that is subdivided into a certain number of branches, each of which is associated with a specific type of research. It is important to note that due to each of these subtypes of evidence-based practices, there is a potential opportunity to obtain truly new scientific information (Mackey & Bassendowski, 2017). Evidence-based experimental and semi-experimental practices provide an opportunity to put a particular problem in a new perspective in order to fill a previously unknown gap in practical medicine or nursing.
It is necessary to draw attention to scientific works devoted to the consideration of various options for filling this gap. In the preceding reports of this study on preventive practices for falling patients, one should name an article that points to a relationship between nursing skills and the incidence of these accidents (Bowden et al., 2018). Other research points to age groups requiring special attention due to the increased risk of falls and injury (LeLaurin & Shorr, 2019). Finally, it is worth mentioning an article that focuses on the implementation of special technical equipment that can reduce the risk of falls and injuries (Dykes et al., 2020). Thus, for the development of an individual methodology in the work, strategies are proposed based on various research experiments using evidence-based practice.
In the analyzed case, it is essential that the research be carried out with minimal risk for the patients. The described problem of patient falls is not about innovation in medicine, testing of a new drug, or a similar problem pertaining to medicine as a biochemical science of treatment. In this case, the direct concern for the safety of patients when moving or in immobility is discussed.
Thus, this is a problem that requires not only immediate practical intervention but also needs a more practically approachable scientific system to develop an adequate methodological apparatus (Horntvedt et al., 2018). In other words, there is no possibility for the hospital to conduct experimental or even semi-experimental research in the context of the fact that this could cause more harm to patients. Rather, in this particular case, hospital administrators are required to come up with a plan and consistently implement their own strategy of action, which, however, will be based on previously obtained scientific and evidence. Thus, an experiment in itself will be considered the introduction of a plan developed on the basis of the past, which will subsequently be statistically evaluated to identify positive dynamics.
The first step in the proposed preventive strategy is to identify risk factors and make decisions to neutralize them. When preparing analytical material for this stage, it is necessary to separate the factors of falling into internal and external factors, for the subsequent elimination of any external ones. Among these factors, are independent of the patient and their health, the training of personnel, as well as modern or, on the contrary, dilapidated equipment and general arrangement of the hospital.
Thus, building on previous developments, and with sufficient funding, it would make sense to equip the hospital with fall prevention systems that have already been proven to be effective. At the same time, the hospital administration should take into account that it is problematic to prevent not only falls but also the possible traumatic consequences of it (Najafpour et al., 2019). One should note the likely need for additional training courses for nurses since research confirms that their professionalism does underestimate the statistics of falls (Bowden et al., 2018). Thus, among the urgently necessary measures, the improvement of the working apparatus is also required, since the coordination of employees can largely prevent the critical harm received from a fall.
A possible hypothetical framework for this work would be the assumption that work on correcting the external causes of patients’ falls could have a positive effect on fixing this problem. In order to practically confirm the benefits of the implemented solutions, the effectiveness ratio should be calculated using the strategies of previous medical researchers. To do this, it is required to record the number of falls using all of the above practices, also taking into account the falls resulting in injuries, both insignificant and fatal. Comparing these numerical valuables would provide direct evidence of the effectiveness of the strategies. Also, in order to differentiate the effectiveness of strategies, it is required to record how each fall occurred, whether it was prevented and how. Then, using this statistical testing method, it will be possible to improve the most effective applied practices.
References
Bowden, V., Bradas, C., & McNett, M. (2018). Impact of the level of nurse experience on falls in medical surgical units. Journal of Nursing Management, 27(4), 833-839. Web.
Dykes, P. C., Burns, Z., & Adelman, J. (2020). Evaluation of a patient-centered fall-prevention tool kit to reduce falls and injuries: A nonrandomized controlled trial. JAMA Network Open, 3(11). Web.
Horntvedt, M. T., Nordteien, A., Fermann, T., & Severinsson, E. (2018). Strategies for teaching evidence-based practice in nursing education: a thematic literature review. BMC Medical Education, 18, 172. Web.
LeLaurin, J. H., & Shorr, R. I. (2019). Preventing falls in hospitalized patients: State of the science. Clinics in Geriatric Medicine, 35(2), 273-283. Web.
Mackey, A., & Bassendowski, S. (2017). The history of evidence-based practice in nursing education and practice. Journal of Professional Nursing, 33(1), 51-55. Web.
Najafpour, Z., Godarzi, Z., Arab, M., & Yaseri, M. (2019). Risk factors for falls in hospital in-patients: A prospective nested case-control study. International Journal of Health Policy and Management, 8(5), 300-306. Web.
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