Patient perspectives on hospital falls prevention education
One of the most effective practices that assist in decreasing the number of falls in hospitals is the education of patients. Heng et al. (2021) interviewed eleven patients from 37 to 92 years old and discovered that six of them fell at least once in the past year. What is more, the absolute majority of patients who experienced falls (five out of six) were older than 70 years (Heng et al., 2021). The purpose of Heng et al. (2021) was to analyze how patients are educated to prevent falls in hospitals and at home after the release from the hospital.
Heng et al. (2021) discovered the following methods of education: verbal instructions from nurses, distribution of fall prevention brochures, occupational therapy falls assessments, falls education groups, and home visits of occupational therapists. Not all of these methods could be regarded as adequate. The essence of verbal instructions was to inform the patients to “use the call bell, or not rush to mobilize” (Heng et al., 2021, p. 4). Brochures and posters were mainly distributed “with no face-to-face discussion on how to use them or what to focus on” (Heng et al., 2021, p. 4). This way, it seems that the medical personnel shifted responsibility for their safety entirely to patients. Home visits of occupational therapists are expected to be most effective because, during these visits, specialists estimate particular dangerous places at home and provide recommendations on how to modify the home to make it safer.
Undoubtedly, it is crucial to inform patients how to escape falls and make their stay at the hospital safer. However, the problem is that frequently nurses neglect verbal interaction with patients and make the security provision at the hospital the patients’ responsibility. Therefore, even though it is necessary to teach patients, especially older ones, how to decrease the probability of falling, the hospital’s staff members must improve the indoor environment to make it safer.
Nurses’ perception toward the effectiveness of using risk fall prevention protocol
In contrast to the study described above, Alderby et al. (2017) focus on precise actions that nurses could do to protect hospitalized patients. First of all, it is worth noting that not all patients are equally likely to fall at home and in a hospital. For this reason, nurses should pay attention to elderly people and those who take certain medications, such as “sleep-induced drugs, cough formula and antiplatelet,” anticonvulsants, antipsychotics, and chemotherapy (Alderby et al., 2017, p. 13). That is because these drugs might make them sleepy and destroy the function of their muscle and nervous systems (Alderby et al., 2017). The preventive measures that nurses should take include educating patients but are not limited to it.
Apart from medications that impair balance, other factors that might lead to falls are “limited mobility, wet floor, confusion, Alzheimer disease, disorientation” (Alderby et al., 2017, p. 13). In addition to that, “visual impairment, lack of handrails in patients’ rooms and bathrooms, inability to follow safety instructions, improper use of side rails” also increase the likelihood of patient falls (Alderby et al., 2017, p. 13). Hence, it is necessary to provide a safe environment and dedicate a lot of attention to the patients at risk of falls.
Alderby et al. (2017) propose such interventions as “locking bed-brakes, clean and dry floor, call-light, low-bed position, lighting the room during day” (Alderby et al., 2017, p. 13). Apart from that, nurses could also ask the patient to fill fall risk assessment form at the stage of admission to the hospital to estimate how likely a particular patient would fall. The articles central message is that patients should not entirely bear responsibilities for their safety. Instead, nurses should constantly estimate risk factors and establish a safe indoor environment. Still, the interaction between nurses and patients is also crucial because it is a way to warn patients and explain how they should behave to protect themselves from falls.
Actions of the fall prevention protocol
The article of Alves et al. (2017) has a lot in common with the study of Alderby et al. (2017). Both papers analyze the fall prevention protocol and identify the most effective nursing interventions. The difference between the two papers is that the one of Alves et al. (2017) emphasizes not only the significance of patient education and specific actions of nurses but also the engagement of family members. Family members should be aware of the potential risk factor and how to ensure the security of a patient after the discharge.
Apart from this, Alves et al. (2017) inform the audience of several interventions that were not discussed by Alderby et al. (2017) and Heng et al. (2021). According to Alves et al. (2017), the number of falls in hospitals could be decreased by identifying “the patient at high risk through signaling at the edge of the bed or bracelet,” moving them safely, and allocating them “near the nursing station” (Alves et al., 2017, p. 8). One of the significant sources of danger for the patient at high risk is bathrooms. Every healthy person, at least once, slipped on the wet floor in the bathroom, not to mention sick people. Consequently, one more helpful intervention is the arrangement of personal hygiene care (Alves et al., 2017). In other words, nurses could help patients who are likely to fall to take a shower.
The interventions described by Alves et al. (2017) will decrease the frequency of falls by establishing safer conditions for the inpatients. The critical advantage of these interventions is that they require the constant control of hospitalized people by the healthcare personnel. This way, the responsibility for fall prevention entirely rests on the shoulder of medical staff who are always in control of a patient and are aware of all risky places in a hospital.
Alderby, A. R., Elgamil, A. E., & Bnjar, H. (2017). Nurses’ perception toward the effectiveness of using risk fall prevention protocol of hospitalized patients. Journal of Nursing and Health Science, 6(4), 9-14. Web.
Alves, V. C., Freitas, W. C. J. D., Ramos, J. S., Chagas, S. R. G., Azevedo, C., & Mata, L. R. F. D. (2017). Actions of the fall prevention protocol: mapping with the classification of nursing interventions. Revista latino-americana de enfermagem, 25, 1-11. Web.
Heng, H., Slade, S. C., Jazayeri, D., Jones, C., Hill, A. M., Kiegaldie, D., & Morris, M. E. (2021). Patient perspectives on hospital falls prevention education. Frontiers in Public Health, 9, 1-9. Web.