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A patient fall is defined as an abrupt change in body position in a downward direction that may or may not result in physical injury. A fall reduction program exists at SUNY Downstate Medical Center in effort to diminish the incidence of patient harm from fall while in the hospital. This includes evaluation of the program’s effectiveness. The Joint Commission, which regulates patient safety policies through their hospital accreditation standards, has declared reducing the risk of patient harm resulting from falls as one of the National Patient Safety Goals.
A significant portion of injuries in hospitalized patients, long-term care residents, and home care recipients results from falls. Thus, the hospital evaluates each individual patient’s risk for falls and takes action to reduce the probability of a fall and subsequent injury. The appraisal includes a patient’s past fall history, review of medications and alcohol consumption, gait and balance screening, assessment of walking aids, assistive technologies and protective devices, and environmental assessments.
The following are the National Patient Safety Goals elements of performance standards for decreasing the risk of falls in the hospital.
In order to meet these goals, fall risk assessment must be made for each patient on each shift at SUNY Downstate or when there is a change in the patient’s medical or mental condition. The nurses properly determine fall risk, as each patient record includes a fall assessment form. Thus, patients are continually assessed and reassessed for risk of falling upon review of the patient’s mental status, physical condition, age, and number of past falls. Hospital staff must also be attentive to any medications which may place the patient in jeopardy of falling.
The following is a list of medications that may impact the patient’s balance and increase their risk of falling in the hospital.
The fall risk rating form, hourly rounding to check the patient’s status, and patient and family education are essential components of preventing falls and reducing their occurrence. The patient is continuously evaluated for risk for fall.
SUNY Downstate Medical Center takes pre-emptive measures when patients are determined to be at risk for falls. These actions are implemented based upon the patient’s score on the FALL RISK ASSESMENT FORM. Listed below are the individual protocols for nursing interventions to prevent the incidence of falls in the hospital.
LOW RISK FOR FALLS
MODERATE RISK FOR FALLS
HIGH RISK FOR FALLS
STEPS TAKEN WHEN A FALL DOES OCCUR
In the instance of a fall, the incident is appropriately and accurately reported. Patient falls are adverse events; hence, each is documented and reviewed as part of a preventative process.
In review of the event in which a fall does occur the environment in which the episode took place is surveyed and any hazards are noted. Furthermore, the patient’s education, existing injury (if applicable), and activity at the time of fall are reviewed.
The National Database of Nursing Quality Indicators has established principle classifications for falls in the hospital. These classifications establish standards for injury levels following fall.
The staff and clinicians at SUNY Downstate Medical Center follow the protocols and procedures in effort to prevent patient falls. In this effort the Joint Commission’s National Patient Safety Goals are consistently prioritized as to achieve maximum levels of safety for all patients during their stay in the hospital and any health care facility.