Magazine article American Nurse Today

Preventing Injuries from Patient Falls

Magazine article American Nurse Today

Preventing Injuries from Patient Falls

Article excerpt

While falls prevention has become standard in inpatient care, injury prevention has gotten less attention, both in research and everyday practice. Injuries from falls can have serious consequences in patients, ranging from minor cuts and bruises to fractures, head injury, and even death. An estimated 11,000 patients die from falls in U.S. hospitals every year.

Injurious falls were deemed a healthcare-acquired condition (HAC) by the 2005 Deficit Reduction Act, and hospitals no longer receive reimbursement for treating injuries resulting from falls occurring during hospitalization. The average cost of treating injurious falls ranges from $24,000 to $27,000.

More recently, the Affordable Care Act led to changes in reimbursement models. These models factor in the occurrence of HACs, including injurious falls, to incentivize hospitals to improve patient outcomes. According to current projections, the annual financial burden of injurious falls will reach $47 billion by 2020.

Regulatory standards require hospitals to provide fall-prevention programs to patients at risk of falling. While these programs include care plans and protocols for preventing falls, they may fail to provide specific guidance or interventions for preventing injuries from falls.

Injury-prevention strategies and devices

Don't confuse fall-prevention strategies and devices with injury-prevention strategies and devices. Bed and chair alarms, lap belts, gait belts, chair wedges, and nonslip footwear are designed to prevent falls, not fall-related injuries. Injury-prevention interventions are critical components of high-quality care. They include the use of material resources, such as floor matting or compliant flooring, hip protectors, low-low beds, and helmets or protective caps.

Special flooring

Compliant flooring and floor matting provide a cushioned surface that reduces impact, decreasing the likelihood of injury if the patient falls. Compliant flooring gives under pressure. This concept is relatively new and still uncommon in inpatient care settings.

Floor matting, on the other hand, has been used in practice for several years. A mechanical engineering study of floor matting showed it reduced injury by as much as 99%. Floor matting has several advantages:

* It offers protection from both fractures and head injury.

* It's relatively inexpensive--usually less than $150.

* It's reusable and easily cleaned between patient uses.

* It's portable, transitioning from the bedside to placement in front of chairs or other areas when patients are mobilized out of bed.

Beveled matting is preferred because it's less likely to pose a tripping hazard for nursing staff. Folding mats are preferred if storage space is scarce. (See Flooring that helps prevent injuries.)

To use floor matting effectively, staff must understand it should be placed only when the patient is left unattended. When staff members are working actively with the patient or the patient is being mobilized by staff, matting should be taken up and placed to the side.

Hip protector

Hip protectors reduce impact from falls that could cause hip fracture. Available in briefs or pant-type options, these garments have protective pads or cushions around the lateral hip areas. They can be particularly effective for frail patients and those who hav degenerative bone disease or a low body mass index. …

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