Fall Prevention In Hospitalized Patients Developing An Implementation Plan Research Papers Example

Fall Prevention in Hospitalized Patients; Developing an Implementation Plan The rate at which inpatient falls occur in hospitals is quite alarming, and this is usually related to quality and safety problems. Patient falls have drastic consequences to the patients, and as such it would be a great relief to patients if the falls are eliminated or brought to a bare minimum. From statistics, it is argued that out of the 2 to 20% of inpatients that are in acute care hospitalization about 2% experience patient falls. More statistics reveal that about 30% of the falls result in death, especially for patients that are aged over 55 years. The statistics are documented by the Institute for Health Improvement and shows that of these falls 10% are of adults. Environmental circumstances in hospitals are highly responsible for Patient falls. At most times, the falls occur in the hospital's patient rooms and bathrooms. The environmental conditions of the hospital and medical issues are on top of the list of some of the issues that increase the prevalence of falls in hospitals. Unfortunately, these falls affect the patient’s emotional health, quality of life and even the long term functions. In addition, it also affects the cost of medication for the patient. Patients that have been involved in accidents will always incur additional treatment cost and longer stays in the hospital. It is also estimated that such patients will have to incur an additional 60% cost on their medical cost. Thus, it is important to develop a strategy hat can help deal patient falls.Seeking approval for the proposal Any patient safety program in a hospital cannot miss having a patient fall prevention strategy. It is because patient falls have significant effects on the patients experience in the hospital that necessitates such a plan. The way towards achieving patient safety is by enhancing communication between the patients, the caregivers, and the patient’s family members. It is important that the staff participate actively in the reporting fall events and subsequent follow-up process since they are an integral part of the fall prevention program and culture. According to the Joint Commission, fall prevention is an issue that requires an organizational patient safety culture and assess communication strategies they use, and they also modify the environment so as to prevent falls. If all the staff, nurses, doctors and caregivers at the hospitals can be tuned to the safety measure that will prevent patient falls, then they will make the hospital safer and will be prepared to reduce the chances of patients falls. In one hospital in Texas patients, fall rates reduced significantly due the culture chance in the hospital. Another example is in Canada were the rate of falls reduced by 2% per 1000 bed days and this was achieved due to management change process. Another case in Australia reported that when the staffs were involved in a falls prevention program they were able to build teamwork and soon cases of patient falls reduced significantly. Team work has the effect of generating positive synergy that is a very effective element for a successful implementation of fall prevention strategies. It is from this perspective that one can argue that prevention of patients falls is both the responsibility of all team players in the hospitals. It is important for staff members and the patient’s families to be involved in providing information and seeking for the way to reduce patient falls. I urge the nurses, the doctors and all the those that take part in providing care for the patients to support this program. Using this strategy makes it possible for the hospital to reduce chances of patient falls in the hospitals.Challenge in the current program In the United States alone between 700,000 to 1,000,000 patients, experience falls every year. Ideally, a fall is defined as an unplanned descent to the floor that might be with or without an injury. There are various health consequences that occur as a result of the falls. Patient falls may cause injuries, fractures, internal bleeding, laceration and even increase the healthcare utilization. Many health practitioners and policy maker argues that these falls can be prevented. However, the are problems that inhibit the effective prevention of hospital falls. The major problem with the current programs is that there is always divided attention from the staff in acute care hospitals. Though the patients are supposed to be given care kept safe, and helped to recovery from mental and physical functions, this rarely happens. Caregivers always fail to provide a balance between priorities. Most of the current programs do not seek to deal with the management of patient fall factors and trying to optimize the hospital physical environment and design so as to reduce patient falls. An interdisciplinary approach to caregiving is necessary for ensuring that the patient falls are reduced. Most of the programs today fail to utilize this approach. It is important to know that while some parts of the programs need to be highly routinized other parts might need to be tailored to the patient’s specific needs and risk factors. Even if a caregiver is so talented, they cannot be able to work alone and prevent all falls. It is only the active involvement of all individuals that includes all teams and disciplines that are into patient’s caregiving that will ensure that a program works. It is through a quality operation, and organizational culture change that will make it possible to reduce patients falls. Today, most of the programs aimed at reducing patient falls do not support teamwork, and this is what makes these programs ineffective. As well, most of the patients, prevention programs today do not have balanced considerations when it comes to the patient’s safety. They lack consideration to issues such minimizing restraints, maintaining patient’s mobility and providing best possible care for the patients. It then requires a systemic focus in order to make the needed changes that can help patients falls in hospitals.Root Cause analysis RCA Among the most effective strategies that can be used to help in reducing the prevalence of patient’s falls in hospital is the RCA. This is a strategy that seeks to find the cause of the falls and propose some measures that can make sure the problem is dealt with. The process involves an Inpatient falls committed and the ward managers or matrons. In this case, the ward managers are supplied with the RCA template forms that they are supposed to fill and return to the committee within a given time frame. The Inpatient Falls Committee is supposed to receive the forms within 15 days of issue, then update the database and provide a specific return date noted. Once the IPFC has received the forms and updated the database, they take time to investigate and deliberate on the most effective measure to deal with the issue. The consultations revolve around providing a complete solution to the problem and an action plan that needs to be carried out. A detailed solution to the problem should be reported back to the specific situations where the incident occurred within a period of 30days. Once the solution has been agreed on, and all stakeholders notified, the action plans is rolled out and implemented in the station.Literature review There is quite little data that show the extent to which falls prevention mechanism can go. This happens mostly because most of the reviews usually depend on largely randomized trails that are quite hard to perform especially in small rural hospitals. Despite these limitations in evidence, there is still some data that we were able to review from various literature. Most of the common intervention programs found in most of the literature relied on bed alarms, rounding, sitters and moving the patients closer to the nurses. The programs that showed more success are those that used a fusion of a variety of strategies. Such strategies targeted on the individual patient fall risk factors rather than just the general aspects. The major challenge to the effectiveness of these programs is that they are not highly prioritized. Much of the literature showed that the effectiveness of any fall prevention program is in it being interdisciplinary. In this case, the program involves the nursing, physical therapy, pharmacy and the medical officers. It also emerged that the most effective intervention programs to reduce inpatient fall are those that involve environmental changes. Some of the categories of intervention measures are mentioned. Psychological changes; in this case it requires the use of tailor made regimens and medication review. Environmental changes; such changes include alarms and restraints(Kannus, Sievänen, Palvanen, Järvinen&Parkkari, 2005). Finally, education and training for the nurses is one of the strategies mentioned. These require that the staff from the nurses to the managers and even the other caregivers be trained on strategies that can enhance the safety of the patients.
Implementation Logistics The process of change is never an easy thing to do. It requires careful structuring, planning so that the process can be managed and affected properly. The logistical aspects of the program implementation are crucial elements that are worth considering. The initiative to improve and sustain falls intervention strategies will involve the following steps.
1. Is the hospital ready for the change? Patient falls a considerable problem in hospitals and efforts to improve or change this require a systemic approach. Such approach requires the change in the and modification in the communication, workflow, and decision-making. It is quite difficult to achieve such change, and that is the reason one needs to assess the readiness of the organization.
2. Does the organization understand the need for change Knowing that they are problems in how things are done is just the first step to achieving change. The most important part of the change process is the motivation the workers have towards the change. It is important that before rolling out the change process in the hospital a survey be done on the readiness of the workforce to embrace the change (Joint Commission Resources 2005).3. Is there any urgency to change Apart from understanding the need for change and having the enthusiasm to achieve the change, it is important to find out if the members of the organization see a compelling need for the change. This is important because the drivers of change are the caregivers, and if they do not see the need for the change then it will totally be impossible to achieve it ('Computerized Physician Order Entry Systems and Medication Errors', 2005).4. Does senior administration support the program? It is also important to assess the support that the senior management of the hospital has the programs. Since this is a program, which will require a total overhaul of the system, it is important that one finds out the opinion of the senior management on the program.Implementation of the program The most daunting part is the implementation of the recommendation. The challenges are encompassed in the diverse dynamics involved for an efficient and successful implementation of the program. It is important that all elements of the program be well thought through prior to implementation. Ideally, there are many resources that will be required for the successful implementation of the program. The first requirement will be to educate the staff on the use of the program. Since this program will be implemented using the face of strategy, the first step will be to educate the workforce. The hospital will then require setting aside some fund that will fund the education process. Apart from the education process technology will be required. Since this program will require the use of a database, servers, computers and other electronic equipment will need to be purchased. Not to mention there will be the need to have assessment tools such as surveys. Such tools are important because they are key to providing information on the readiness and preparedness of the hospital for planning. Ideally this strategy is just the best that the hospital needs to deal with patient falls.

References

Computerized Physician Order Entry Systems and Medication Errors.(2005). JAMA, 294(2), 178.
Joint Commission Resources, Inc. (2008). Reducing the risk of patient harm resulting from falls: Toolkit for implementing national patient safety goal 9. Oakbrook, Ill: Joint Commission Resources.
Kannus, P., Sievänen, H., Palvanen, M., Järvinen, T., &Parkkari, J. (2005).Prevention of falls and consequent injuries in elderly people.The Lancet, 366(9500), 1885-1893.