C493: Task 1
WGU RN to BSN
Patient-Centered
Fall Prevention
1
The Problem & Explanation
What is the problem?
•
Preventable inpatient falls
among the elderly
•
All patients on an
Orthopedic & post-op unit
are at high risk for falls
•
Current practice is clinician-
centered fall prevention & is
less effective due to minimal
patient influence on
interventions used, resulting
in minimal patient
participation
Impact on patient
•
Increased risk of morbidity &
mortality
•
Risk of fractures, possible
surgery, extended stay in
hospital, requiring physical &
occupational therapies
•
Impaired immobility causing
pressure injuries, pneumonia &
blood clots
•
Decreased autonomy
Impact on hospital
•
Loss of reimbursement from
Centers for Medicare &
Medicaid
•
Loss of confidence in care
and safety from the patient,
family & the community
•
Lower satisfaction ratings on
the end of hospital stay
survey
2
A1 & A1a
Investigation: Studies
Avanecean et al.
(2017)
•
Systematic review of the
effectiveness of fall
prevention & the
reduction of falls
•
Fall prevention is most
effective when patient
interventions were
individualized
Kiyoshi-Teo et al.
(2018)
•
Qualitative research
article that assessed
patients fall risk scores &
perceptions of fall risk
•
Fall prevention programs
were more effective
when patients were
involved in the fall
prevention plan of care
Ambutas, Lamb &
Quigley (2017)
•
Quality improvement
study that evaluated
areas of improvement
for the current practice
of fall prevention
•
More active participation
by RN and CNA staff was
more effective at
preventing falls rather
than standardized fall
prevention strategies
Tzeng & Yin
(2015)
•
A study that compared
clinician-centered fall
prevention vs. patient-
centered for
effectiveness in reducing
falls
•
Patient-centered fall
prevention strategies
were more effective
because they
encouraged the patient
to take a more proactive
role in their care
3
A2 & A2a
Investigation: Current Practice
Fall Prevention Protocol
•
Morse Fall Risk assessment upon admission to unit and
every shift
•
Moderate to high score indicate fall prevention is needed
•
Fall prevention is standardized for every patient
•
Bed and chair alarms
•
Call light within reach
•
Non-slip socks worn at all times
•
Fall risk sign at door
•
Special fall risk indicator bracelet on the patient
•
Stand-by assist or contact-guard assist and gait belt
with all ambulation or transfer
•
Physical therapy and occupational therapy consult
4
Post Fall Protocol
•
Head CT, additional diagnostic imaging of any possibly
affected areas
•
Medication evaluation for possible causes of fall
•
Increased fall prevention measures
•
View room with constant visual
•
“Post-fall huddles” with all floor staff at time of fall
•
Discuss the possible causes
•
How to prevent in the future
•
Thorough reports provided to nurse management and
risk management about the fall
•
Quarterly report is emailed to all applicable hospital
staff with information about all falls that have
occurred, patient outcome, and suspected cause of
fall
A2 & A2a
Investigation: Interviews
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- Fall '20
- steele
- • Falls
