Clinical/Organizational Problem
According to the United States Department of Health and Human Services Agency for Healthcare Research and Quality (2018), between 700,000 and one million patients in the United States fall while in hospital each year, and about one third of these falls could have been easily prevented with effective administrative procedures and best practice protocols. Yet many organizations lack the quality and safety initiatives they need to prevent patient falls in hospital. As a result of negligence to prevent falls, patients experience a number of injuries that could even lead to higher mortality rates. Hospitals like this, which do not have fall preventing strategies in place, risk malpractice suits and fail to fulfill their ethical responsibilities to patients. Therefore, the organizational problem is related to insufficient—even nonexistent--fall prevention strategies.
Description of Problem
Falls occur at a rate of three to five per every 1000 bed stays, and are more prevalent in long-term care facilities (Patient Safety Network, 2018). The most significant consequences of falls include head trauma, bone fractures, and even death (Patient Safety Network, 2018). Even when a fall does not result directly in injury, it can seriously undermine patient trust in the healthcare team and perceptions of institutional quality of care (Patient Safety Network, 2018). Insurance providers and the Centers for Medicare and Medicaid Services do not reimburse hospitals for the “additional costs associated with patient falls,” (Patient Safety Network, 2018, p. 1). Given the tremendous ethical and financial costs associated with preventable falls, hospitals like this one need a comprehensive and immutable fall prevention strategy with the means by which to maintain a culture of safety throughout the organization.
Causes of the Problem
Falls are complex incidents, with several interrelated variables impacting patient risk. Patient factors in falls include age, muscle weakness or orthopedic issues, perceptual impairments, medications that may interfere with orientation, and chronic health conditions (Butcher, 2013). Contextual, situational, or environmental variables include lack of patient monitoring, slow response times to patient alerts, improper positioning of beds or furniture, or physical obstacles that increase risk including poor lighting or wet floors. While age may be a factor, though, not all falls are elderly patients and younger patients may be at even higher risk due to factors like being “embarrassed to ask for assistance or may put a higher priority on privacy than on safety,” (Health Research & Educational Trust, 2016, p. 14).
Explanation of Causes
In a comprehensive analysis of patient fall data, research shows that ineffective risk assessment is a contributing factor in preventable falls (Health Research & Educational Trust, 2016). Each patient should be considered a fall risk, “regardless of age or other factors,” (Health Research & Educational Trust, 2016, p. 14). Lack of patient alert systems, lack of patient education or awareness, and lack of staff training are some of the underlying causes of preventable falls, too. Administrative issues include the lack of staff training...
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