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Research Proposal: Part 2
Valerie Vick
UIN # L29354112
Liberty University
The consistency of falls being a National Patient Safety Goal (NPSG) are congruent to falls still
being a frequent occurrence within the healthcare setting. The CDC reported in 2016 that the
costs of injuries from falls are $31billion annually. Two-thirds of that cost is attributed to
hospital costs. The growing concern and prevalence of falls has gained attention from
researchers seeking to find, not only exactly what factors are intrinsic or extrinsic, but what can
be learned or changed to reduce its frequency of incidence. Since most falls are unanticipated
and are rarely observed, most research from this retrospective reporting has led to documenting
and preventing the intrinsic (e.g. psychological, physiological conditions) factors. This has often
led to the overlooked extrinsic (e.g. environmental) factors that surround each fall incident. This
paper will discuss the research findings of 3 different studies that considered the environmental
and hospital design features and the impact that it has on the prevalence of falls or its
contribution as a fall risk.
Research Proposal: Part 2
The Center for Health Design: Study 1
The Center for Health Design and Coalition for Health Environments Research (CHER)
joined together to research the physical environment surrounding falls. Since falls are
multimodal and the factors involved are based on a combination of different factors and
circumstances, they realized that their framework needed to be representative of these as well.
Their approach was to examine the falls risk from the Lawton and Nahemows competence
model. The factors are characterized by the equation B=f (P, E, (PxE)). B is behavior, or falls, P
is the person (intrinsic factors), E is the environment (extrinsic factors), and PxE is the
interaction between the environment and the person. In order to have an influence on B (falls),
there would be a need to impact all the elements of P and E. As environmental factors was of
most concern, their focus was entirely on the E factor. Environmental factors can be
multifactorial and can involve lighting, flooring, footwear, room layout, or having single-patient
Layout changes can be challenging and their modification too costly, making the impact
of spatial layout difficult to study. Interior features within the environment can be more easily
modified without mounting costs. Interior features can include furniture and its placement, the
presence of handrails and their location, and types of flooring. These have been studied and
have been easily altered when these factors interfered with a having safe environment. What this
report found was that furniture should be positioned so that it does not become an obstacle and
rooms should permit clear movement within the room. The type of flooring was not a factor in
fall risk, however, the type of floor finish is. High-gloss surfaces should be avoided as it causes
a glare can contribute to a fall-risk environment The substantial research on the lack of handrails