Preventing In-Patient Hospital Falls

Synopsis

The PICO question to be addressed in the current project is, "Do nursing interventions such as fall prevention kits, assisted trips to the bathroom, hospital orientation, and monitored medication, versus patient restraints among in-patients, especially those aged 65 years old and above, reduce the number of falls and fall-related injuries during a hospital stay?" This question is derived from research (e.g., Kraus et al., 2007; Dykes et al., 2010) suggesting that such interventions have been effective in other sub-disciplines of health and medicine. For example, Dykes and colleagues (2010) found that a fall prevention kit in hospital units and health information technology significantly reduced the rate of falls in four urban U.S. hospitals. Additionally, Kraus and colleagues (2007) found that fall prevention programs targeting the elderly, falls in the bathroom, unassisted falls, and in-patient care areas can reduce the chance of injury all while reducing the need for bedside sitters.

Upon examining the evidence regarding fall prevention programs, it appears that significant efforts have been placed into evaluating different methods for diminishing the prevalence of falls in hospital and home settings. Dykes and colleagues (2010) utilized health information technology (HIT) to evaluate patients' risk of falls and found this strategy to be effective in detecting early fall warning signs. Additionally, Kraus and colleagues (2007) suggested that detecting early warning signs in different hospital settings could help predict the likelihood of falls.

Overall, the evidence to support fall-prevention programs is fairly strong, with interventions and correlational research both supporting the use of systematic and evidence-based fall-prevention strategies. There are some key areas where research is lacking, such as inconsistencies in research design and dependent variables. However, the available evidence allowed for the PICO question to be answered in the affirmative.

Dissemination of Findings

Nursing interventions such as fall prevention kits, assisted trips to the bathroom, hospital orientations, and monitored medication do, in fact, help reduce the number of falls during a hospital stay - especially for geriatric patients. There also appears to be evidence that evidence-based fall prevention programs can be effective in a range of settings. Therefore, it is important to ensure that findings regarding fall prevention programs be disseminated in the proper manner in order to ensure that patients are protected. For example, a vast majority of falls occur in the bathroom, where patients are often left unattended and at-risk (Kraus et al., 2007). Providing this evidence to hospitals may help improve patient safety, as well as prevent costly litigation associated with negligence or malpractice.

One way to disseminate these findings regarding fall prevention programs is to prepare a press release, both for hospitals and for the media. A press release regarding the facts behind falls and fall prevention programs would likely reach a wide audience, where this raise awareness could spark action. Another method of disseminating this evidence is through research publications, conference presentations, and flyers. Conducting an actual study on this topic and having it published in a respected, peer-reviewed journal would be the most optimal way to ensure the findings were read by the desired scientific audience. Additionally, presenting these findings at conferences, where health professionals and stakeholders are present, could inspire action to implement fall prevention programs. This strategy would also spark conversation about the issue and potentially serve as a catalyst for future research.

References

Dykes, P. C., Zuyov, L., Tsurikova, R., Meltzer, S., Chang, F., Benoit, A., et al. (2010). Fall prevention in acute care hospitals: A randomized trial. JAMA: The Journal of the American Medical Association, 304(17), 1912-1918.

Krauss, M.J., Nguyen, S.L., Dunagan, C., et al. (2007). Circumstances of patient falls and injuries in 9 hospitals in a midwestern healthcare system. Infection Control and Hospital Epidemiology, 28(5). Retrieved from: http://www.jstor.org/stable/10.1086/513725. Accessed 13 February 2014.