Hospital Biz: Prevent Falls and Keep Patients Safe

April 25, 2016

Written by Anne Grogan-Hanford, MSN, APRN, ACNS-BC, AGPCNP-BC, CRRN, Adult Health Clinical Nurse Specialist

Although some may feel that there is too much emphasis on the topic of patient falls, they are a crucial part of providing excellent patient-centered care. In fact, the topic is being researched, examined, and thoroughly discussed in organizations and institutions across the country. The American Association of Retired Persons (AARP), a national organization devoted to address issues of those age 50 and older, published an article exploring the “hidden crisis of falling” in December 2015. 

Once overlooked and incorrectly considered as a normal part of aging, falling is now regarded as a serious and preventable concern for those who make policies and provide care. 

According to the Centers for Disease Control, the number of older adults in the US who actually died from falls each year doubled from 10,273 to 25,454 during the years 2000 to 2013.  As a result, the cost of caring for those who had fallen increased to more than $30 billion a year.  It's anticipated that this cost may double again by 2020.

Falls are the leading cause of ER visits in adults ages 45 to 64 and for those adults 65 and older.  It is known that that 1 in 3 adults over the age of 65 fall each year.  Many of these individuals sustain an injury such as a fractured hip or a head injury.  This translates into more than 2.5 million older adults treated in ERs for fall-related injuries with   approximately 734,000 being admitted to the hospital for further treatment. 

Data may be skewed as well, since patients who want to maintain their independence may be hesitant to reveal that they have fallen previously upon admission.

Purposeful Hourly Rounding on patients is an intervention used in hospitals nationwide to promote patient safety and timely nursing care. 

Each time the patient room is entered the five P’s are asked: Pain, Potty, Position, Possession, and Plan of Care. A sixth "P" can help prevent patient falls – Presence. 

To be truly present with the patient, the staff enters the patient’s room to engage the patient and meet their needs. For this reason, since patients may desire independence and have the need for toileting assistance, it's suggested that the patient be encouraged to toilet every 3rd hour, and that while the patient is toileting, the staff member needs to “stay in the vicinity” (nearby). Patient privacy is important, but patient safety requires serious consideration.

The actual number of patient falls at Providence Hospitals has decreased over the previous year, and the ultimate goal is to have no patient falls as we continue to promote patient safety and quality care standards.

Green Cross Safety Society On Fall Prevention Intervetnion For Providence Health[Left to Right: C. Estes, A. Spiegler, I. Bethune, J. Casteen, S. Coyle, S. Hutchinson, F. Cox, J. Gantt, and L. Edmonds with Anne Grogan-Hanford]  These are Providence Hospitals' newest members of the Green Cross Safety Society which is comprised of RNs who complete a class outlining fall prevention interventions. Members of the Green Cross Safety Society can be recognized by the green safety pin worn on their ID badge.