Leadership in Clinical Practice: Reducing Falls and Improving Safety

This report examines the critical issue of patient falls in clinical practice, highlighting their prevalence, causes, and consequences, including increased healthcare costs, reduced staff morale, and potential patient injuries. It emphasizes the importance of effective leadership in implementing preventive measures, such as improved communication, prioritization, and technology utilization. The report also discusses barriers to fall prevention, including inadequate training, patient denial, and lack of continuity of care. Furthermore, it underscores the significance of fall risk assessments and screening to identify vulnerable patients and tailor interventions accordingly. Ultimately, the report advocates for a comprehensive and collaborative approach to fall prevention, with healthcare leaders playing a pivotal role in fostering a culture of safety and ensuring optimal patient outcomes. Desklib offers a wealth of resources, including past papers and solved assignments, to support students in understanding and addressing complex healthcare challenges like patient falls.

Running Head: LEADERSHIP IN CLINICAL PRACTICE 1
Leadership in Clinical Practice
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Leadership in clinical practice
A patient fall is an unexpected falling to the floor or lower surface with or without an
injury to the patient. From the recent research, a fall is seen as a major public health issue not
only in the United States but also across the whole world (Kathy, 2013). There are three types of
a fall: accidental falls, anticipated or unanticipated physiological falls. Accidental falls can be
caused by slipping, tripping or any minor incident. Patients here are not at risk for fall but can
experience them due to unforeseen accidents that may occur.
Anticipated physiological falls are the ones attributed to the patient's age, ailment or
medication and are reflected to the risk profile of the victims. Therefore, these falls can easily be
predicted and prevented (Sandra, 2011). However, unanticipated falls are those which arise from
physiological reasons and their risks cannot be assessed because their causes are unforeseen. Out
of the three causes, anticipated physiological falls are the most common in hospitals making it to
78% of the falls. This means that majority of the falls in the health care centers can be prevented.
However, there are other types of falls which are not categorized under patient fall though they
may happen within health care facilities (Scott & Scott, 2010). These include falls by visitors,
staff members or patients under units not entitled to reporting. This is because a collapse is only
categorized under patient fall if it occurred in eligible reporting units.
A fall by a staff member can only be classified under patient fall if it happened while he
or she was trying to prevent the impact of a fall within eligible nursing reporting units (Jane,
2015). It is therefore important for health care providers to know the exact cause of a fall in
order to give correct guidelines to a patient on how they should prevent them.

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The recent researches show that there is an increased number of patients fall close to 45%
of the 1000 patients per day in all hospitals and other healthcare facilities. It is also confirmed
from the studies that most of these falls occur along bedsides or in the bathroom, most of them
being mentally ill or physically impaired patients with 30-35 % of them sustaining serious
injuries like internal bleeding or fractures (Khushminder, 2017). Studies also show that more
than one-third of these falls can be prevented. Although ways of preventing this patient fall have
been introduced in the hospital, most caregivers and patients have ignored them systematically.
Since patient fall has become a common thing in most of the hospitals and health centers,
health caregiver professionals should come up with ways to prevent this problem. This is
because some of these falls can lead to serious situations which may easily lead to death. Also,
they can lead to depression and also make a person stay inactive all through (Karen, 2015).
Minor fractures or soft tissue injuries resulting from a fall can lead to serious functional
impairment, pain, and distress. From the studies, it shows that patient fall has lead to increased
stay in health care services and poor health outcomes among 30- 45% of the patients whereby the
number increases day by day. This problem can be controlled if only proper guidelines can be
put in place within the hospitals.
The level or admissions due to trauma and readmissions resulting from patient fall have
also increased within the health care centers. A change is important for it will help reduce
dangers associated with a fall and also utilize the hospital facilities (Diamond, 2014). From the
research, it shows that a single fall with no serious injuries can cost hospital or health care center
over 3500 dollars. This results to waste of resources and time which they would have utilized
well in attending to other patients.

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Apart from increased health issues and costs, patient fall can bring down the morale of
the healthcare service providers. This is because they make them dishearted and face more
complex and demanding goals while trying to maintain patient’s safety (Christiane, 2011). This
can lead to lack of staffs or a team of indiscipline caregivers which in turn will affect the safety
and dignity of the patients. Indiscipline caregivers can easily reduce the patient turnover rate
within the hospital because most of the patients would prefer health care centers which attend
them with a lot of care and able to meet their expectations.
According to Nancy & Agnes (2010), California hospital engagement network has
engaged in activities which will help in reducing not only falls but also readmissions due to falls.
It is also essential to introduce measures which will help prevent these falls for the good image
of the hospitals. This is because some of these patients may not take that as a normal thing but
may think something might have influenced the fall (Theresa, 2018). Since most of the falls that
occur in hospitals are anticipated one and can be prevented, it is, therefore, crucial for service
care centers to improve the prevention measures.
Prevention and reduction of falls have become a worldwide health priority. Though an
organization can come up with measures to prevent these falls within the hospital, there some
factors which can hinder them from implementing the change. Some of these falls are serious
and should be attended from the baseline and with a lot of safety (Theresa, 2018). This will,
therefore, need a group of health providers because no clinician no matter how trained and
talented he or she is can prevent all falls alone. This can be a challenge to most hospitals and
health centers if they have few service providers.
Moreover, lack of well-structured guidelines and inadequate training to health caregivers
have contributed to high levels of falls. This is because most of them are not able to give patients

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proper advice on how they should do about a fall (Bill& Amy, 2013). These guidelines also
enable caregivers to handle a particular fall in a way which is recommended hence ensuring
dignity and safety of patients. For example, a fall that has occurred as a result of slippery floor
cannot be handled the same with that of physiological reasons. Through proper guidelines and
training, hospitals will, therefore, find it easy in preventing patient fall. According to Natalie
(2017), education to health caregivers has reduced the number of qualified personnel within the
hospitals. This has also increased the level of fall within the hospitals because most of the
caregivers lack knowledge on how to manage a fall.
Some patients also tend to ignore the directives from the caregivers because they feel
they will have an impact change in self-image or is a sign of weakness. Some of these directives
are the use of supportive devices such as walking sticks. They end up ignoring because some
claim that they don’t look good on them. The studies show that denial can also be a barrier in
preventing patient fall (Kenny, 2015). This kind of behavior is most common with old people.
This is where they don’t want to admit their weaknesses like joint problems, muscle issues and
they end up blaming external factors like slippery floors. Lack of proper continuity care for a fall
can also be a barrier in preventing it (Cheri, 2011). This is whereby different caregivers attend
patients in shifts. This makes it hard for them to manage patient fall which should be observed
from the start. It would also confuse the patients because of the different opinions given in every
visit.
Though some of the changes introduced in hospitals have not shown positive results,
caregivers in these eligible reporting units should have outstanding leadership skills which will
enable them introduce change and cope with the same. They should, therefore, exercise these
skills fully to accomplish their responsibility (Jane & Candice, 2011). One of these leadership

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attributes which can easily facilitate change in patient fall is having effective communication
style. This is an essential tool for a change not only in hospital or health care center but also in
every business organization. Health caregivers should have excellent communication skills
which will enable them to advise patients on how they should prevent falls and also encourage
them to follow the instructions given.
Caregivers can also engage patients in discussions to know how they are faring and if
they are satisfied with the services given or not. Communications can be made verbally or by
placing stickers near patient’s beds or most dangerous areas which can cause a fall like slippery
floors (Bill& Amy, 2013). From the studies, it is shown that a 200-bed hospital in united states
created ‘a call don’t fall’ campaign by placing written materials in the patient's rooms which
reminded them to call before leaving the bed. This campaign helped to reduce up to 43% of the
patient fall within the hospital.
Hospital managers should also engage nurses and caregivers in discussions to know the
problems they are facing in preventing falls. This will help in coming up with more advanced
ideas of controlling fall and ensuring patients safety (Cheri, 2011). This also helps caregivers to
understand their roles and responsibilities in each unit and individual part in prevention of a fall.
Also, it improves the safety of most patient because hospital managers will be able to allocate
individuals with right skills in different units.
Ability to decide on priorities and solution is also an important skill which can help in
preventing patient fall. Under this attribute, managers and service providers can decide the most
critical problems which requires urgency and how the patient will be affected if the fall is not
prevented in time (Patricia & Sarah 2013). They should be able to produce the idea and come up
with possible solutions. For example, if a fall has occurred due to geographical reasons like the

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slippery floor, they should come with solutions to prevent more dangers. This would include
putting signs on the slippery floor or modifying it.
Another skill a health caregiver should have is the knowledge of the technology within
the hospital. This will enable them to run an efficient health service (Patricia & Sarah 2013). It
will also enable them to keep data of a particular patient which is essential in identifying trends
in serious and intermediate care in all aspects of fall including patient’s age and location. Having
a data of patients helps service providers to have correct information about a patient in case they
have been readmitted (Cheri, 2011). This would help in using different medication or procedures
if the previous ones did not work to avoid repeating the same mistakes.
Healthcare professionals should also be able to conduct a fall risk assessment and
screening. This is usually conducted once per year among adults aged 65 and above. The
research shows that these clinical practice procedures on fall risk assessment were introduced by
an American and British geriatrics societies (Cheri, 2011). Risk assessment process should
include asking patients how many times they have fallen in the past year or received medication
due to a fall and whether they stag while walking. Patients who therefore seem to be most
affected have increased risks for fall and should be engaged in more assessment.
Those who have fallen at most once and had no injuries, their way of walking or body
balance should be properly investigated and if they have abnormalities should receive extra
assessment (Cheri, 2011). Fall risk assessment also involves laboratory tests and findings which
include determining level of sugar, sufficient blood count, levels of different body vitamins and
thyroid stimulating hormone (Patricia & Sarah 2013). Insufficieny or lack of these components
in the body can lead to hypertension, or a patient can easily faint.

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A 2012 Cochrane systematic review showed that clinical fall risk assessments had
reduced the level of patient fall to 24%. Risk assessment is essential because it helps in reducing
incidents associated with a fall like gait imbalances, injury or even death.
It is concluded that united states have the highest number of falls in the hospitals whereby
people between 700000 to 1000000 per year being affected. Since 70% of these falls are
foreseen, they can, therefore, be prevented.

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References
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from the Patient's Perspective. The Qualitative Report, 23 (2), 50-69
Cheri, L. (2011). When It Comes to Transitions in Patient Care, Effective Communication Can
Make All the Difference. Generations, 35(1), 458-469.
Christiane, B. (2012). The Relationship between Nurses' Perception of Work Environment and
Patient Satisfaction in Adult Critical Care. Journal of Nursing Scholarship, 44(4), 154-
154.
Diamond, Z. C. (2014). An Integrative Review of Knowing the Patient. Journal of Nursing
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Jane, B. (2015). Primary Nursing in a Short-Stay Unit. Creative Nursing, 21(1), 68-79.
Jane, W. S & Candice, A.T (2011). Improving the Culture of Patient Safety through the
Magnet® Journey. Online Journal of Issues in Nursing, 16, (3), 70-87
Karen, H. S. (2010). Improving Quality and Patient Safety by Retaining Nursing Expertise.
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Kathy, F. (2013). Relationship-Based Care in the Neonatal Intensive Care Unit. Creative
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Kenny, B. (2015). A Bright Future: New Institute Links Hospitality, Design, and Health
Administration to Improve Patient Care. Human Ecology, 43(2), 67-80.
Khushminder, C. (2017). How Your Body Language Affects Patient Care. Current Psychiatry,
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