Capstone Project

Identified Issue

I met my mentor at the practicum site, and we discussed my capstone project topic selection. It was agreed that I would base my capstone project on patient falls in hospital and healthcare facilities. Patient falls been a big challenge in many health-related institutions leading to undesirable results. Proper prevention measures have not been put into place to address this issue to the required standard. Continuing to ignore patient falls may lead to even worse results, painting a bad picture in our health sector.

Setting

The site of the practicum is a large nursing home accommodating five hundred patients at full capacity. The Joint Commission well accredits the facility, and most of the patients are older adults who require the services of healthcare provides.

Issue Description

Patient fall is when a patient experiences an unplanned descent to the floor with or without injury to the patient. Sometimes it can be fatal, resulting in lacerations, fractures, or internal bleeding, which means the healthcare facility will increase health care utilization. An approximate of 30 to 50 per cent of all falls result in injuries. According to a study carried out by the World Health Organization, falls mostly affect people aged above 65 years and children aged 15 years or younger (Boyle et al., 2015). Great care should be taken by the nurses to prevent the cases of falls whenever possible. The WHO study also showed that a third of the falls that occur could be prevented. Various factors contribute to falls in health facilities. They include age, rising patient acuity, shortage of healthcare providers, inefficient working environment and lack of leadership in health facilities to establish a safe climate culture.

Impact of Issue

Patient falls increase healthcare costs and increase the length of stay of patients in the hospital, especially if the fall was fatal. Some patient’s fall may lead to lawsuits which result in millions of dollars for settlement of patient injury. Many hospitals and healthcare facilities now cater for the extra costs of a patient who sustain falls which could have been prevented (Maben et al., 2015). Due to the high costs incurred by hospitals in dealing with patient falls, many of them have started to take precautions and prevention procedures that lower the risks of falling. They encourage healthcare providers to utilize their skills well to provide excellent health care to the patients.

Falls are second in frequency in the causes of harm in hospitals and are the biggest category of reported cases in hospitals. In 2007, the charges in acute care hospitals of incidents related to unintentional falls were above $471 million (Sherrington, 2017). The costs are expected to go up as more cases of falls are being reported. Proper measures should be put in place to address this critical issue before it gets out of control.

Significance of the Issue

Considering the impacts patient falls have had both to the patients and the health facilities, many states have resolved to address the matter. For example, Massachusetts hospitals have taken the lead to encourage efforts to address this issue. “Our hospital leaders continue to encourage efforts to address this serious issue, particularly regarding falls-associated morbidity and mortality for older adults” (Guirguis et al., 2018). Hospitals have come together and are establishing Fall Prevention Programs following Joint Commission Hospital Standard to implement interventions to reduce falls. Hospitals have been voluntarily reporting severe cases of falls to the Department of Public Health since 2009 (Maben, at el, 2015). The data collected has been used to asses ways in which the rate of falls can be minimized. MHA, partnered with the Organization of Nurse Leaders (ONL) Practice Committee, to add extensive fall prevention knowledge by carrying out research and sharing the best practices to be used in hospitals.

Proposed solution

The solution to this issue would be increasing the nurse to patient ratio. Research has shown that low staffing contributes to the increased cases of patient falls because the few nurses cannot handle a large number of patients in hospitals (Boyle et al., 2015). Sufficient staffing has been proposed as one of the best ways of preventing falls in hospitals. Installing a bed and chair alarm can help to alert healthcare providers whenever patients try to get out of a chair or bed without their help. For the patients who are disoriented and unable to adhere to instructions, safety companions should be provided to lower their odds of falling. Nurses should conduct safety round in the wards to make sure every patient is in good order and not in any risk.