Assignment: Fall Prevention
Assignment: Fall Prevention
Assignment: Fall Prevention
Fall prevention is a national patient safety goal of The Joint Commission and is considered a standard of practice in most institutions.
The obstetric population is considered a healthy group of patients. Should a fall prevention program be implemented on an OB unit for every laboring and postpartum patient?
Describe two factors that place the obstetric patient at risk for falls. Explain why the identified factors increase the obstetric patients risk for injury.
Describe how the implementation of a fall prevention program on the OB unit would help to improve patient outcomes.
Describe the role of the RN in the implementation of a fall prevention program on an obstetric unit.
Across the care continuum, fall and injury prevention continues to be a significant concern.
Unintentional falls are the leading cause of nonfatal injuries among adults over the age of 65 in the United States.
Each year, up to 32% of community-dwelling persons over 65 fall, with females falling more frequently than males in this age range.
1 & 2
Fall-related injuries are the leading cause of accidental death among adults over the age of 65, accounting for around 41 deaths per 100,000 people each year.
After the age of 85, injury and mortality rates grow considerably for both males and females across all races, but males over 85 are more likely than females to die from a fall.
Unfortunately, fall-related fatality rates in the United States climbed from 29 to 41 per 100,000 people between 1999 and 2004.
2 and 7
Unfortunately, these figures are falling short of the Healthy People 2010 fall-prevention objective, which aims to reduce the number of deaths caused by falls among people aged 65 and up from 38 per 100,000 in 2003 to no more than 34 per 100,000 by 2020.
As a result, falls are becoming an increasingly serious public health issue that must be addressed.
The consequences of falls are expensive.
In the first month after being discharged from the hospital, fall-related injuries account for up to 15% of rehospitalizations.
According to data from 2000, the entire annual projected expenditures for nonfatal, fall-related injuries were between $16 billion and $19 billion, and the total yearly estimated costs for fall-related deaths were around $170 million across all care settings in the community.
Several factors have been identified as potential causes of falls and injuries, but no definitive predictive profile has been discovered to yet.
Although the individuals underlying health condition may have a role in the fall and subsequent injury, the trauma caused by the fall is the most common cause of morbidity and fatality.
Over the last 20 years, gerontology experts, led by Yale Universitys Mary Tinnetti, have conducted extensive research to address the problem of falls and injuries in the community.
However, widespread adoption of such therapies is still lacking in the community.
Fall- and fall-related-injury prevention has the potential to be addressed across the care continuum as health care moves toward patient-centered care and as a growing body of research gives guidelines for widespread fall-prevention initiatives.
For nearly 50 years, inpatient fall prevention has been a specific nursing priority.
12 and 13
All inpatient falls are recognized as adverse events in traditional hospital-based incident reports because they are deemed avoidable.
Falls are, in fact, the most commonly reported adverse effects in adult inpatient settings.
However, because fall occurrences may be underreported, injury reporting is a more consistent quality measure over time, and organizations should consider analyzing the effects of interventions based on injury rates rather than just fall rates.
Depending on the service area, inpatient fall rates range from 1.7 to 25 per 1,000 patient days, with geropsychiatric patients having the highest risk.
According to extrapolated hospital fall statistics, the overall chance of a patient falling in an acute care setting is between 1.9 and 3% of all hospitalizations.
The number of hospitalizations in the United States is estimated to be around 37 million every year19; as a result, the number of falls in hospitals could exceed 1 million per year.
Acute inpatient falls are reported to cause injuries in 6 to 44 percent of cases.
5, 20, and 23
Serious injuries from falls, such as head injuries or fractures, occur less frequently (28%), but account for over 90,000 serious injuries per year in the United States.
In the inpatient setting, falls-related deaths are relatively uncommon.
Although only around 1% of inpatient falls end in mortality, this amounts to about 11,000 fatal falls in the hospital environment each year across the United States.
Because falls are deemed preventable, deadly falls should never happen while a patient is in the hospital.
Residents in long-term care facilities are reported to fall between 29 and 55 percent of the time.
Injury rates in this population have been reported to be as high as 20%, which is twice as high as the community-dwelling elderly.
Long-term care residents are more vulnerable than those who can function in the community, which may explain the rise in injury rates.
In the United States in 1988, Rubenstein27 reported 1,800 long-term care fatal falls.
The current number of long-term care fatal falls has not been calculated; nevertheless, in 2004, the United States had 16,000 nursing facilities caring for 1.5 million residents.
This population is expected to rise in the coming years, making fall and injury prevention a top priority.