Introduction Quality initiative is the process of building from existing research and data from various health care facilities to improve the quality of care in America’s healthcare. It has been reported that 44,000-98,000 Americans die annually due to differing medical errors (Medscape Nurses, 2007). Falls and injuries related to falls have posed a great risk to individuals in hospitals which cause a large amount of inpatient and outpatient medical expenses. It stated that an annual $55 billion dollars are spent on fall related injures (Kramer et al. , 2014).
The objective of health institutions is to decrease the amount of falls and possible eliminate falls as a whole as a type of quality improvement initiative. Developing a program with a particular target group that is most affected by falls, and cost justification will be discussed in this paper. Purpose and Target Population for Program Falls are not only limited to hospital settings but home settings as well and according to the Center for Disease Prevention (CDC) in 2010 fall injuries for adults aged 75 and older per 1,000 individuals were 43 (2012).
Research conducted globally has not shown a reduction in inpatient falls and the falls amongst patients still pose a great threat to patients. A program designed to eliminate or reduce falls can help patients across the world. There are numerous reasons that contribute to falls such as medications, weakness, disorientation, and environmental factors. The main key in preventing falls is education and appropriate interventions based on the individual patient needs. Designing a inpatient fall program as well as an outpatient home fall program can reduce falls both inpatient and outpatient.
The program will target individuals 65 and older who have a history of falls, patients who have diagnosis of dementia, and those who may be experiencing muscle weakness that places them at a greater risk for falls. According to the National Patient Safety in 2010 there were more than 28,000 falls that resulted in 80 deaths and more than 1,000 patients with fractured hips (Dean, 2012). With statistics such as this, proves why fall prevention programs are essential. Benefits of the Program Effective fall prevention programs are essential in reducing falls through a combination of interventions.
In designing a fall program it will help reduce and possible eliminate falls and the injuries related to a fall. The fall program will not only address the needs of the patients while inpatient but outpatient. Patients that have certain risk factors will have a health care worker visit their home and educate the patient and family on medications side effects and measures to prevent falls at home. Some of the factors that will be addressed at home are safety hazards, physical exercise if indicated and addressing the patient’s weakness if identified and inform the patients of limits until physically cleared to perform certain activities alone.
Oftentimes patients believe that they can do certain things and not at terms with certain limitations that illness may have placed on their lives. Informing the patient it is not a removal of independence but an intervention of safety to prevent further hindrances in his/her life until they are able to regain their strength can promote compliance. Also, adding to the interventions that are in place to prevent inpatient falls will be implemented. Educating nurses on safe patient practices and methods to encourage patients to adhere to safety precautions.
Some of the inpatient methods will be to ask questions as it relates to fall history, monitor for delirium, perform a cognitive screen and so forth. The overall goal of the program will be to eliminate all preventable falls and as a result reduce the amount of deaths and injuries suffered due to a fall. Budget Justification Falls are not only detrimental to a patient’s well-being but also place a financial burden on many health institutions and families. It has been stated that hospital falls occur cost over $4,000 in excess charges for hospitals (Inouye, Brown, & Tinetti, 2009). In essence if a hospital
sustains 10 falls in one week they are looking at an additional $40,000 of funds allocated for the fall the patient sustained. Programs that have been instated and displayed fall reduction have also showed a cost reduction related to falls by approximately $776,064 (Trepanier, & Hilsenbeck, 2014). This large consumption of monies can be implemented in other areas of the hospital such as more nurses to assist with the nursing shortage and educational programs as needed. Basis Upon Which Program is Evaluated The program will be evaluated on the amount falls sustained in a given time period and if any injuries were related to the fall.
Also, looking into the type of fall will indicate if prevention methods were effective or non-effective. Using a standardized tool to evaluate the types of falls, injuries sustained manpower on duty and test procedures after a fall. The program will also evaluate individuals who were provided the education prior to fall versus those who were not and how many amongst each differing group sustained a fall.
The program will not eliminate the fall measures in place but add to the existing measures. Looking at the financial data as it relates to cost to determine if there has been a decrease in financial lost due to falls and fall sustained injuries. Conclusion Illness can pose many risks to an individual that was once stable and able bodied but now has been stricken with an illness and not be able to operate in the manner in which they did prior to the illness. One of the complications of a debilitating illness is that the patient may suffer from falls due to medicine, weakness and overall illness. Falls are serious problems for patients and can prove to be difficult to manage. Some falls are considered unpreventable and occur when all measures are in place and being adhered to but the patient still sustains an injury.
It is the role of the healthcare provider to prevent these injuries and falls. Developing a fall prevention program can help with this problem and in turn help decrease the financial cost related to falls. References Center for Disease Control and Prevention. (2012, February 3). CDC – Older Adult Falls – Data and Statistics – Home and Recreational Safety – Injury Center. Retrieved from http://www. cdc. gov/homeandrecreationalsafety/Falls/data. html Dean, E. (2012). Reducing Falls Among Older People In Hospital. Nursing Older People, 24(5), 16-19 Inouye, S. K. , Brown, C. J. , & Tinetti, M. E. (2009).
Medicare Nonpayment, Hospital Falls, and Unintended Consequences. New England Journal of Medicine, 360, 2390-2393. doi:10. 1056/NEJMp0900963 Intensity. Journal Of Aging & Physical Activity, 22(3), 372-379. Kramer, B. J. , Creekmur, B. , Mitchell, M. N. , Rose, D. J. , Pynoos, J. , & Rubenstein, L. Z. (2014). Community Fall Prevention Programs: Comparing Three InSTEP Models by Level of Medscape Nurses. (2007). Quality Improvement in Healthcare. Retrieved from www. medscape. org/viewarticle/561651 Trepanier, S. , & Hilsenbeck, J. (2014). A Hospital System Approach At Decreasing Falls with Injuries And Cost. Nursing Economic$, 32(3), 135-141.