Falls in Inpatient Settings, Article Review Example

Background

 

Patient falls in hospitals are an important issue to nurses.  Indeed, not only do patient falls present a patent risk to the patient and their health, but it also poses threats to the care offered in hospitals.  Nurses should learn strategies and tactics to present falls as a key factor to promote safety in hospitals.

Objective

The main objective it to examine research studies that examine strategies to prevent falls in an acute setting.  The four research articles chosen all evaluate different strategies to prevent falls in an acute setting.

Search for Evidence

Overall, a thorough search was conducted of articles that researched how to reduce falls in the following databases: Medline, Google Scholar, and Proquest. A total of 14 articles were found in these databases.  After examination, however, five articles were outside the recommended publishing range of 5-7 years; another five articles replicated similar research techniques in the reduction of falls. Thus, four articles were ultimately chosen to examine for this paper.

Feasibility

Tzeng and Yin (2009) researched the relationship between call light use and response time and inpatient falls in acute care settings.  The authors found that: longer response time to call lights was correlated to fewer total falls and less fall-related patient harm.  The authors’ research challenged conventional wisdom that reducing frequency of call light use and fall rates are two outcome indicators of conducting hourly patient rounds. Tzeng (2010) further identifies mental status as a risk factor in falls: the presence of mental status deficits was identified as the dominant issue in 34% of falls; this finding was statistically significant.

Merrett et al. (2011) reported results from the GEM FIT collaboration that worked to reduce the number of falls among elderly individuals in a hospital.  The collaboration centered on a number of interventions: exercise and education about falls.  The collaboration found that these interventions were useful in preventing falls in the elderly population.

Overall, the literature found that three interventions had a positive impact on reducing falls; another intervention (shorter response to call lights) was found to actually increase the risk of the falls.  Hospitals should adopt these evidence-based guidelines, particularly when dealing with elderly patients.

Those evidence-based practice guidelines could be codified into these principles:

  • Mental health status should be carefully monitored as a key risk factor for falls among elderly hospital inpatients. This should not only be part of the initial interview, but also should be monitored throughout the stay to promote patient safety.
  • Response to call buttons should be closely monitored as well. Although an intuitive perspective would promote a quicker response to the call light as a means to maximize patient safety, research has actually show the opposite: a quicker response time actually leads to a higher risks for falls.
  • Finally, the collaboration shows that interventions including exercise to strengthen joints and education to raise awareness of the genesis and danger of falls can be important to prevent falls in an elderly population. This is important evidence that fall prevention strategies should not only be implemented in the hospital, but also before admissions to the hospital.

References:

Tzeng, H.M. & Yin, C.Y Relationship between call light use and response time and inpatient

 

falls in acute care settings.  Journal of Clinical Nursing, 18, 3333-3341.

 

Tzeng, H.M. (2010).  Inpatient falls in adult acute settings: influence of patients’ mental status.

Journal of Advanced Nursing. 1741-1746.

 

Merrett et al.  A collaborative approach to fall prevention.  Canadian Nurse.  107(8), 24-29.