Patient Fall Management to Promote the Safety and Culture of the Hospital

Answer

Patient Fall Management to Promote the Safety and Culture of the Hospital

Falls among geriatrics is a significant public health concern. According to Gale, Cooper, and Aihie Sayer (2016), falls are common among the aged who are 65 years and older and are the leading causes of injuries. Some of the core challenges associated with patient falls are injuries, increased length of stay at the hospital, inability to complete the activities of daily living, disabilities, and mortality. Also, falls have financial implications on both the healthcare facilities and the patients. The issue of gender is also reflected in patient falls. Notably, women are more likely to fall compared to men. This is attributed to the high loss of bone mineral density among women compared to men. This paper entails the development of a PICOT that relates to patient fall management to promote the safety and culture of the hospital.

Background

Injuries from falls form the majority in admissions at the emergency department (ED) for aged patients. The centres for disease control and prevention (CDC) estimates that approximately 2.5 million of nonfatal falls were managed at the ED while 734,000 patients were admitted in 2013 (Ozturk et al., 2017). Among the risk factors associated with patient falls, especially among geriatrics, include developing the post-fall syndrome, which is a psychological issue. To manage these falls, both pharmacological and non-pharmacological approaches are vital. Pharmacological approaches involve the use of supplements and medicines, while the non-pharmacological management strategies involve lifestyle modification such as exercises and healthy meals. In developing fall management plan, it is imperative to conduct a comprehensive patient assessment, including physical, social, environmental, and psychological (Phelan, Mahoney, Voit, & Stevens, 2015). Other elements that should be considered during fall management are a collaboration between patients and their caregivers, exploring the role of balance exercises and strength, and prioritisation of the risk factors. However, there are concerns regarding the effective evidence-based practices to manage falls and their relationship with patient outcome.

The Problem

Inpatient falls remain a significant challenge to patients, especially those with chronic illnesses. Various EBPs have been established to address these cases and promote patient recovery. As espoused by Cuttler, Barr-Walker, and Cuttler (2017), the implementation of these strategies depends on the staffs’ knowledge and commitment. Also, extra steps are required, especially for approaches that utilise information and communication technology. Bed exit alarms, for instance, play an important role when the patient moves about in the bed. The nurse is alerted when there are any of the three sensitivities, including most, intermediate, and least. The challenge with this approach is the resources and the need for advanced ICT knowledge among the nurses. Another approach entails the use of a bundled approach. According to Richardson et al. (2015), the bundled care approach focuses on a comprehensive patient evaluation, which determines the application of various approaches such as the call bell and suitable footwear. However, the two approaches have not been compared for their effectiveness and complexities, which is the foundation of this project.

Potential Change Plan

To address the disparity between the bundled care and the bed-exit plans. The 2010 VersaCare beds have inbuilt bed exit alarms that measure three sensitivities. The most sensitive entails patients moving about in the bed, the intermediate sensitive involving a situation where the patients are seated on the bed’s edge, and the lest sensitive focusing on the time the patient is about to get out of the bed (Cuttler et al., 2017). The bundled care approach involves suitable practice measures that are developed for various patients, including the general ones, the aged, and the vulnerable. The bundled care strategy consists of establishing the individual’s history of falls, urinalysis during the admission, new prescriptions at night, and a call bell that is reachable to the patient. For the aged, the bundled care approach further involves a cognitive assessment, evaluation of the risk factors, and a review of the medication. In this regard, it is essential to examine the different impacts of the two EBPs in reducing the number of falls and injuries and promoting the quality of stay at the hospital.

The PICOT question for the project is; for aged patients above 65 years (P), how do bed exit alarms (I) compare with the bundled care approach (C) in reducing the number of falls, promoting patient recovery, and enhancing the individual’s quality of stay at the facility (O) within 12 weeks (T)?

Importance of the Evidence-Based Project

This project's importance is to compare the two core approaches in reducing patient falls and promoting the patient’s recovery. The comparison entails the use of bed exit alarms and bundled fall prevention approaches. According to Mazur, Wilczynski, and Szewieczek (2016), an effective fall management approach is vital in reducing the individual’s risk of fall, morbidities, and mortality. This project will involve the evaluation of the effective management plan that will change the organisational culture and promote patient safety. Also, this research will provide insights into the most effective EBP, the implementation challenges, and the merits of each. This information will be essential in establishing an effective EBP that meets the diverse patient’s needs. 

Conclusion

Fall management among geriatrics is a vital element in promoting patient recovery, reducing the length of stay at the hospital, and averting the mortality and morbidity rates. Various EBPs have been developed to manage these falls, such as bundled care and bed-exit plan. This project entails an evaluation of the two EBPs, in regards to promoting the individual’s recovery, reducing the number of falls, and enhancing the quality of stay at the facility. The information obtained will be essential in enhancing the hospital’s safety and culture.