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Introduction
Patient falls are one factor posing a threat to an individuals health due to the high likelihood of injury from the effects of falling. Although it may seem that patients in hospitals are under constant observation and they should not be at risk of falling, such incidents occur frequently even in professional healthcare settings. The present proposal suggests recommendations for a fall prevention program for the University of Miami Hospital.
Aspects to Take into Consideration
When creating a program for fall prevention, it is important to take the hospitals mission and values into account. The mission of the University of Miami Health System (UMHS) involves operating a modern academic medical facility that serves the area of South Florida and beyond ( Mission & values, n.d.). To accomplish this mission, high-quality compassionate care is delivered to each patient, and future medical leaders receive a proper education. In addition, the UMHS works hard to promote the well-being of all community members.
Another crucial aspect in this consideration is the Morse fall scale (MFS), a method that helps evaluate an individuals predisposition to falling ( Morse fall scale, n.d.). The approach is simple and does not require much time, but its outcomes have proven highly valuable. The MFS consists of six items: the patients history of falling, secondary diagnosis, ambulatory aid, intravenous therapy, gait, and mental status ( Morse fall scale, n.d.), each of which receives a numerical point value. Based on the resulting total score, which can vary between zero and 165, the type of action is defined. A score of 0-24 is regarded as no risk, 25-50 points indicate low risk, and 51-165 points mean that the patient is at high risk of falling.
The Beers Criteria, or the Beers List, is a set of recommendations that address patient safety when prescribing drugs to older adults. For example, these guidelines emphasize the danger of prescribing unnecessary medications (The American Geriatrics Society 2015 Beers Criteria update expert panel [AGS], 2015). The Beers List also contains advice on adverse drug reactions and drug interactions that promote a rise in risk-benefit correlation (AGS, 2015). As part of the present program, the Beers Criteria may be used to eliminate prescribing drugs that might induce dizziness, decreased neuromuscular function, and cognitive impairment.
Finally, it is necessary to keep in mind the Ps of nursing rounds, which increase the level of care and eliminate the risk of falls. The most important Ps are pain control, potty (toilet needs), and patient positioning (Mitchell & Lavenberg, 2014). When the frequency of rounds is high, the likelihood that a patient might attempt to stand up to fulfill one or more needs will decrease.
Interventions, Their Goals, and Patient Training
The program includes the following interventions:
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Making the hospital environment safer (installing rails in departments for elderly patients, increasing the amount of light in corridors, removing unnecessary furniture that might pose a tripping hazard);
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Evaluating patients by the Beers List (excluding drugs that might have a negative effect on an individuals ability to think clearly and walk confidently);
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Increasing patients mobility (volunteer-based walking activities; non-slippery shoes and mats; Growdon, Shorr, & Inouye, 2017);
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Vitamin D and calcium supplementation (Guo, Tsai, Liao, Tu, & Huang, 2014);
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An intervention involving physical exercise (Guo et al., 2014).
The main goal of the listed approaches is to decrease the rate of patient falls at the University of Miami Hospital. Another important purpose is enhancing patients well-being and general psychological state. Finally, the program carries out the intention to reduce the hospitals financial burden since patient falls have the potential to cause severe budgetary losses. Patient training includes instruction on every aspect of the identified measures. In particular, nurses will teach patients how to use bed alarms and when to call a specialist. Patients will also be educated about the significance of non-slippery shoes and mats. Moreover, the role of drug prescriptions will be explained.
Expected Outcomes
Assumptions regarding the programs outcomes are positive as the plan covers important aspects and suggests a variety of approaches. The best-anticipated result is a reduction in patient falls by 50-60% within the first four weeks of the program. Depending on patient mobility, more than one intervention may be implemented to increase effectiveness. Also, nurses will collect feedback from patients to evaluate the efficiency of each intervention and identify the best-performing.
Items Needed for the Program and the Estimated Cost
The items necessary for the project include bed alarms, non-slippery mats, electronic health records (for the analysis of patient prescriptions), and lighting equipment. The estimated cost of the project is $20-35 per patient day. This number is low in comparison to fall care costs ($1,500-$30,000; Spetz, Brown, & Aydin, 2015). Thus, although the program will incur some expenses, it will result in financial benefit to the hospital in the long run.
Conclusion
The suggested multi-intervention fall prevention program is aimed at reducing the rate of patient falls at the University of Miami Hospital. The facilitys mission and values focus on enhancing patient well-being. Implementing a program incorporating the Beers List, the MFS, and the three Ps of nursing rounds will make it possible to protect clients from adverse outcomes of hospital stays and develop the hospitals image.
References
The American Geriatrics Society 2015 Beers Criteria update expert panel. (2015). American Geriatrics Society 2015 Updated Beers Criteria for potentially inappropriate medication use in older adults. Web.
Growdon, M. E., Shorr, R. I., & Inouye, S. K. (2017). The tension between promoting mobility and preventing falls in the hospital. JAMA Internal Medicine, 177(6), 759-760.
Guo, J.-L., Tsai, Y.-Y., Liao, J.-Y., Tu, H.-M., & Huang, C.-M. (2014). Interventions to reduce the number of falls among older adults with/without cognitive impairment: An exploratory meta-analysis. International Journal of Geriatric Psychiatry, 29(7), 661-669.
Mission & values. (n.d.). Web.
Mitchell, M. D., & Lavenberg, J. G. (2014). Hourly rounding to improve nursing responsiveness. The Journal of Nursing Administration, 44(9), 462-472.
Morse fall scale. (n.d.). Web.
Spetz, J., Brown, D. S., & Aydin, C. (2015). The economics of preventing hospital falls: Demonstrating ROI through a simple model. The Journal of Nursing Administration, 45(1), 50-57.
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