Fall Risk Assessment and Prevention in Healthcare

This assignment focuses on understanding fall risk assessment and prevention strategies within healthcare settings, particularly for acute hospitalized patients. It examines various instruments used to evaluate fall risk, analyzes contributing factors to falls, and explores evidence-based interventions aimed at mitigating this significant safety concern. The analysis draws upon a collection of research articles that shed light on the complexities of fall management in hospitals.

Running head: NURSING LEADERSHIP 1
Nursing Leadership
Name
Institution

NURSING LEADERSHIP 2
Nursing leadership
Introduction
Falls and associated injuries are common and serious issues which affect the older
people. The people with the age of 65 and above are susceptible to falls and it has been found
that 30 percent of people older than 65 years and also 50percent of those older than 80 years at
least falls once in a year in the United Kingdom (Gazibara et al., 2014). The impact of falling
include, pain, mortality, distress, loss of confidence and loss of independence. However, falling
can affect the quality of life of the people affected and even those of their families. The patient
should be routinely asked if they had fallen earlier, the frequency of fall, the context of the fall
and the features associated with the fall. These ideas could prevent the patient from further falls
in hospital.The essay will address the case of patient aged 84 who was admitted to hospital with
a history of falls.
Risk assessments
The patient should have been assessed on the risk of falls by the use of comprehensive
assessment approach. This is the method which nurses and geriatricians use to examine and treat
a patient who is at risk or even the one who had recently fallen. However, this approach may be
part of overall geriatric assessment or just particular to the risk factors for falling and one of the
parts of pots fall evaluation (Aranda-Gallardo et al., 2013). Furthermore, the comprehensive
assessment involves in-depth medical assessment of the previous cognition, gait, and falls,
strength, balance, chronic diseases, nutrition, chronic ailments and other medications. The
approach could have assisted the patient in identifying the intrinsic factors which could have
been treated to minimize the possibility to fall. However, the multifactorial falls risk assessment

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should have been done on the patient (How croft et al., 2013). This involves identification of
falls history, evaluation of osteoporosis risks, the assessment of visual impairment and the
assessment of the cognitive impairment.
Bedrails
Bedrail should have been placed in the bed to prevent the patient from falling. Bedrails
are crucial for adults’ hospital patients to keep them from falling. Studies have shown that
introduction of bedrails in the beds of fall patients prevent them from falling (Moore et al.,
2013). Practical and ethical considerations imply that bed rails are appropriate for only patients
who need them. As for the patient in the case study, there was a need for bedrail because the
patient had a history of falls. Thought the patient eventually fell, there was a need for the nurses
to know that fatal bedrail entrapment can be prevented by getting rid of outdated equipment.
They should have ensured there is a good combination of bedrail, bed and mattress and I
believed that it could have saved the patient
Fall risk avoidance measures and culture on care
Situational awareness and human factors such retrogressive cultures, individual
perception on medications and fear to undertake certain interventions are great factors which
affect service delivery on elderly hence education should be offered to assist patients to
overcome them (Toebes et al., 2015). Education interventions are significant measures meant to
increase the knowledge on the fall preventions and also offered appropriate knowledge to
patients concerning their risks of falling and strategies of fall preventions (Toebes et al., 2015).

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The approach is one of the programs which results in positive outcomes like behavioural change,
increased mobility and decrease the fear of falling. The education measures commonly take the
form of fact sheets and the evidenced-based items. It offers preventive measures which can assist
them from falling. They also come up with a check list that can assist them to identify all forms
of fall hazards at their homes and settle on the necessary preventive measures. Furthermore, the
affected patients are informed on places where they can get help in case of falls in order to shun
the long lie condition. Nurses have a great role in ensuring that patients are well educated on
matters concerning their health (Olsen & Bergland, 2014). The psychology department has
played role in many hospitals in the United Kingdom in counselling patients about the safety of
their health. However, the clinical leadership should increase their engagement with the families
of the patients and not patients only. The move will ensure that family members will be in a
position to assist the patients at their homes.
Another risk measure is the home assessments. It involves clinicians visiting the homes
of the affected patients and evaluate how the environment of the home is suitable in relation to
patient's mobility. The conditions of the elderly should always be checked to ensure that they are
safe from any risk factors and this calls for frequent checkup and assessments. An assistive
equipment is then prescribed to the patients in an aim to reduce the falls within the surrounding
of home (Kendrick et al., 2014). Clinicians will eventually develop adaptations through the
installed assistive equipment in order to enhance the independent living and also alleviate the
possibilities of falls.
Technology-based interventions have been used in many types of falls prevention
instances. It encompasses diagnosing and treating the falls, detecting falls, keen adherence to the

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interventions and alerting the clinicians in case of any falls. Technology is also an important tool
as it helps the concerned patient to assess themselves (Potter et al., 2017). The innovations have
provided a great opportunity for lessening the cost and reducing the burden on the healthcare and
also improving effectiveness and quality of the service offered.The old patients should be
monitored closely. It is important for family members to hire someone who could be looking
after the sick each and every time to avoid any instance of fall. This is the best method in cases
where the patient has developed falls frequently.
The kinds of foods and drinks which the elderly eat is one of the health initiative which
assist patients from contracting diseases. Eating food with lots of fats can lead to overweight thus
risking the patients to fall and other conditions such as hypertension. However, the use of alcohol
is not a good practice for elderly people. It results in loss of coordination and it can exaggerate
and affect functions of some medicines (de Brito Vieira et al., 2016). Also, smoking cigarettes
is another lifestyle which has a great potential of affecting the mass density of the bones.
However, by using excessive cigarettes and alcohol, it can contribute to osteoporosis. All these
can increase the risk of falling and it is important to teach the patients about the importance of
reducing or even abstaining from cigarettes and alcohol so that they can reduce the risks of
falling.
Elderly people are susceptible to other conditions which can increase their risks to fall
and even other illness. For instance, they are susceptible to conditions which affect the quality of
their bones. For instance arthritis and osteoporosis. There is a need to be subjected to frequent
assessment so that these conditions can be identified as early before leading to major fatalities.
These people should be frequently under calcium supplement drugs which are in a position to

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boost the strength of their bones (de Brito Vieira et al., 2016). However, they should be given
vitamin D supplements to assist in building up the weak bones.
In relation to the effects of ward culture on the care offered in the hospital, the patient in
the case study was greatly affected by the inefficiency of the nurses; the staffing levels have been
linked to adverse events in health care. It was evident that the nurses were busy to mean that
there were not enough nurses to attend the patient and even offer close care which could have
prevented the patient from falling (Giles et al., 2015). Quality care services are crucial in any
hospital but due to greed for money, there exist some hospitals which accommodate patients
which exceeds the standard ration of the existing staff. The clinical leadership should work based
on the set regulations and ensure that the staff personnel are enough to meet the needs of the
patients. They should not just admit patients because they are in a position to attend them but
they should base their decision on the ability to offer a quality care.
The use of single bed and variable acuity room have been found to be more conducive for
patients care. These rooms reduce stress among patients and reduce the levels of noise which can
affect the recovery process of the patients. Environmental noise and lights can cause
interruptions and sleep disturbance which can make the patients fall out of their beds. Single
rooms allow more privacy and comfortable environment which patients can get more support
and education about their condition (Giles et al., 2015). The design of the room of patient allow
much flexibility and also can be transformed to achieve changing acuity. With these kinds of
rooms, the care of the patient has been found to facilitate better medication, reduced medication
errors and falls. In order to improve the services offered in the healthcare, the nursing leadership
should do intensive research on how better conducive environments can improve the conditions

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of the patients. If they found that the existing literature is not efficient, they should conduct their
trials and come up with a genuine outcome so that they will be in capable to bring changes that
suit the needs of the patient.
However, the decentralized nursing workstations are one of the factors which contribute
to the falls of the patients in the hospital's bed. Nurses need to be close each and every time to
the patients, however, if there get their medical suppliers such as medicine and equipment from
different rooms, their movements up and down could lead to fatigue and reduce the efficiency.
Anything can happen to the patient each time the nurses are away. Centralized workstations
assist the nurses to increase patient surveillance and close inspection of the patient. However, in
regards to the staff, nurses should not work for long hours in a day (Rheaume & Fruh, 2015). In
situations which nurses work for more than eight hours, there are high possibilities that they will
not be in a position to work efficiently to meet the need of the patients. Long hours of work can
result in fatigue and a nurse can end up making mistakes that can risk the life of the patient. It is
therefore, necessary for the governance of nurses to ensure that their staff work within the
standard time to ensure they maintain their efficiency at work
The nursing leadership should work hard and change the design of the wards and the
work how nurses work within the ward. It is crucial to work at one point so that the care of the
patients can be effectively worked out. The patients will be in a position to call for help at any
time when they feel their positions should be changed or any other kind of help (Giles et al.,
2015). The clinical leadership should also realize that the needs of the elderly are different from
those of other patients hence close relationship should be maintained between nurses and the
concerned patients.

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Hospitals that are large enough to accommodate the family members to the care units
assist effective care of the patients. Family members have been found to understand well the
needs of the patients. Some patients cannot conceal their issues in front of the nurses but they can
tell their families instead. By accommodating, family members to the care units can be a solution
to decentralized care units where the movements of the nurses can result to falls of the patients
(Rheaume & Fruh, 2015). Different hospitals have different policies regarding the inclusion of
patients in the care of the patients. There are those who believe that nurses should be given all
responsibility and family members should only visit occasionally. However, others have worked
out and included a few number of family members to care their patients. It is the responsibility of
any health care to ensure and acknowledge that the needs for the elderly and any other patient
should be paramount. They should be offered a care which their members of the family
participate fully in order to offer other services which the nurse might not be in position to offer
due to some cultural difference
The kinds of beds which the hospitals use for people with risks of falls also is another
factor which can influence the type of care of the patient. A raised bed can risk the patient to fall.
The quality of the mattress used also should not be high density that can allow free movements
of the patient with the bed (Giles et al., 2015). However, it should be compatible with the bed in
such a manner that it cannot get tilted and risk the patient to fall. These beds also should have
bedrails each and every time based on the assessment done on the patient before being admitted
Individual factors have a great impact on the care offered to the patients. Based on the
age and the stability of the elderly, the floor of the hospital dictates the care which should be
provided to them. The wards which have slippery floors risk the patient to fall. It is advisable for

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all wards to have rough flows which can make the patient move freely and smoothly without any
risks of fall. The hospital floss and corridors also ought to be free of any obstacles which can
stumble the patient when moving in and out. Majority of the elderly people admitted in hospitals
have eyesight and other sensory-related problems. As a way to ensure that their needs are
catered, the wards should have convenient lighting within the room (Rheaume & Fruh, 2015).
There are patients who need more lights while others need little lighting in the room. In order to
achieve their needs, these patients should be placed on different rooms with respective lighting
conditions.
Clinical governance have a big role in ensuring that nurses offer quality health. They do
so by evaluating the work of nurses. Different nurses have a different way of doing things. There
are those who love their work while others are lazy but any form of laziness in unethical practice.
Such nurses can keep procrastinating the issues of the patients and end up failing to deliver what
the patients’ needs. With such culture in the ward, patients are at risk of encountering fatalities
due to negligence. Clinical governance should conduct the assessment of their staff through
patients (de Brito Vieira et al., 2016). The responses collected will be used to caution the lazy
and unethical staff who risk the life of the patients. The move will ensure that the nurses work
under the set regulations.
Conclusions
Falls among the elderly patients have been common among a significant percentage of
people in the United Kingdom. Falls have lots of consequences to the concerned patients as well
as their families. In regards to the context provided, the was need for some assessments to be
conducted before admissions of the patients so that it could have been easy for the nurses to save

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the patient from further falls. However, there was necessity of bedrails for the patient. It was
meant to ensure that it prevents the patient from falling. Though it did not work, there is a
possibility that nurses were not close to the patient at night. There are many factors which have
been associated with the falls among the elderly people and it calls needs for nurses to come up
with better strategies within and outside the healthcare facilities. In addition, wards culture have
a significant impact on the healthcare services provided. If not for negligence and lack of
adequate staff in the hospital, I believe that the very patient could not have ended up dying. It is
crucial for leadership of the nurses and health care governance to ensure that the safety of the
patients are prioritized during and after admission to the hospital.

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References
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