Interventions to Decrease Fall Injury
Overview of the Problem
Fall has been a significant cause of unintentional injury and mostly affects the vulnerable people in the society such as the elderly. According to the Joint Commission (2015) report, patient among the patients who experience falls in hospital, 30-50 percent result to injury. Among these injuries, 30 to 40 percent leads to serious health issues such as hip fracture and head injuries. The Joint Commission report also indicates that fall chances increases as hospital stay are prolonged. Additionally, the cost for such falls has been seen to be at an average of 14000 dollars CITATION The151 l 1033 (The Joint Commission, 2015). In another case, fall has been recognized as a significant healthcare concern as it increases the health cost burden. For instance, the Canadian healthcare system spends approximately 8.7 billion dollars in the management of fall-related health issues annually CITATION Reg17 l 1033 (Registered Nurses’ Association of Ontario, 2017). According to Slade et al. (2017), the United States and the United Kingdom, have spent $31 billion, 2 billion euros in the treatment of fall-related health cases annually respectively. This, therefore, indicates that fall injuries are among the health and economic burden in the world today.
According to the world health organization, fall is a significant issue since it has been linked to 424000 deaths globally. This further suggests that fall is entirely responsible for over 17 million cases of disability in the world CITATION SCS17 l 1033 (Slade, Carey, Hill, ; Morris, 2017). According to Slade and Colleagues (2017), the elderly population has been isolated as the most affected part of society. This, therefore, indicates that fall chances increase significantly for an individual with 65 years and above in the community. Additionally, the incidence of fall for this population is hospital is between 3.4 to 3.9 per person-year especially in the geriatric words CITATION SCS17 l 1033 (Slade, Carey, Hill, ; Morris, 2017).
Significant of the Problem
According to a report by the Joint Commission (2015), fall in a substantial health issue since it results to injuries as well as reducing patient safety in the healthcare setting. Although, some paradigms have put more focus on the elderly and the frails as most affected by fall injuries, the Joint Commission (2015) reports acknowledge that anyone is vulnerable to fall risks in healthcare facilities. This, therefore, makes it a significant issue when it comes to patient safety and overall safety in the healthcare facility. In essence, any person is at risk of fall due to medical related condition, surgery and other medical procedure CITATION The151 l 1033 (The Joint Commission, 2015).
Fall has been isolated as the causative to wellbeing changes due to physical injuries in the form of fractures, bruising and abrasions CITATION Reg17 l 1033 (Registered Nurses’ Association of Ontario, 2017). These injuries can be significant in such a way that they increase the chances of hospitalization or even death. The report, therefore, recommends that nurses and other healthcare practitioners have a central role in reducing incidents of fall in the healthcare facility. In the healthcare, facility fall has been seen to affect the quality of health for older adults undergoing geriatric and rehabilitation procedures CITATION SCS17 l 1033 (Slade, Carey, Hill, & Morris, 2017). Additionally, the works of Slade et al. (2017) has indicated that in the healthcare facility fall may increase with an increased stay and poor health outcomes for patients.
Article review: BIBLIOGRAPHY l 1033 Szekely, L. S., Waters, C., Brandt, K., & Blum, C. (2018). Individualized Fall Prevention Program in an Acute Care Setting: An evidence-based practice improvement. Journal of nursing care quality, 1-6.
Purpose of the Study
The purpose of this study was to establish the effectiveness of inter-professional fall prevention model among patients. In the same aspect, the study purposed to evaluate the efficacy of the hospital-based fall program while using another evidence-based approach to fall prevention.
Variables from the Study
The purpose of the study has indicated that the analysis is oriented to descriptive and qualitative study with several significant interests. Therefore, the variables of interest include evidence-based fall prevention program and integrated or inter-professional fall prevention approach.
Participants in the Study
The study did not majorly focus on the participants per se, but instead, put emphasis on the methods that would be salient in preventing fall. However, in evaluating the effectiveness of different approaches to prevent fall, the overall patients in elderly care were monitored via a video. In this case, therefore, there were no specific criteria to select the participants in the study. Besides, the eligibility to be enrolled was centered on the fact that patients are in the healthcare setting where the study was carried out. Additionally, another eligibility criterion was centered on fall risk or the population with a higher chance of registering fall.
The approach adopted by this study oriented majorly on the attributes of descriptive study and information was gathered through by meeting with the participants of the study in a healthcare setting. The participants, therefore, were subjected to an evaluation using the PICO (patient, intervention, comparison and outcome) model which was relevant in giving the information regarding the workability of the available preventions methods and the new interventions for reducing fall.
The methodology used in the collection of data regarding fall preventions relied on several models. Firstly the evidence-based practice improvement (EBPI) model was used to give a procedural approach regarding the collection of information. For instance, this tool was essential in promoting the essence of small tests of change (STC) that was essential in the evaluation of the subjects under study. Additionally, PICO was adopted as an essential tool to evaluate the aspect raised regarding the study. PICO, in this case, is therefore imperative in assessing different parameters regarding the fall preventions approaches adopted in the healthcare setting.
The collection of information also relied on the evidence outlined by the clinical practice guideline (CPG) tools. In this respect, the CPG selected to give high-quality information was the Institute for Clinical System Improvement Health Protocol on Prevention of Fall in Acute Care Institutions. The rationale of choosing this tool to gather information regarding fall prevention is centered on the idea that the CPG focused primarily on an adult acute care setting.
Data collection was also done through the evaluation of the CPG 7 core practices that are essential in fall preventions. In that case, therefore, it was essential to monitor the workability of current policy as per the seven critical practices to the fall preventions. In essence the, the evaluation or the data would rely on how the gap created as a result of this evaluation. The analysis of these gaps gave paved the way for the use of the literature review as a data collection tool which would provide further information regarding the evidence-based interventions for the deficiencies identified. Therefore the information collected through literature review was relevant in giving insight and recommendations regarding the chosen or the current fall prevention program.
The study relied on observation measurement tool to assess the effectiveness of the fall prevention method employed. For instance, video monitoring was used for evaluating the progress of the participants subjected to the fall prevention program. In this sense, patient care assistants watched the patient’s movements while evaluating the effectiveness of the methods appraised to prevent fall. This tool was used because it was cost effective which would be used to watch up to 12 patients at a time.
In this case, data analysis entailed distinguishing or establishing the gap between the old fall prevention approaches and the new methods. The analysis was done in the form of a graph which was essential in showing the impact or the results from the observation or video-monitoring of the patients and their responses to the implemented methods of fall prevention. The graph also was essential in establishing the distinction between the number of cases of falls per specified time between the old and the new methods.
The study indicates that the fall prevention program adopted led to a 54 percent reduction in falls cases. This reduction was as a result of the evaluation of fall per a 1000 patient days on the inpatient medical-surgical units. In essence, the falls recorded in 2014 was 2.51 per 1000 patient days which was reduced to 1.15 between last half of 2016 and the first half of the subsequent year. This, therefore, indicates that the approach adopted was effective in reducing falls in the healthcare setting. The results also suggest that the intervention led to a 72 percent reduction in the usage of sitter which is equal to 84 000 dollar savings on an annual basis.
Fall prevention requires input in terms of research to assess the most effective approach that can be used. The study relied on observations from the adopted methods regarding fall prevention. The interventions have proven to be effective in fall preventions especially in a healthcare setting.
Individual Analyzing Published Research Summary Table
Articles Study Purpose
Inclusion ; Exclusion Criteria Procedures What was done? Data Collection Measurement Tools Sociodemographic Findings) (5)
All Other Findings (5)
Article: BIBLIOGRAPHY l 1033 Szekely, L. S., Waters, C., Brandt, K., ; Blum, C. (2018). Individualized Fall Prevention Program in an Acute Care Setting: An evidence-based practice improvement. Journal of nursing care quality, 1-6.
Descriptive/ qualitative study Evaluate the effectiveness of hospital-based fall program
The eligibility of the participants was centered on the fall risk criteria. Meeting with the participants in the healthcare setting. participants were among the patients undergoing care processes Tools used in data collection included the EBPI, STC, PICO, and CPG which gave the procedures on relevant approach to the study aim The measurement was majorly done through the use of observation approach. This was done through video monitoring by the PCAs 54 percent reduction was recorded on the overall effect of the approach used.
BIBLIOGRAPHY l 1033 Registered Nurses’ Association of Ontario. (2017). Preventing falls and reducing injury falls. TORONTO: RNAO.
Slade, S. C., Carey, D. L., Hill, A. M., & Morris, M. E. (2017). Effects of falls prevention interventions on falls outcomes for hospitalized adults: protocol for a systematic review with meta-analysis. BMJ Open, 1-6.
Szekely, L. S., Waters, C., Brandt, K., & Blum, C. (2018). Individualized Fall Prevention Program in an Acute Care Setting: An evidence-based practice improvement. Journal of nursing care quality, 1-6.
The Joint Commission. (2015). Preventing falls and fall-related injuries in health care facilities. The Joint Commission.