Working in the hospital Emergency department we see patients come in on a daily basis status post fall at home with devastating consequences such as hip fractures, and other injuries requiring hospitalization. When I was in nursing school 3 years ago I did some research on the mortality rate of patients over the age of 65 who suffered from fractured hips, and the result was surprisingly high. I remember the figure of 40% mortality rate in the 2 years following hip fracture for patients over the age of 65. We have been working on measures to reduce the number of falls within our inpatient population and that is what I would like to make my clinical issue. In the inpatient setting we use various methods to prevent patient falls. In my facility preventing falls is a major undertaking.
Hourly meaningful rounding has been implemented where both the RN and nursing assistants must enter the patient’s room at least once an hour to check on the 3 P’s; (Pain, Positioning and Potty). Confused patients are placed on bed and chair alarms that will allow staff to hear if they try and exit the bed or chair when they are out of bed and more likely to try to ambulate unassisted. It’s been determined that more falls occur in these situations than when the patient is actually in a bed. Patients with a high Braden score are moved closer to the nursing station for better observation. As healthcare workers, we have the obligation to keep our patients safe. The following PICO question was developed to question the effectiveness of using patient bed check alarms to help prevent inpatient falls (Chamberlain College of Nursing, 2017).
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