Reducing Patients Falls
According to Kalisch, Tschannen, and Lee, a fall is a situation when a patient is found on the floor (either observed or unobserved), or it may be unplanned lowering of the patient (2012). Patient falls is one of the greatest set back of treating patients. Despite of the several measures that have been put in place, the problem has not been fully eradicated. Very often, patients illness is exacerbated by such falls. In the study done by Kalisch et al, they report that for every 1000 patients, there are 4-14 cases of falls reported (2012). Patient fall can be prevented only if the common factors contributing to their fall are identified and intervention measures put in place. Some of the common factors contributing to patient falls are discussed below.
Some patients fail to call for assistance from the nurse. Patients who are not oriented in time and place fail to realize that they are in an unfamiliar environment. As a result, such patients fail to use the nurse call button anytime they leave their beds (Ruddick, Hannah, Schade & Bellamy, 2009). In addition, some patients out of pride may opt not to call the nurse for assistance and instead try to get out of the bed on their own. Secondly, failure to set the bed exit alarm has also been identified as having a role in patient falls. Bed exit alarms helps in alerting the staff in case the patient is attempting to get out of bed. Patients susceptible to wandering or those with urinary incontinence may opt to leave the bed without assistance, hence increasing their chances of falling. The nurse or the staff member may fail to reactivate the alarm once the patient gets back to the bed or after giving bedside care to the patient. It increases the risk of patient failing the next time they get out of bed since the alarm will not ring. The third factor contributing to the increased risk of patient falls is when he/she is on high risk medication for instance, anti-depressants and sedatives. Such medication increases dizziness, confusion and as a result, impairs the mobility of the patient increasing the chances of falls (Patient Safety Partnership, 2010). Inadequate patient evaluation also contributes to patient fall. During the time of admission, a patient may not be evaluated for fall risk. In other circumstances, one may be evaluated as having low fall risk, and in reality, the patient may be overestimating his/her ability. As a result, such patient does not benefit from patients preventive measures for falls. It increases the chances of such a patient falling since such a patient does not enjoy the privileges of having a low bed, using non-slip footwear and being close to the nursing station to help on case the patient is in need of toileting assistance (Patient Safety Partnership, 2010). Nurses delaying to respond to the call also play a role in increased cases of bed fall. Impatient patients may not be ready to wait for the nurses to respond to the call bell. Instead, such patients may decide to leave the bed unassisted which increases their chances of falling. Other factors known to increase patient falls is lack of ambulation assistance, failure to control bowel problems and inattention
Basing on the above factors that contribute greatly to increased incidences of patient falls, we realize that most of them can be prevented. The issue of nurses delaying to respond to the calls can be addressed by increasing the number of nurses (Ruddick et al, 2009). It is logical that increased ratio of patient to nurse will mean one nurse will have to attend to many patients. There is the need to increase the number of nurses in any hospital in order for effective attendance to patients. It is in accordance with research done by Kalisch et al which showed that a higher percentage of nurses will result to lowered incidences of patient falls (2012). The study also pointed out that nurses should be more mindful when dealing with patient. They should avoid relying solely on the installed gadgets. Employing more nurses will mean increased budget to the side of the administration.
Another possible way of reducing patient falls could be installing automatic exit bed bells. It is true that even we have enough patients to nurse ratio, at some point, the nurse may forget to attend to the patient. It, therefore, calls for an additional gadget to remind the nurses anytime the patient wants to leave the bed. In addition, automatic exit bed bells do not need reactivating the bells every time the patient leaves the bed which may be forgotten. They will ring anytime the patient leaves the bed or is close to the edge of the bed. It will remind the nurses in case it happens that they have forgot to reactivate them. The cost of installing automatic exit bell will need to be considered in the budget.
Another way that can help in curbing patient falls is making a proper diagnosis. Patients who are at risk should be identified and given low beds. As a way of preventing patient falls, low beds should be recommended to be used by all patients who need acute care. It will minimize falls and injuries associated with it. There is also a need to perform fall risk assessment every now and then for one to identify changes in the patient during patient care. Moreover, there is a need to encourage ambulation as a way of reducing patient falls, according to the study done by Kalisch et al (2012)
The criteria that will be used to assess the success of the intervention will be assessing the total ratio of patients to nurses and the incidences of falls recorded. It will be expected that decreased ratio of patient to nurse will also lead to reduced incidences of falls. For automatic bed exit alarms, a comparative study can be done to record the cases of patients fall before the installation of automatic bed exit alarms and after. For patient assessment, a thorough assessment of the patient will be done and the use of low beds also implemented. Thereafter, the total number of falls reported after the implementation of thorough examination of patient and use of low beds is recorded. The team will then compare the total number of falls before the implementation of the suggested strategies and after. If there is reduced number of falls after the implementation of the suggested methods above, it will mean it has been successful. It, therefore, will lead to implementation of the suggested methods of minimizing patient falls.