Patient fall in hospitals is one of the greatest challenges facing the healthcare industry in the Unites States. It is estimated that about 3-20% of the patients fall once during their inpatient care (Quiqley & White, 2013). Moreover, one patient fall incident without serious injuries costs a hospital about $3,500 whereas patients with more than two falls with small injuries attract a cost accounted for approximately $16,500 (Quiqley & White, 2013). However, if the fall leads to serious injuries, the hospital has to pay about $27,000 (Quiqley & White, 2013). The above percentage statistics and cost figures present a grave situation to any hospital and, therefore, demand a precise, diligent, and comprehensive patient fall prevention undertaking. The current patient fall prevention program proposal aims at finding the best way of reducing and ultimately eliminating patient falls in Memorial Manor Nursing Home, a member of Memorial Healthcare System since 1989.
Rationale of the Program
Place New Order
With improved life expectancy, there is a constant increment in the number of elderly people who require periodical inpatient services in different hospitals and, therefore, prone to become victims of patient falls. In a study undertaken based on the data from the National Database of Nursing Quality Indicators in the United States from 2006-2008, it was evident that a total of 315,817 incidences occurred (Bouldin et al., 2013). Approximately 82,332 of them resulted in injuries, presenting 26.1% of the total falls (Bouldin et al., 2013). The falls occurred at a rate of 3.56 falls/1000pd (pd = patient days in a hospital). There is a pressing need for Memorial Manor Nursing Home to have an elaborate patient fall prevention program because this phenomenon has become a common problem in the health care industry in the United States. Memorial Manor focuses on the provision of high-quality care for its clients; therefore, it needs to be on high alert to ensure that elderly patients have a safe time in its facilities. Moreover, the program will guarantee that the hospital is safeguarded from the additional cost of catering for the bills caused by the injury costs that patients have after falls. In addition, the program will help Memorial Manor hospital to meet conditions set by the Joint Commission in 2013 whereby accredited hospitals are expected to conduct patient fall studies in their facilities (Quiqley & White, 2013). However, the primary intention of this program proposal is to formulate a platform which Memorial Manor can utilize to attain fall-free time for the elderly in its facilities.
Continuous Thorough Data Collection
Continuous collection of data on patient falls will assist in identifying their number and patterns in terms of the departments. Having the right data will help the management to determine areas of improvements but, above all, it will provide a reference point, making all the players in the hospital more proactive regarding prevention of patient falls. According to the Joint Commission (2015), one of the contributing factors leading to patient falls is an inadequate assessment. Therefore, there is a need for the administration of Memorial Manor to implement continuous data collection which will run concurrently with the operations of the hospital. The pattern identified will be useful in taking a preventive measure which will be based on the prevailing evidence of the hospital.
Fall Prevention Team
This team should comprise members from all dockets in the hospital. It will assist in forming a team that is conversant in different demands of the health caregivers and a potentially risky situation where falls occur (The Joint Commission, 2015). This team will enable Memorial Manor Nursing Home to take different well-informed measures through the utilization of an inclusive approach where insights from various departments will be referenced in addition to the data collected.
Standardized Communication Practices
The communication practices agitated by this proposal should be centered on the evidence gathered by the data collection on patient falls within the hospital. Moreover, there is a need to utilize general practices agitated by different relevant bodies, for example, the Joint Commission. One common practice utilized is the standardized patient-caregiver communication aimed at helping caregivers to understand better the fall prone situations to provide the relevant help proactively (The Joint Commission, 2015).
Individualized Patient Care System
Having effective communication with patients will guarantee that the information available will make sure that nurses and other health caregivers are aware of different avenues where falls or potential falls can occur (Ganz et al., 2013). The insights provided should be utilized to introduce a detailed care system that will enable the hospital to take an inclusive measure that will cater for all sorts of falls possible within the hospital.
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According to this strategy, the hospital should ensure that the lighting of the patient rooms is sufficient in addition to having lighting switches within a comfortable reach of all patients. Moreover, there is a need to ensure that all beds have functioning brakes that help to maintain steady bed at any time (Ganz et al., 2013). Another component of interest is to ensure that the facility has sturdy handrails in areas of potential fall risk, thereby providing the necessary support to the patients in areas that may require privacy like toilets. Besides, it is of the essence to make sure that every patient has nonslip fitting footwear, which will heavily aid in eliminating the accidental class of patient falls.
Institutionalization of the Fall Prevention Program
Despite the patient falls being a threat to the well-being of the healthcare industry, there is a need to appreciate that patients visit hospitals in search of other health care services. Therefore, patient fall prevention measures need to be availed concurrently with the primary care patients need (Ganz et al., 2013). In appreciation of this fact, this patient fall prevention program agitates for training exercises that will empower caregivers to safeguard patients from falling without sidelining their core mandate. One of the key areas of training is regarding data collection and analysis. It is a critical area where caregivers need to be conversant in methods of data collection. Furthermore, they should understand the findings and act accordingly.
Moreover, there is a need to have training on good communication skills that will enable caregivers to have a healthy exchange between them and patients, hence sharing the right information that will aid in implementing relevant fall prevention programs. In addition, this proposed program will be more efficient if it has the blessings of the administration of Memorial Manor Hospital. This is in appreciation of the fact that any culture of an organization is heavily influenced by the management. Therefore, to attain a culture of patient fall free culture, there is the necessity to have total support from the leadership, which will ensure that all relevant resources will be available to enable the actualization of the program within the hospital.
In the line of ensuring that every concerned party is fully aware of this preventive program, it is the intention of the proposal that a thorough awareness campaign will be performed in the hospital for both caregivers and patients. For the caregivers, the aim will be to sensitize them on different evidence-based facts about patient falls, thereby giving them a head start regarding their prevention. On the other hand, patients will be informed about different identified risk areas where due care is needed in addition to various ways of conduct in such areas. Open forums and leaflets should form the backbone of the marketing plan.
Patient fall prevention being a multi-approach undertaking demands the hospital at hand to provide all necessary support, human and non-human capital, and the accompanying items. In the proposal, the following items will be of great help towards its actualization:
Fall prevention awareness leaflets
Additional lighting bulbs and switches
Nonslip footwear for both caregivers and patients
Training kits for caregivers (Ganz et al., 2013)
Taking into consideration that resources are scarce and there is the presence of competing demands within the Memorial Manor Nursing Home, it is the intention to keep the program as cost-effective as possible. Moreover, there is a need to ensure that the program is not used as a profit generating venture since prevention of patient falls is a fundamental requirement as demanded by the Joint Commission (2015). Therefore, this program should be institutionalized at its break-even point where cost = profits.
Estimated cost = Min ((Training cost (TC) + Accompanying items cost (AIC) + operationalization cost (OC) + evaluation cost (EC)) = Min (TC + AIC + OC + EC). Profits = foregone cost of patient fall expenses. Therefore, the prevention program should be institutionalized under (Min ((TC + AIC + OC + EC)) - (foregone cost of patient falls)) = 0. The cost of one fall with no serious injuries = $3500, more than one fall = $16500, serious injuries from fall = $27000 = potential foregone cost per patient after the fall (Quiqley & White, 2013). Therefore, the program should meet this condition:
Min (TC + AIC + OC + EC) = n ($3500) + n (16500) + n (27000) where n = a possible number of respective falls within the hospital. Thus, to ensure the perpetuity of this program in Memorial Manor Nursing Home, the management should consider that Min (TC + AIC + OC + EC) - ((n ($3500) + n (16500) + n (27000)) = 0.
The optimal goal of this proposal is to empower the Memorial Manor Nursing Home into becoming a health care facility that has zero patient fall cases through a well-coordinated, comprehensive, and inclusive approach. Health caregivers will be more informed about areas of interest in the line of ensuring improved safety and welfare of patients during their stay in Memorial Manor Hospital. On the other hand, the program will not only inform patients about the areas where more caution should be observed but also teach them the best way of conduct in areas perceived as risk prone. In addition, the institutionalization of this program will help the Memorial Manor Hospital to achieve its goal of providing high-quality healthcare services in a compassionate and dignifying setting.