Fall prevention programs are now considered to be one major area of focus for the nursing care aspect, especially for the long term care in the resident group of patients. Taking a look at this program, some level of successes has been achieved at various levels, especially in the aspect of enhancing the patient experience. Some of the programs are now referred to a national patient safety priority which is meant to help achieve quality improvement strategy (MacLaurin & McConnell, 2011). Avoiding falls, or fall prevention strategies are major specific safety concerns in nursing practice that help the patient avoid falling, or associated injuries.
Falls is a major public health challenge worldwide. Hospitalization has been noted to contribute to increase the chances/risks of falls worldwide (Dykes et al., 2011). The main reasons noted for this change relates to the associated unfamiliar environment, the illness and treatment modalities. The results or consequences of the fall are usually devastating to patients, family members and healthcare personnel in charge of the patient.
Nurses are the major health professional that spends the most time with patients. This creates an important attachment/integral role in keeping the patient safe hence it is important for the nurse to understand effective measure/modalities that help or can be instituted to achieve fall reduction goals. It is an important protocol/modality to ensure that patients and the families are engaged in the safety discussion for better understanding and reduction of falls (Nitz et al., 2014).
Another important measure is a continuous monitoring of patient at risk especially while toileting. Shortening of pajama length to prevent tripping is also very important (Stanford hospital & clinic, 2013). Fall prevention committees are created to ensure close monitoring, especially of those at risk and gathering of information from nurses whose patient fell. This is to understand those factors causing a fall at such hospital (Stanford hospital & clinic, 2013).
The use of a fall prevention tool kit in hospital settings has been found to significantly reduce the patient fall rate when compared to the usual care programs in similar settings (Dykes et al., 2011). It is also important to note that educating those nurses at the control units still plays a great role in fall prevention.
Various approaches have been tried to help reduce the associated risk simply because of the health hazards and problems that falls are liable to cause. Such measures that seem to be currently used by nurses or built for those that are under nursing care are the; modifications placed in home and health care environment to reduce the risk (Kozier, 2008). This modification can be considered for patients, especially those on the wheel chair. They need modifications that will support and secured them because of their status and simply because they are prone to falls. In such situations side rails and safety bars for toilets, wheel locks on beds & wheelchairs are all beneficial in fall prevention measures. It is important to understand that the patient's health condition and management status play a major role in determining the fall prevention strategies or measures that can be used for such patient (Kozier, 2008).
Measures can also be classified as Stairs, Handrails, floor coverings, and orientations (Kozier, 2008). These listed measures are newer categories of measures that are focused majorly on prevention of falls by older adults. In the case of stairs, obstruction caused by protruding objects needs to be removed, proper lighting of each tread needs to be considered while the edge of the tread needs to be made with contrasting colors.
It is important to understand that materials that can cause obstructions, such as excess furniture and equipment needs to be removed, while patients, that are not very strong needs to be monitored in terms of what such patients wear (Kozier, 2008). They need to wear rubber-soled shoes or slipper that will make the walking easier (Nitz et al., 2014). Nurses also need to consider the need to remove clutter from halls, stairs and traffic areas around any patients at risk. Patients that are in need of aids or uses aids already needs to be ensured that such uses walking sticks, crutches or walkers that are made with rubber tips (Kozier, 2008).
The major rationale for the stairs aspect of measures is that of ensuring that there is a uniform size stairs which will lessen the need for continuous vision adjustment for older adults (Kozier, 2008). When the colors are made in a way to also consider their visions that can't adjust also easily, it tends to reduce the falls that could occur in such areas. Handrails need to be installed in such a way that makes it slip resistant, and firm. Once the handrail is installed in the bathrooms, it allows the patient to have a good support while rising to standing position. It also needs to be constructed with 5cm distance to the wall so that the patient or person can grasp the handrail easily (Kozier, 2008).
For older adult, the floor covering is an essential measure, which ensures that there is a reduction in the chances of slipping. Patients are ensuring they wear properly fitting shoes or slippers that will not skid on such surfaces (Nitz et al., 2014). Carpets, mats and tiles around where this group of patients is must be secured so as to prevent any form of slipping lead to fall (Nitz et al., 2014). Orientation fall prevention measures must be strategies in such a way that will ensure that patients are not disoriented. This can be achieved by ensuring that such patient at risk are frequently observed, especially by the nursing staff on duty (Barbara, 2008). Patients that are confused needs to be properly supervised so for them not to wander out of the bed. Considering the psychological aspect of restraint that is placed around patients to reduce the fall risk, such patients have the natural tendency of trying to remove such restraints. This then placed them at an increased risk if such is eventually removed. Another major problem as indicated by studies is that which states that the patient that is immobilized by restraints has the predisposition of developing pressure ulcer formation, fecal incontinence or urinary retention.
MacLaurin and McConnell from the safety research project found that there are certain important processes and outcomes that need to be considered when falls prevention and injury reduction programs are being mentioned (MacLaurin & McConnell, 2011). We need to ensure that such factors relate to outcome measures of falls per 1000 resident days, percentage of falls that cause harm, percentage of falls risk assessment completed on admission or change in status, percentage of "at risk" residents with intervention or those with restraint use. The great thing about these listed factors is that understanding the presented data plays an important role in supporting improvement.
It can be seen from the provided information that fall prevention programs or modifications has undergone various modifications which all falls to be reduces greatly. Nursing roles are essential in most of the fall prevention measure simply because of the relationship and the amount of time nurses spent with their patients. Hence it is essential to ensure nurses understand the measures and involve in the full incorporation.
References
Kozier, B., (2008). Fundamentals of Nursing: Concepts, Process and Practice. Developing a culture of safety and quality. Chapter 15. Page 287. Pearson Education.
Dykes C.P et al., (2011). Fall prevention in acute care hospitals. A randomized trial. US National Library of Medicine. National Institute of Health.
Retrieved from www.ncbi.nlm.nih.gov/pmc/articles/PMC3107709/
MacLaurin, A. & McConnell, H.(2011). Utilizing quality improvement methods to prevent falls and injury from falls: Enhancing resident safety in long-term care. Progress report. National safety council. Journal of Safety Research 42 (2011) 525–535.
Nitz et al., (2014). Outcomes from the implementation of a facility-specific evidence-based falls prevention, intervention program in residential aged care. Feature Article. Geriatric Nursing, Volume 33, Number 1.
Stanford hospital & clinic (2013). Fall prevention. Patient Centered Care. Stanford Nursing, Medical Services.
Retrieved from Stanfordhospital.org/clinicsmedicalservices/nursing/patients/fallprevent.html/
