Prevention of Inpatient Falls
Patient falls remain the most common adverse event in acute care facilities, with 2%-15% of hospitalized patients reported to fall at least once. Falls can lead to pain, loss of function, fear of further falls and even death (Tanaka, Sakuma, Ohtani, Toshiro, Matsumura, & Morimoto, 2012). An increased focus is being placed on inpatient falls because of morbidity, mortality, increased cost of care, and lack of reimbursement (Cumbler, Simpson, Rosenthal, & Likosky, 2013). The National Database of Nursing Quality Indicators (NDNQI) defines a fall as “an unplanned descent to the floor with or without injury to the patient” (Miake-Lye, Hempel, Ganz, & Shekelle, 2013). Approximately 30% of patients experiencing falls …show more content…
Financially, falls lead to increased medical costs and longer length of stays. A single fall can increase hospital costs by up to $13,316. In 2010, total direct costs of injurious falls in the United States amounted to $30 billion (Goldsack, Cunningham, & Mascioli, 2014).The Centers for Medicare and Medicaid Services have listed falls as a “never” event and therefore will not reimburse hospitals for expenses associated with the care for an inpatient fall (Cumbler et al., 2013). The reported rate of falls in acute care hospitals ranges from 1.3 to 8.9 per 1000 bed-days. Higher rates are reported in neurology, geriatrics, and rehabilitation floors. Because falls are most likely underreported, most estimates may be overly conservative (Miake-Lye et al., 2013). The purpose of this root cause analysis is to discover and implement interventions to prevent falls in order to provide safe and high quality care to …show more content…
This requires that fall prevention interventions are immediate and make an impact within a short amount of time. Implementing a patient-centered hourly rounding program is associated with a significant reduction in fall rates (Goldsack, Bergey, Mascioli, & Cunningham, 2015). Structured hourly rounding is an effective method to also improve clinical outcomes for patients. Elements that are assessed during hourly nurse rounding include pain level, need for toileting, and assessment of the environment including proximity of personal items, safety hazards, and positioning of the patient (Brosey & March, 2015). Purposeful hourly rounding requires either the nurse or assistive personnel to assess the patient’s needs and safety each hour. The purpose of hourly rounding is to reduce the incidence of falls by ensuring that patients are not trying to get out of bed without assistance to go to the toilet, reach a personal item, or change position (Lowe & Hodgson, 2012). In addition, performing hourly nurse rounding proves to be cost-effective because it promotes cost avoidance by reducing injuries related to falls which may extend hospital length of stays (Brosey & March, 2015). Hourly rounding is only one approach to help reduce falls. Evidence indicates that inpatient multicomponent programs are most effective at reducing falls (Miake-Lye et al., 2013). Other strategies include a required falls risk
Patient falls remain the most common adverse event in acute care facilities, with 2%-15% of hospitalized patients reported to fall at least once. Falls can lead to pain, loss of function, fear of further falls and even death (Tanaka, Sakuma, Ohtani, Toshiro, Matsumura, & Morimoto, 2012). An increased focus is being placed on inpatient falls because of morbidity, mortality, increased cost of care, and lack of reimbursement (Cumbler, Simpson, Rosenthal, & Likosky, 2013). The National Database of Nursing Quality Indicators (NDNQI) defines a fall as “an unplanned descent to the floor with or without injury to the patient” (Miake-Lye, Hempel, Ganz, & Shekelle, 2013). Approximately 30% of patients experiencing falls …show more content…
Financially, falls lead to increased medical costs and longer length of stays. A single fall can increase hospital costs by up to $13,316. In 2010, total direct costs of injurious falls in the United States amounted to $30 billion (Goldsack, Cunningham, & Mascioli, 2014).The Centers for Medicare and Medicaid Services have listed falls as a “never” event and therefore will not reimburse hospitals for expenses associated with the care for an inpatient fall (Cumbler et al., 2013). The reported rate of falls in acute care hospitals ranges from 1.3 to 8.9 per 1000 bed-days. Higher rates are reported in neurology, geriatrics, and rehabilitation floors. Because falls are most likely underreported, most estimates may be overly conservative (Miake-Lye et al., 2013). The purpose of this root cause analysis is to discover and implement interventions to prevent falls in order to provide safe and high quality care to …show more content…
This requires that fall prevention interventions are immediate and make an impact within a short amount of time. Implementing a patient-centered hourly rounding program is associated with a significant reduction in fall rates (Goldsack, Bergey, Mascioli, & Cunningham, 2015). Structured hourly rounding is an effective method to also improve clinical outcomes for patients. Elements that are assessed during hourly nurse rounding include pain level, need for toileting, and assessment of the environment including proximity of personal items, safety hazards, and positioning of the patient (Brosey & March, 2015). Purposeful hourly rounding requires either the nurse or assistive personnel to assess the patient’s needs and safety each hour. The purpose of hourly rounding is to reduce the incidence of falls by ensuring that patients are not trying to get out of bed without assistance to go to the toilet, reach a personal item, or change position (Lowe & Hodgson, 2012). In addition, performing hourly nurse rounding proves to be cost-effective because it promotes cost avoidance by reducing injuries related to falls which may extend hospital length of stays (Brosey & March, 2015). Hourly rounding is only one approach to help reduce falls. Evidence indicates that inpatient multicomponent programs are most effective at reducing falls (Miake-Lye et al., 2013). Other strategies include a required falls risk