The Problem of Patient Falls in Hospitals

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Table of Contents

Issue
Technology Innovation
Workflow Analysis Before Innovation
Workflow Analysis After Innovation
Timeline
Change Theory
References

Issue

Patient falls can be discussed as one of the most serious threats to patient safety in hospitals and medical centers. The problem is in the fact that accidental falls can cause significant patients’ injuries and fractures while affecting the patients’ overall physical state and treatment outcomes. The problem of patient falls is typical for different types of hospitals, and patient falls are reported for 2% of hospital stays.

The factors which can be discussed as influencing the risk of the fall are the patients’ age, physical state and the severity of illness, psychological state and mental status.

The problem of patient falls in hospitals should be addressed with the help of using the appropriate technologies because patient falls can affect the quality of the provided health care significantly.

There are many reasons to address the problem of patient falls in hospitals.

Thus, according to Bouldin, “the rates of falls in US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (Bouldin, 2013, p. 13). Moreover, “25% of falls in hospitalized patients result in injury, and 2% result in fractures” (Bouldin, 2013, p. 13-14). In 2008, about 19 thousand “older adults died from unintentional fall injuries” (Ferrari, Harrison, & Rawashdeh, 2012, p. 13). In addition, patient falls result in increasing the costs associated with patient care. That is why the specific act according to which the Centers for Medicare and Medicaid Services (CMS) should not pay for health care costs on patient falls was signed in 2008.

Technology Innovation

The technology which can address the problem of patient falls in hospitals is the five-sensor motion detection wireless system (5S-MDS).

The system works based on the use of wearable motion sensors. The wearable motion sensors can measure the patient’s movement in space. Wearable monitoring devices are based on the use of accelerometers in combination with a gyroscope to detect falls and associated movements. The connection of accelerometers, a gyroscope, and Bluetooth technology allows the accurate real-time monitoring and prevention of falls. The patients’ movements are not only detected but also visualized with the help of video recording.

Why Can the 5S-MDS Address the Problem?

The answer to this question is in the fact that the 5S-MDS detects the changes in the patients’ movements. As a result, the patients’ movements that lead to the fall can be recognized. That is why the use of the 5S-MDS allows the prevention of patient falls in hospitals. The received video reports are real-time, and the prevention of falls becomes possible.

Why Can the 5S-MDS Be Considered as the Best Choice?

The 5S-MDS is the best choice to cope with the problem because the sensors detect the patients’ movements accurately. Moreover, patient falls can be prevented, and the 5S-MDS can serve as the early warning system. The patients and nurses discuss the use of the sensors as acceptable and easy. In addition, the traditional systems and technologies such as bed alarms, video monitoring, and sensor alarms are limited in comparison with the 5S-MDS.

Workflow Analysis Before Innovation

The algorithm of actions associated with patient fall prevention includes such stages as the necessity to determine the high-risk patients and to ask the adult patients about the previous falls.

The patients can answer that there were no falls in the past. In this situation, fall prevention instructions and training are provided. The alarm sensors are used on-demand.

If the patients answer that they fell in the past, much attention should be paid to informing the patients about the opportunity to use bed and chair alarm monitoring systems, video monitoring, and sensor alarms. These systems are implemented separately, and the received data are analyzed separately. If there is a failure to prevent the patient’s fall, assistance is provided by the available staff

Workflow Analysis After Innovation

Having implemented the innovation, the nurses receive the opportunity to prevent the patients’ falls more effectively. After informing the high-risk patients about the fall prevention technologies such as the 5S-MDS, the staff can monitor all the patients’ movements associated with the possible fall with the help of the system which provides real-time video visualizations. Patient falls can be successfully prevented. The benefits are in the opportunity to monitor all the changes in patient’s movements in a complex.

Timeline

The project will be completed before the end of 2014. The implementation process includes the following stages:

The purchase of the 5S-MDS is the first step: June 2014.
Implementation of the computer system for video monitoring: July-August 2014.
Staff training: August-September 2014.
The use of the 5S-MDS in one department of the clinic: October 2014.
The use of the 5S-MDS in all departments of the clinic: November-December 2014.

Change Theory

The implementation of new technologies in the hospitals should be based on the principles of Quade and Brown’s Active Change Model. The main steps of this model are PERCEIVE, then DESCRIBE, then ACCEPT, then QUESTION, then ACT, and finally CHANGE. Thus, these stages can be explained with references to the implementation of the technology innovation the following way:

Perceive means to focus on the problem of patient falls and the 5S-MDS features
Describe means to analyze the aspects and factors of the problem
Accept means to understand the existence of the patient falls problem
Question means to ask about the principles of the 5S-MDS’s work
Act means to focus on advantages and begin to use the 5S-MDS for adult patients
Change means to use the 5S-MDS instead of traditional sensor alarms

There is also the important question: How can the change theory influence the success of the innovation? Quade and Brown’s Active Change Model is effective to implement the 5S-MDS because it is based on such advantages as:

The focus on the problem;
The analysis of all the pros and cons;
The active implementation of the new approach;
The active implementation is based on the research and analysis;
The possibility to understand the principles of the 5S-MDS’s work;
The possibility to assess the benefits.

References

American Nurses Association. (2008). Nursing informatics: Scope and standards of practice. Silver Spring, MD: Author.

American Psychological Association. (2010). Publication manual of the American Psychological Association. Washington DC: Author.

Bouldin, E. (2013). Falls among Adult Patients Hospitalized in the United States: Prevalence and Trends. Journal of Patient Safety, 9(1), 13-17.

Dykes, P. (2010). Fall Prevention in Acute Care Hospitals: a Randomized Trial. JAMA, 304(17), 1912-1918.

Ferrari, M., Harrison, B., & Rawashdeh, O. (2012). A pilot study testing a fall prevention intervention for older adults: determining the feasibility of a five-sensor motion detection system. Journal of Gerontological Nursing, 38(1), 13-16.

McGonigle, D., & Mastrian, K. (2009). Nursing informatics and the foundation of knowledge. Sudbury, MA: Jones and Bartlett.

Nurses influencing change. (2014). Web.

Titler, M., & Shever, L. (2011). Factors Associated With Falls During Hospitalization in an Older Adult Population. RTNP, 25(2): 127-148.

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