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1 Psychiatric Fall Risk Assessment: An Evidence-Based Project Lori Parker BSN RN Walden University
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2 Psychiatric Fall Risk Assessment Tools: An Evidence-Based Project Accidental falls are predictable and preventable events. The patient relationship between patient-related risk factors and environment are the cause of most inpatient falls (Jorgensen et al., 2015). Thousands of hospitalized patients fall each year, with 30-50 percent resulting in an injury. The Joint Commission (2015) reports serious injury related falls as one of the top 10 reported sentinel events. Fall risks are not the same in every patient environment. Orthopedic patients fall risks are likely not the same as patients on an oncology unit or pediatric unit. Hanger, Wills, & Wilkinson, (2013) hypothesized that not all falls and fallers are the same. Their study concluded that patient groups have different risk factors and outcomes implicating the need for fall prevention strategies. The purpose of this paper is to evaluate the evidence regarding fall risk factors and assessment tools for acute psychiatric populations. Components of an Evidence-Based Project Evidence-based nursing is the translation of research evidence into practice. Evidence- based practice ( EBP) is aimed to improve outcomes by coupling the best current evidence with decision making to improve patient care and outcomes (Stevens, 2013). There is a strategy of multiple components in successful evidence-based projects. An opportunity for change must first be recognized. The idea is posed as a question in a format known as “population/patient problem, intervention, comparison, outcome and time (PICOT). A purpose must be identified for research to be focused on what is to be accomplished. A literature search and review is done to determine if enough evidence is available. Use of EBP databases can facilitate the search for credible evidence when used with proficiency. A hypothesis is formulated to provide a tentative answer to the relationships between variables (Polit & Beck, p. 56). Once a design method is chosen that will address the research question a sample and study setting can be selected. Data is then collected, analyzed, and conclusions drawn for practice recommendations. Problem Significance
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3 Fall risk assessment tools are an essential tool used in nursing practice. When assessment tools fail to alert the nurse that a patient is at high risk for falling, they become vulnerable to fall- related injuries. Traditionally fall risk assessment tools have not addressed the unique risk factors associated with acute psychiatric inpatients. Some acute psychiatric inpatient characteristics include a predominantly ambulatory environment, cognitive and behavior disturbances and psychotropic medication side effects. The Joint Commission (2015) estimates the cost of one injury-related fall at $14,000. The Centers for Medicare & Medicaid Services (CMS) stopped reimbursement for expenses related to fall injuries in 2008 (Reich, Farrell, Maloney, Drayton, & Johnson, 2017, p.40).
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