Each year, somewhere between 700,000 and 1,000,000 people in the United States fall in the hospital. A fall may result in fractures, lacerations, or internal bleeding, leading to increased health care utilization. Research shows that close to one-third of falls are preventable. Fall prevention involves managing a patient’s underlying fall risk factors and optimizing the hospital’s physical design and environment. There is a business case for fall prevention: Falls are associated with increased length of stay, higher rates of discharge to nursing homes, and greater health care utilization. One study found that operational costs for fallers with serious injury were $13,316 higher than non-fallers. As of 2008, Medicare no longer reimburses hospitals for increased costs due to injury from an inpatient fall. (Department of Health and Human Services, 2021) Using your e-book or search engine: 1)   Discuss at least 4 steps you as a nurse may take to prevent falls in the facility. 2)   Discuss physical complications of falls to the client. 3)   Your client has fallen.  Write 5 nursing actions you take as you care for this client over the next 24 hours (including any you would anticipate receiving orders for). Reference(s): Department of Health and Human Services. (2021). Agency for Healthcare Research and Quality. Retrieved from Preventing Falls In Hospitals: https://www.ahrq.gov/patient-safety/settings/hospital/fall-prevention/toolkit/ready-change.html#1-5

Falls in the hospital setting are a significant concern, with an estimated 700,000 to 1,000,000 falls occurring each year in the United States (Department of Health and Human Services, 2021). These falls can result in various complications such as fractures, lacerations, and internal bleeding, leading to increased health care utilization. However, research indicates that about one-third of falls are preventable, emphasizing the importance of proactive measures to mitigate this risk (Department of Health and Human Services, 2021).

As a nurse working in a hospital, there are several steps that can be taken to prevent falls among patients. Firstly, conducting fall risk assessments is crucial. By assessing each patient’s individual risk factors, such as age, previous fall history, mobility impairments, and medication use, nurses can identify those who are at a higher risk of falling (Department of Health and Human Services, 2021). This assessment should be done upon admission and regularly throughout the patient’s stay, as their condition may change.

Secondly, implementing appropriate interventions based on the identified risk factors is key. This includes measures such as providing non-slip footwear, installing bed alarms for patients at high risk, and ensuring that call buttons and personal belongings are easily accessible (Department of Health and Human Services, 2021). Additionally, developing personalized care plans that address the specific needs of high-risk patients, such as frequent toileting or assistance with mobility, can significantly reduce the likelihood of falls.

Thirdly, educating both patients and their families about fall prevention strategies is essential. By raising awareness about the potential risks and teaching patients how to minimize those risks, they can actively participate in their own safety. This education may involve explaining the importance of using assistive devices, encouraging proper lighting and clear pathways in their environment, and promoting regular exercise and physical therapy to maintain strength and balance (Department of Health and Human Services, 2021).

Lastly, fostering a culture of fall prevention within the healthcare facility is crucial. This can be achieved by implementing interdisciplinary fall prevention teams, which consist of healthcare professionals, including nurses, physical therapists, and administrators (Department of Health and Human Services, 2021). These teams can collaborate to develop and implement evidence-based fall prevention protocols, ensuring consistency and efficiency in fall prevention efforts. Regular staff training sessions and knowledge sharing can further enhance awareness and understanding of fall prevention strategies.

When a patient experiences a fall, there can be several physical complications that arise. Fractures are one of the most common consequences, especially in older adults whose bones may be more fragile. Fractures can range from minor to severe, such as hip fractures, which often require surgical intervention (Department of Health and Human Services, 2021). Lacerations and bruises are also common, particularly if the fall occurs in a hazardous environment or involves contact with sharp objects. Additionally, falls can result in internal bleeding, which may not be immediately apparent and can lead to further complications if left untreated.

In the immediate aftermath of a fall, as a nurse, there are several actions that can be taken to provide optimal care for the patient. Firstly, ensuring the patient’s safety is paramount. This may involve calling for assistance, assessing the patient’s condition, and providing immediate medical attention if necessary. It is essential to document the details of the fall accurately, including the location, time, and circumstances surrounding the incident.

Once the patient is stabilized, it is crucial to conduct a thorough assessment to identify any injuries or changes in their condition. This may involve assessing for pain, swelling, or deformities, as well as monitoring vital signs and neurological status (Department of Health and Human Services, 2021). A comprehensive assessment allows for appropriate interventions to be implemented promptly.

Furthermore, communicating with the healthcare team, including physicians and specialists, is vital to ensure coordinated care. This may involve reporting the fall, relaying relevant information regarding the patient’s injuries or changes in condition, and advocating for any necessary diagnostic tests or treatments (Department of Health and Human Services, 2021).

In terms of nursing interventions, promoting mobility while ensuring safety is crucial. This may include assisting the patient with repositioning, moving, or ambulating as tolerated, while utilizing appropriate assistive devices if needed (Department of Health and Human Services, 2021). As the patient may experience discomfort or pain, providing adequate pain management is essential.

Moreover, educating the patient and their family about fall prevention measures is crucial to prevent future falls. This education should focus on individualized strategies based on the patient’s specific risk factors and may involve teaching proper body mechanics, demonstrating the correct use of assistive devices, and discussing environmental modifications that can enhance safety (Department of Health and Human Services, 2021).

During the next 24 hours, several interventions and actions may be anticipated. Depending on the patient’s injuries, specialist consultations, such as orthopedics or neurology, may be requested to further evaluate and manage their condition. Diagnostic tests, such as X-rays or CT scans, may be ordered to assess for fractures or head injuries. Pain management interventions, ranging from oral pain medications to intravenous administration, may be initiated and adjusted based on the patient’s response and level of discomfort.

In addition, interdisciplinary involvement may be necessary in the form of physical therapy or occupational therapy consultations. These professionals can assess the patient’s functional abilities and develop a rehabilitation plan to regain strength, mobility, and independence (Department of Health and Human Services, 2021).

Overall, falls in the hospital setting pose significant risks to patients and can lead to various complications. As a nurse, implementing strategies such as fall risk assessments, customized interventions, patient and family education, and interdisciplinary collaboration are essential for effective fall prevention. In the event of a fall, providing prompt and comprehensive care, coordinating with the healthcare team, and initiating appropriate interventions are crucial in ensuring the best possible outcomes for the patient.