Benchmark - Capstone ProjectChange. DUE BY 1/17 Proposal

Running head: PATIENT FALLS 1

PATIENT FALLS 5

PATIENT FALLS Comment by Vicki Swaney: Do not format first level one heading in bold and not in all caps

PICOT Question

For geriatric patients, does restriction using bed-side rails reduce the future risk of patient falls, as compared younger adults not being restricted using bed-side rails? Comment by Vicki Swaney: You may want to consider other interventions for prevention of falls since most facilities do not allow side rails any longer since these are considered a restraint. Your time period is missing from the PICOT question.

Evidence-based Solution

Falls are quite a major concern for nurses all over the world. Patient falls are also the most common adverse safety event patients face while in the hospital. Despite numerous measures being brought forward in an attempt to curb this menace such as bedside shift reports and hourly rounds, the numbers are still alarming. In the United States alone, the rates of falls range from about 3.3 to 11.5 patient falls per 1000 patient days. Every year, approximately 700,000 to 1 million patient falls occur in United States hospitals (Lelaurin & Shor, 2019). These numbers however vary depending on the hospital unit. As such it is essential that as custodians of the patients while in the hospital, nurses find ways to ensure these numbers decline, and use of bedside rails is one key intervention. Geriatric patients are among the patients most at risk of falls. This is due to the numerous risk factors that predispose them such as multiple comorbidities, advanced age, history of falls, gait disorders, female gender, cognitive decline as well as various environmental factors. Comment by Vicki Swaney: Citation needed for statistics

Nursing Intervention

Nurses employ the use of various guidelines for prevention of falls. One of these is identifying patients who are at risk of falling. This is however not always accurate as some of those presumed not to be at risk end up on the floor on a number of occasions. The use of bedside rails is one measure that has been in practice for years. However, its effectiveness in comparison to no use of bedside rails is yet to be documented (Marques et al., 2017). Comment by Vicki Swaney: I would recommend changing your intervention to other measures for falls prevention with support from the literature

Patient Care

Despite limited documentation on its effectiveness as compared to no use of bedside rails or any form of restraints, this is one of the most common methods of preventing patient falls, and especially among geriatric patients. According to Marques et al. (2017), falls are the leading cause of injury or death among the geriatric population. This therefore means that nurses, as well as other health care practitioners, need to develop complimentary interventions in order to preserve the lives of the elderly patients. It quite unfortunate that these elderly patients seek help for one condition, only to end up with more complications than they came in with. This ultimately deters the elderly from seeking medical attention which is not a desirable outcome.

Healthcare Agency

Inpatient geriatric falls have become a frequent and common occurrence that leads to significant morbidity and mortality for the elderly (Mazur, Wilczynski &Szewieczek, 2016). This is becoming quite a costly adverse event for both the patients and health facilities. Patients incur more cost in managing complications of falls while healthcare facilities incur heavy financial losses in terms of reimbursing the aggravated patients. Hospitals also stopped receiving reimbursements from the Centers for Medicare & Medicaid Services (CMS), in the year 2008.

Nursing Practice

Being the primary caregivers in hospitals, nurses bear the greatest responsibility for the prevention of patient falls. Despite the fact that there exists a growing body of research on prevention of falls among the elderly, findings may not be generally applicable to all settings. It is therefore the nurses’ responsibility that they develop ways to minimize fall within the confines of nursing practice. Comment by Vicki Swaney: This is where I would also recommend adding the need for education and change in policy for falls prevention with support of the literature

References

LeLaurin, J. H., & Shorr, R. I. (2019). Preventing Falls in Hospitalized Patients: State of the Science. Clinics in Geriatric Medicine. May; 35(2): 273-283

Marques, P., Quieros, C., Apostolo, J., & Cardoso, D. (2017). Effectiveness of bedrails in preventing falls among hospitalized older adults: a systematic review. JBI Database of Systematic Reviews and Implementation Reports. Retrieved from https://doi:10.11124/JBISRIR-2017-003362 Comment by Vicki Swaney: Double space only here

Mazur, K., Wilczynski, K., & Szewieczek, J. (2016). Geriatric falls in the context of a hospital prevention program: delirium, low body mass index, and other risk factors. Comment by Vicki Swaney: Missing journal name, volume, and issue number, and Doi #