Falls are a common phenomenon amongst the elderly. In most cases, fall victims end up dying, immobilized, or institutionalized in a clinical facility. Therefore, key players in the health care sector have to come up with ways of preventing this occurrence. This paper is a literature review on the best practices related to fall prevention. The paper will also highlight the importance of implementing preventive policies coupled with giving suggestions on how the implementation process can be accomplished successfully.
According to Dykes et al. (2010), anyone can be a victim of falls, but the risk is high amongst the elderly population. Hospitalization also increases the risks of a patient falling, which necessitates the need to come up with preventive mechanisms. Dykes et al. (2010) hold that the use of health information technology (HIT) plays a critical role in preventing falls as it “improves communication and facilitates information access and decision support” (p. 1915). Therefore, healthcare institutions should come up with fall prevention tool kits (FPTK), which incorporate HIT in a bid to improve communication and decision-making on the prevention of falls. Unfortunately, information on the effectiveness of HIT in preventing falls is scarcely documented. However, a study by Dyekes et al. (2010) shows that HIT plays a critical role in preventing falls in clinical setups.
In another study, Rubenstein (2006) notes that considerable evidence “documents that the most effective (and cost-effective) fall reduction programs have involved systematic fall risk assessment and targeted interventions, exercise programs and environmental-inspection, and hazard-reduction programs” (p. 37). Apparently, the majority of falls can be linked to known risk factors like general body weakness, psychotropic medications, muddiness, and unsteady pace. Therefore, prevention measures should be tailored around these risk factors in a bid to counter the problem before it happens. According to Rubenstein (2006), the available research findings indicate that dealing with the risk factors reduces the problem significantly. Other “evidence-based fall reduction methods include systematic exercise programs and environmental inspection and improvement programs” (Rubenstein, 2006, p. 40). In addition, clinical guidelines for approaching the risks associated with falls are critical in the quest to prevent the problem.
According to a study by Spoelstra, Given, and Given (2012), hospitals can reduce falls by “using multifactorial fall prevention programs via evidence-based interventions to reduce falls and injuries” (p. 92). Spoelstra, Given, and Given (2012) support Rubenstein’s (2006) claims that dealing with the risk factors is one of the most critical steps of preventing falls in hospital settings. Some of the single interventions used in this approach include avoiding the administration of psychotropic drugs coupled with introducing exercise programs for hospitalized elderly individuals. The multifactorial approach includes “post-fall review, patient education, staff education, footwear advice, and toileting” (p. 97). In addition, hospitals should adopt universal fall safeguards and inform patients on the same upon admission. Moreover, after admission to a hospital, caregivers should carryout a risk assessment to establish the patients predisposed to falls. After this assessment, each patient should have a customized intervention plan as a way of optimizing prevention and response efficiency.
Response from my clinical facility
The policies in my clinical facility correspond to the majority of the best practices highlighted above. We have incorporated international clinical guidelines on the prevention of falls in hospitals. In addition, we carry out an assessment after admitting any patient prone to falls in a bid to establish the potential predisposing factors. We then tailor the prevention measures based on the patient’s risk factors. However, even though we have a functional communication system, I think we need to incorporate HIT and FPTK. This move will ensure proper and timely communication and accurate decision-making in a bid to avoid and prevent falls.
Importance of implementing preventive policies
As aforementioned, falls lead to immobilization, prolonged hospitalization, or even death in some cases. According to the available literature, 4 out of every 1,000 patients are victims of falls in hospitals across the United States (Bouldin et al., 2013). This prevalence rate is high, and thus it underscores the importance of implementing falls’ preventive policies in hospitals. In addition, falls lengthen the time that an individual spends in a hospital, which increases the cost of healthcare services. Moreover, relatives of falls patients have to take care of them for longer periods, and this aspect interferes with normal living and the execution of duties. Therefore, implementing falls preventive policies will reduce the associated risks, hence the prevalence. This aspect will ensure that patients do not incur extra costs and prolonged stay in hospitals due to falls.
In a bid to accomplish a successful implementation of preventive policies, hospitals should consider the following recommendations:
- Hospitals should implement HIT and develop FPTK in a bid to improve communication and the decision-making process. This move will allow timely response to fall cases or in combating risk factors.
- Healthcare facilities should adopt detailed fall risk assessment for every patient in a bid to come up with customized prevention measures.
- Hospitals should adopt both single and multifactorial intervention strategies in a bid to prevent falls from happening.
- Finally, healthcare institutions should adopt universal intervention strategies by following the set clinical procedures for falls prevention.
Bouldin, E., Andresen, E., Dunton, N., Simon, M., Waters, T., Liu, M.,… Shorr, R. (2013). Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of Patient Safety, 9(1), 13-17.
Dykes, P., Carroll, D., Hurley, A., Lipsitz, S., Benoit, A., Chang, F.,…Middleton, B. (2010). Fall Prevention in Acute Care Hospitals: A Randomized Trial. JAMA, 304(17), 1912-18.
Rubenstein, L. (2006). Falls in older people: epidemiology, risk factors and strategies for Prevention. Age and Ageing, 35(2), 37-41.
Spoelstra, L., Given, B., & Given, C. (2012). Fall prevention in hospitals: an integrative review. Clinical Nursing Research, 21(1), 92-112.