How to prevent patient falls

Prevention of Patient Falls

Patient falls are the leading hospitalization adverse effects report in the healthcare system. Over the years, hospital administrators, nurses, and nursing assistants have made tremendous efforts to address patient falls (LeLaurin & Shorr, 2019). When a patient falls within the hospital environment, the event can lead to a cascade of events that are detrimental to the hospital and the patient. The patient may sustain injuries that can increase the length of hospital stay. These injuries may even exacerbate the patient’s condition, thus increasing the cost of providing medical care. For instance, patient falls may cause internal bleeding in an anemic patient. In this case, the patient may lose a high amount of blood, prompting the doctor to prescribe blood transfusion. Moreover, the internal injuries sustained may need surgical procedures to correct. It means, therefore, that the length of hospital stay is increased in addition to the rise of patient care costs. To avoid the downstream effects associated with patient falls, a fall prevention strategy comprising environmental restructuring, fall risk assessment, and improved nurse-patient ratio is necessary.  

Environmental conditions are critical in the prevention of patient falls. The structure of the patient’s room determines the probability of the patient falling. If the room has a slippery floor, the patient may slide and fall while walking around the room. Additionally, the illumination of the room will influence the visibility, especially for patients with vision problems. The accessibility of the patient’s room concerning the nursing station has also been found to influence the chances of falling or the response time in case of an incident. As part of the quality improvement, it is recommended that the floor in all patient rooms be made of a material that enhances friction even when the place is wet. Additionally, the room should have both artificial and natural lighting to enhance vision. According to Brewer et al. (2018), the nursing station should be designed close to the patients’ room to allow for visual and aural monitoring of patients. 

Fall risk assessment provides the best method of proactive fall management. The patient’s condition, age, physical ability, and medications affect their likelihood of falling. Patients with a mental condition, vestibular or gait problems have a higher risk of falling. The fall rate among elderly patients is usually higher in most facilities. Moreover, a patient with visual, hearing or motor problems has a higher probability of falling than the one without any physical incapacity. Furthermore, patients taking sedatives stand a higher risk of falling due to the effect of the drug on cognitive and motor functions. It is, therefore, advised to conduct a thorough risk assessment that considers all these factors. Standard tools that comprise relevant parameters are important, although the National Institute for Health and Care Excellence (NICE) recommends that all patients over the age of 65 years should be considered to have a high-risk fall (LeLaurin & Shorr, 2019).

The number of patients that each nurse cares for determines the amount of attention that the former receives.  The shortage of nurses in the hospital has been attributed to missed or rationed care (Muabbar & Alsharqi, 2021). This is means that nurses may fail to offer due concentration to the patients, denying them a chance to conduct fall assessment among other required considerations. When the nurse-patient ratio is very low, that is, one nurse cares for more than the required number of patients, it is impossible to attend to falls in the shortest time possible, thereby causing injury to the patients. To address this challenge, it is recommended that all hospitals conduct the nurse adequacy assessment to ensure that all patients receive the highest quality of care. After this assessment, the hospital can identify gaps that exist in patient care. if any inadequacy is observed, the hospital should employ more nurses to avoid any unforeseen missed or rationed care. 

Additionally, the hospital should redeploy nurses in the various departments to ensure that the areas where patients are prone to falls are well-staffed. For instance, geriatric wards should have nurses who work closely with the patients to identify and address the high risk of falls prevalent in this area. The nurses employed in the wards should be taken through continuous professional development to ensure that they are conversant with the latest knowledge on fall prevention. The employer should engage nurses in seeking feedback and contribution on the applicable strategies that will reduce patient falls. Nurses should also be aware of the immediate actions to take when the patient experiences a fall. They should know full body assessment to identify any broken bones or damaged tissues. In sum, staffing the patient rooms with adequate nurses is not sufficient. Equipping these nurses with relevant knowledge goes a long way in preventing falls and responding to them expeditiously in case they occur. 

In conclusion, environmental controls, risk fall assessment, and adequate staffing of nursing units are potential interventions in addressing patient falls. Environmental restructuring entails appropriate illumination, installment of non-slippery floors, and redesigning of nursing areas to ensure a carer’s close proximity to patients. The correct nursing ration should be maintained in areas where the risk of falling is high. Adequate staffing of nursing units ensure that patients receive sufficient attention in an endeavor to avoid missed care. Through the implementation of these quality improvement strategies, it is possible to reduce fall rates and avoid the negative impacts associated with these unfortunate incidents. 

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