Patient Falls in our Hospital
Patient falls cannot be prevented, though, hospitals do their best to reduce such occurrences. Over the recent years, our health institution has had 2000 patients who have experienced unintentional falls with 28 percent of the falls resulting in injuries. Our hospital has been in the lead in exploiting all possible options to minimize the number of patient falls. According to the Medicare and Medicaid report 2008, their centers do not pay hospitals for the extra care associated with inpatient falls and the traumas associated with these falls (Vincent, 2010). Since such state of affairs has proven to be a real tragedy, our research team necessitated the research on patient falls, their causes and possible solutions to the issue.
Description of Patient Falls
Patient fall is the unintended descent to the floor by a patient whether they get injured or not. Falls may affect persons ability to function as a productive member of their family and/or society (Szumlas, Groszek, Kitt, Payson & Stack , 2007). Patients aged 65years and older are in the vulnerable group owing to chronic conditions, weak muscular system, use of a cane or a walker.
Frequency of patient falls increases due to the factors such as negligence by medical staff, increased number of patients and delayed attendance to patients (Vincent, 2010).
Communication Techniques to Inform Staff
The first step introduced by our hospital involved bridging the gap between the patients and health workers to allow for immediate action in the event of various emergencies. If the patient could be demonstrating some degree of cerebral impairment, the attendants available would use a bed alarm and /or chair alarm to notify the nurses or any available specialist of the patient fall; if these measures prove ineffective, a non-emergent restraint could be considered (Szumlas, Groszek, Kitt, Payson, Stack, 2007).
Finally, the most common means of communication that was employed in the event a patient falls is verbal communication. Those witnessing the event would normally call the nurses either physically or telephone them through the landlines installed in various parts of our hospital.
Safety Processes that were Neglected
The problem of patient falls can be partly blamed on negligence from the hospital staff, the first procedures were not put in place to give our patients orientation towards and use of the call light in the hospital, thus, they were alien to our facility and in the event of an emergency, they couldn't have acted on their own (Szumlas, Groszek, Kitt S, Payson, Stack, 2007).
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Secondly, contrary to the regulations that beds must be placed in low positions except when performing nursing care, our staff placed the beds in high positions which proved to be a problem in the event where a patient would want to leave or get on their bed and fall in the process.
Additionally, responsibility of the staff to ensure a patient has personal items within easy reach such as telephone, call light, bedside table, water, eyeglasses and urinal was neglected. What is more, assistive devices, such as walkers, cane crutches, etc., were not placed within reach. Even in the event in which they were available the staff did not ensure optimal use of eyeglasses and hearing aids by ensuring they are clean and work (Vincent, 2010).
The nurses did not monitor effects of medication on the patients and encourage them on regular toileting, besides, they did not provide psychological and emotional support.
Recent years have witnessed a growing number of claims aimed at seeking reimbursement for lapses in patient safety, healthcare providers and facilities owe a legal duty of care to their patients. Recent examples of SARS-related litigation demonstrate that individuals may even sue provincial governments for allegedly failing to provide adequate funding to health facilities. In the context of patient fall a patient may file a case against the hospital for negligence (Vincent, 2010).
Continuous Quality Monitoring
The following measures, as shown in the chart below, will be taken regarding the patients prone to falls to ensure continuous quality monitoring. Firstly, the door of the ward of such patients will be identified with Help Prevent Falls magnet which will ensure they are easily accessed; further, aHelp Prevent Falls sign will be placed in the ward to help the caregivers to be keen when dealing with such patients. Secondly, the patients will be identified with yellow armband placed on the wrist to ensure they are given the necessary attention. In addition, assistance to bathroom/commode or use of receptacle and hydration will be offered every 2 hours while awake and periodically at night which will ensure the patients are under constant monitoring and in good health. The above measures will be accomplished by visual hourly checks of patients by staff members. Such measures are essential to provide the necessary attention and every 2 hours reorientation which is best suited for elderly patients and those who are mentally ill. Additionally, bed alarms should be installed in such a manner that those who witness the falls can alert the staff immediately. Patients prone to falls should be placed inwards close to the nurse's station, low beds should be fitted and call lights should be placed within easy reach by patients. The patients should be demonstrated how to use the call light which would ensure that all patients are attended immediately, hence, reduce the number of patient falls. Comment by Editor: Impossible to understand the initial idea
Recommendations to the CEO
For our hospital to ensure quality services, to reduce the number of patient falls, the following recommendations are to be given to the CEO. First, special low beds should be used to ensure patients don't fall in the event they try to climb or leave their beds. Secondly, when the bed is in use, a bed pad needs to be placed on either side of the bed to ensure that in case a patient falls he will not get injured. The facility should be equipped with bed and chair alarms to ensure that in case of an emergency, the nurses are timely notified, hence, the necessary care actions will be delivered. (Vincent, 2010).
Patients in our hospital should be oriented to surroundings and the staff assigned to monitor them keenly. Light cords should be placed within reach so that patients can easily access them whenever required.
Since our hospital receives cognitively impaired patients we recommend use of sitters for them. In order to ensure safety when walking around the hospital, clutter, electrical cords and unnecessary equipment should be eliminated. Patients personal care items should be put within arm length and beds fixed in the lowest position with wheels locked.
Patient education is an essential part of patient reduction measures of our hospital, thus, we should educate and supply patients and their families with fall prevention information; hospital wards should be placed closer to nurses' station and completed with bedside mats. Elevated toilet seats should be installed along with beds with relaxation tapes that enable patients to position themselves more comfortably. Exercise/activities program is another means of reducing the number of patient falls. Finally, the hospital should actively engage patients and their families in all aspects of the fall prevention program so as to achieve better results.
We believe that if the measures recommended will be implemented, our hospital will have taken strides in minimization of patient falls.
The Checks and Balance Step
The system of checks and balances is an important part of any organization. In the case of our hospital, its essential to ensure that all its activities run effectively, hence, management of every department should monitor their performance; overall performance should be evaluated by the top management (Vincent, 2010).