Preventing Falls in a Hospital Setting Essay

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A Hospital Based Practice Paradigm to Improve Patient Outcomes

Advanced practice nurses are well situated to assume leadership roles in improving patient outcomes through the development and implementation of evidence-based interventions that affect large patient populations (Curley & Vitale, 2011). All types of evidence-based interventions, however, are not necessarily appropriate or optimally effective in all circumstances, making the need for ongoing research an essential part of the process (Mateo & Foreman, 2013). Nevertheless, some interventions already have proven efficacy in a wide range of hospital settings, and it just makes good sense to draw on these in formulating new practice paradigms. The purpose of this paper is to describe a fall-prevention hospital based practice paradigm that can improve patient outcomes in virtually all inpatient settings.

Review and Discussion

With a growing percentage of the American population entering their elder years today, it is reasonable to suggest that a greater share of already scarce health care resources will need to be used for age-related illnesses and infirmities in the future. In many cases, inpatient care and aggressive treatment will be needed to help these senior citizens regain their health. One of the major risks associated with inpatient stays is falls, and this problem is especially pronounced in acute care settings where infirm elderly patients may be heavily medicated and disoriented with respect to time, person and place (Hill & Vu, 2009).

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The scope of the problem, though, extends to patients of all ages and medical conditions. In fact, the Agency for Healthcare Research and Quality (2018) reports that, “Between 700,000 and 1 million patients fall in hospitals each year” (Butcher, 2017). Although most of the patients who fall in hospitals are not injured seriously in the process, the potential for harm is still significant and patients can even die from falls. An extreme case in point occurred at a Department of Veterans Affairs Medical Center in Oklahoma City. The policy in place at the time required patients to fall three times before receiving a fall warning. In one case, an elderly veteran patient who had already fallen once fell yet again, breaking open his colostomy bag which infected his surgical sites and resulted in his death within 2 days (pers. knowl.). Furthermore, beyond the human costs that are involved, the economic costs that are associated with injury-causing falls in hospitals are significant, with the Joint Commission estimating….....

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References

Butcher, L. (2017, June 1). The no-fall zone. Hospital & Health Networks. Retrieved from https://www.hhnmag.com/articles/6404-Hospitals-work-to-prevent-patient-falls.

Curley, A. L., & Vitale, P. A. (2011). Population-based nursing: Concepts and competencies for advanced practice. New York: Springer Publishing Company.

Farene, J. (2014, August). Joint Commission targets solutions for fall prevention. Health Facilities Management, 27(8), 5.

Hill, K. D. & Vu, M. (2009, August). Falls in the acute hospital setting - Impact on resource utilization. Australian Health Review, 31(3), 471-475.

Mateo, M. A., & Foreman, M. D. (2013). Research for advanced practice nurses: From evidence to practice. (2nd edition). New York: Springer Publishing Company.

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