Patient Falls in the Hospitals

Impact of the Problem on the Patient

Patient falls in the hospitals prominently impact the individuals mainly because of the risk of incurring further injuries and medical complications. According to Chu (2017), patient falls increase the length of stay, treatment costs, and the risk of lawsuits from the clients due to the unprofessional healthcare medical care. Ideally, it is an issue that trickles down to poor living quotient among the patients due to the intensified pain from the incidences especially among the weak and vulnerable, such as elderly and children. It is crucial to incorporate measures that enhance the alleviation of the challenge since it contrasts the physicians’ mandate to protect and improve the health index among the customers.

Impact of the Problem on the Organizations

Patient falls pose a significant impact to the organizations mainly because of the increased re-hospitalization rate and the essence of longer admission time for the in-patients. Chu (2017) argues that due to the increased cases of the patient falls in hospitals in America, in 2008, the Centers for Medicare and Medicaid Services (CMS) incorporated a policy to contribute in the accountability of the organizations to the issues. Therefore, CMS established that it will no longer reimburse for any conditions acquired while in the hospital causing a longer hospital stay. As a result, the hospitals absorb the costs for the patient injuries from the falls usually preventable by utilization cautionary measures in patient handling. However, in 2009, the Joint Commission (TJC) recorded at least 465 patient falls and injuries sustained from the incidences. Notably, the risks associated with the problem render a dynamic impact to the well-being of the patients and the organizations’ reputation thus the importance of implementing a program appreciating the prevention mechanism.

Identification of PICO components

  • P- Any patient within a hospital environment accessing medical care services.
  • I- Implementation of an effective prevention program on patient falls.
  • C- Current practice.
  • O- Alleviate the patient falls

Evidence-Based Practice Question

Will the implementation of prevention training programs among practitioners contribute in the reduction of patient falls in hospitals compared to the current practice?

Development and effect of a fall prevention program based on the King’s goal attainment theory for fall high-risk elderly patients in long-term care hospital

Background Introduction

The author states that the main purpose of the study entails assessing the effectiveness of a fall prevention program in improving high-risk elderly patients’ long-term care in the hospitals. The strategies enhance an optimal outcome regarding the healthcare service delivery system and the level of professionals among the practitioners.

Research Methodology

The author used a mixed-method approach in the analysis of the data collected hence the optimization of the qualitative and quantitative aspect. Part et al. (2019) used a non-equivalent control group through the pre-test and post-test design. In this case, the researchers used 52 high-risk patients to falls for the experiment and 45 for the control group. Park et al. (2019) focuses on the qualitative and quantitative data analysis to derive the conclusions. The author utilized evidence from other researchers, such as Kim and Seo (2017) and Lee et al. (2017) to comprehend the nurses’ awareness concerning the healthcare practice issue. The article was released in 2019 as an update and awareness creation among stakeholders concerning the negative impact of the patient falls in the hospitals. Primarily, the experiment indicated a proficient efficacy rate for the implementation of the fall prevention program.

Research Level

The research level of the article is level III mainly because of the utilization of pre-test and post-test design to collect data for analysis and presentation of vital insights.

Data Analyses

The researchers used SPSS program for data analysis utilizing X2-test, descriptive statistics, t-test, and the Wilcoxon tests.

Ethical Considerations

The researchers attained informed consent from the participants while there was significant use of in-text citations and referencing for information outsourced from previous studies.

Quality Rating

I give this article “Development and effect of a fall prevention program based on the King’s goal attainment theory for fall high-risk elderly patients in long-term care hospital.” a high-quality rating. The main reason regards the comparative essence of the content from medical practitioners while rendering an optimal inductive insight for further research through the experimental details.

Research Results/Conclusions

This article focuses on the vital aspect of promoting evidence-based practice involving the significant involvement of the professionals in the prevention process. In this case, the researchers recommend the establishment of a training program that is utilized in improving the performance quotient among counterparts. Patient’s safety is an essential factor in the hospital mainly because of the risk from complications during treatment and recovery based on the patient falls incidences. The experimental design aptly lowered the problem from the PICO question due to the focus on evidence-based research analysis and deduction.

Preventing in-patient falls: The nurse’s pivotal role

Background Introduction

The non-research article focuses on the concept of introducing a program that contributes in the alleviation of the patient falls’ issue. In this case, the context explores the dynamic means involving the impact to the patients and the efficacy in promoting competence healthcare services. Many of these incidences are often associated with a lack of education among the nurses despite having the noble duty to ensure the safety of the individuals (Chu, 2017). The non-research article establishes that slips can be prevented in hospitals once therapist gains the skills and knowledge on how to overcome them through training.

Type of Non-Research Evidence

The non-research context is based on expert opinion evidence regarding the efficacy level of the fall prevention program and the necessity of nurses’ proficiency in the implementation process.

Non-Research Level

Under the spectral view of the John Hopkins Nursing evidence-based practice research appraisal tool, the article falls under level V mainly because of the use of previous studies to contribute in the improvement of the fall prevention program concept.


The quality level of the non-research article is good mainly because of the provision of an analysis from previous literature materials with an aim of enhancing an insight to the improvement of the implementation strategy. The researcher utilizes resources, such as Center for Medicare and Medicaid services (2016) and Center for Medicare and Medicaid (2008) to derive crucial details. Therefore, Chu (2017) focuses on the interpretation and description of specific techniques that enhance the inquiries’ quality in the study. Ideally, the evidence is found in the conclusive analysis of the report.

Non-Research Authors Recommendations

The results answer the evidence-based practice question mainly because of the deduction that the fall prevention program attributes to better long-term healthcare services for the patients. The quality of healthcare is comprised of clinical safety that is considered a crucial component that identifies and reduces the risks faced by patients. Chu (2017) defined falls as adverse events which occur in a hospital environment and have a significant impact of about 10% of income made by the organization. The effects come in terms of costs, damage, pain, and mistrust of the health system by patients. Every incident report regulation and standard of medical institutions vary the rates of stumbles. The intervention lowered the problem from the PICO question through the intersection of previous research materials towards projecting the essential role for the nurses in alleviating the issue.

The decision to propose the change within the facility is based on previous investigations and the current situation at the facility. Falls often occur when healthcare professionals are not keen on helping guide clients. This is often contributed by limited skills and knowledge to observe policy standards when handling patients, which is attributed to a lack of education among nurses. The purpose of the proposed change is to improve the education of nurses when it comes to preventing falls.

Medical care is a multifaceted phenomenon that entails the incorporation of dynamic strategies for effective treatment. Chu (2017) examined adverse events as the cause of mortality and morbidity, considering that they lead to issues of clinical safety hence the need to avoid falls in health institutions. Therefore, the researcher identified falls as a major safety concern when it comes to the hospitalized patients considering the severe impacts it causes, such as reducing life quality, increasing the stay in hospitals, and being costly to patients.

Recommended Practice Change

Both articles support the use of fall prevention program mainly because of the profound impact to the reduction in the cases. Park et al. (2019) argue that education has a significant impact in ensuring that nurses acquire knowledge and skills to identify risk factors, identify dangers, and apply this knowledge in healthcare settings. Further, Chu (2017) establishes that the involvement of nurses in the planning, development, and implementation process boosts the effectiveness in alleviating the patients falls problem. The recommended practice change enshrines healthcare managerial team developing a training program for the practitioners concerning best patient handling aspects during care provision.

Reduced slips after implementation of change proposal show the effectiveness in the treatment and recovery among individuals. Evidence-based practiced in this change project help evaluate the success of the implementation. This involves data delivery on the risks in respect to areas and during discharge of patients (Park et al., 2019). The management should obtain support and assist in improving the educational practices of nurses to prevent clients from tumbling. The monitoring system tracks the changes in the rates of stumbles. The program is sustained through constant informing of senior managers on the progress of reducing slips.

Key Stakeholders

The main stakeholders to involve in the implementation of the training program encompass the managers, practitioners, and the patients. The managers’ involvement entails mobilizing the workers while coordinating the implementation of the program across the distinct departments. The role of the practitioners enshrines the active training concerning the best prevention mechanisms to use in the promotion of patient care. Although the nurses will learn the theoretical aspect of the analysis, it is critical to incorporate strategies that elevate the interdependence across the variables. The patients’ mandate encompasses understanding the distinctive risks of falling within the hospital during their locomotive movement. The success of the program engulfs the apt participation of all stakeholders in the planning, development, and implementation phases.

Barrier to Implementation

The implementation of the strategies alleviating the patients’ stumbling problem entails evaluating the needs, set goals, and preparing for the change to prevent falls. The educational intervention program will be successful in preventing falls. The education of nurses is attained by integrating organizational ongoing operation procedures. The strategy starts by defining the responsibilities and roles of nurses in preventing falls and the requirement to change to execute the best approaches (Park et al., 2019). The system needs to be monitored to track the changes and sustain the program through constant informing of senior managers on the progress of reducing falls.

Strategy to Overcome the Implementation Barrier

Evidence-based practice is an essential initiative within the healthcare sector mainly because it attributes to the projected outcomes. The main goal in the medical care sector enshrines the apt improvement of the service delivery system. However, one of the profound challenges among the practitioners involves the coordination among all relevant stakeholders. It is vital incorporate strategies that foster the alleviation of implementation barriers. One of the crucial strategies engulfs healthcare quality and leadership. The approach significantly contributes to the prominent effect of medical care provision among the patients and the prevention of the barriers during the implementation process.

The reputation of a medical institution relies on the competence in the provision of competent healthcare services. It is the responsibility of the managerial team to focus on the factual baseline of promoting the interdependence quotient. In this case, the necessity of enhancing the stakeholders’ coordination encompasses the ability to alleviate the situation causing poor patient care service delivery. On the one hand, effective recovery among patient leads to reduced healthcare costs hence attributing to optimal service experience. As a result, the clients align their loyalties with the quality of services provided in the organization. On the other hand, the increasing rate in the patient falls causes the lack of confidence from the client concerning the leadership and healthcare quality capacity. Notably, the institution incurs a bad reputation based on poor perception of the practitioners’ professionalism. Therefore, the first strategic means affirming the quality and leadership essence encompasses mobilizing inclusivity of all internal and external environmental variables.

The second strategic initiative in alleviating the implementation barriers is the intersection of dynamic concepts on handling patients. It is important for the workers and patients to understand the organization’s cultural values. An excellent example is the intensification in the prominent aspect of patient-practitioner relationship. In this case, it is recommended that the professionals utilize the metaparadigm of nursing concept to improve patient-centric care. Park et al. (2019) establishes that intensifying the awareness campaign among the parties fosters the significant impact of promoting healthcare quality and leadership.

A demonstration that renders the applicability of the initiative is the provision of a program that enhances engagement between the workers and the clients. One of the illustrations is the development of brochures and warning signs regarding slippery floors and the practices that pose the risk. Ideally, it is the responsibility of the medical practitioners to assert the safety of the personnel. Therefore, the brochures educate individuals within the hospital concerning the risks of patient falls. Apart from the brochures, the physicians optimally enlighten the patients about the aspects that expose the patient to falls. The final strategic initiative is the actualization of the patient fall prevention training. During the process, the nurses and patients significantly engage in practical demonstration to indicate the various means to prevent and handle the situation. The training is scheduled for one day in a week mainly for the in-patients.

A distinct strategy that further intensifies the effectiveness in the implementation process is the integration of monitoring aspects. The initiative attributes to the core ideology of improving patient care and expertise among the counterparts. Therefore, the monitoring is a follow-up concept that demonstrates the commitment among the practitioners and the managerial team to advance the competent service care delivery system. The monitoring enshrines nurses observing the patient’s behavior, movement, and the adept necessity to provide assistance. The coordination elevates the prevention of patient falls and the frequency the proficiently affects expertise practice.

Indicator to Measure the Outcome

There are dynamic indicators for the reduction of the patient falls that encompass the reduced records of injuries from the incidences. A different indicator is the practitioners’ proficiency in handling patients within the hospital and the implementation of an effective monitoring program. The monitoring involves the nurses’ observation and prevalence in ensuring the optimal care among the clients. It is important to demonstrate competence among patients mainly because of the build of trust. Therefore, the monitoring program enshrines observing and engaging the patients regarding the recommended care to enhance their comfort while accessing the hospitals medical care services. The lack of definitive platform to boost the relationship between the patients and medical practitioners risks the key aspect in promoting effective treatment and recovery. Patient falls is a threat to both the clients and the organizations hence the necessity of integrating vital aspects of the practice.


Centers for Medicare and Medicaid Services. (2016). Hospital-acquired conditions (present on admission indicator).

Centers for Medicare and Medicaid. (2008). State Medicaid directory letter.

Cleveland Clinic. (2020). Reducing your risk of falls in the hospital. Cleveland Clinic. Web.

Chu, R. Z. (2017). Preventing in-patient falls: The nurse’s pivotal role. Nursing2020, 47(3), 24-30. Web.

Kim, S. H., & Seo, J. M. (2017). Geriatric hospital nurses’ knowledge, attitude toward falls, and fall prevention activities. Journal of Korean Gerontological Nursing, 19(2), 81-91.

Lee, H. O., Lee, B. H., & Lee, C. H. (2017). Effect of strength exercise on patient fall prevention program: Focusing on the fall high risk group elderly patients. Journal of Health Informatics and Statistics, 42(4), 338-345.

Park, B. M., Ryu, H. S., Kwon, K. E., & Lee, C. Y. (2019). Development and effect of a fall prevention program based on the King’s goal attainment theory for fall high-risk elderly patients in long-term care hospital. Journal of Korean Academy of Nursing, 49(2), 203-214. Web.

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