Patient Falls: Causes, Risk Factors & Prevention - Essay Sample

Introduction

Patient falls are a challenge to the safety of patients in hospitals, and it has many adverse effects such as increasing costs and length of stay, cause severe injuries, and even at times lead to the death of affected patients. Risk factors that contribute to falls among admitted patients are divided into different parts that include factors related to patients as well as a unit and process-related factors. Various factors increase the risks of falls for patients admitted in the hospital, and they include old age, fall history, vision impairments, environmental hazards, limitations of mobility, use of multiple medications, pain from amputations, and cognition impairments. The discussion section will answer the research questions from the introduction section.

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Findings in Theory

The results of the research on the "Outcome of fall on the patients at King Abdul-Aziz Specialist Hospital" are evidence that many patients that have experienced a fall in the hospital are the elderly who are more than 60 years old at 46.7%, and most of them are males at 55.6% (Almegbel et al., 2018). Most of the elderly people admitted to hospitals depend on mobility and require assistance to walk around by family members at 72.7% (Almegbel et al., 2018). Lack of enough caregivers makes the elderly patients walk themselves around the hospital, and most of them fall and injure themselves, especially on floors that look too slippery for them to walk alone. Older people also suffer from arthritis and pain as well as physical weakness, which increases the chances of falls.

Patterns in the Results

The lengths of stay in hospital and fall history are also risk factors for patients. The results from the study showed that there exists a relationship between increased risks of falls and the length of stay in hospitals (AlSowailmi et al., 2018). Circumstances under which past falls have happened for certain patients repeat themselves in current falls. Such circumstances include impaired balances that are evidence of underlying problems in the patients. The relationship of the findings in the results section and those in Saudi Arabia show that the results from this study are evidence that when nurses neglect the prior history of falls of patients such as confusion, lack of cooperation with patients, and failure to ask the patients leads to loss of valuable information. Nurses are, therefore, expected to make it a trend to ask patients about past falls and what caused them to create strategies that will help reduce the number of falls in hospitals.

Patients with ambulatory aid, especially those that use crutches, walkers, and canes, are also more likely to experience falls in hospitals. This fact is because increased mobility from the use of assistive devices has a history of causing patient falls, most of which cause serious injuries (Almegbel et al., 2018).

Expectation: Nurses and doctors are expected to introduce physical therapy to patients to decrease their usage of assistive devices as they will get more support in their weak body parts reducing chances of tripping and falling.

The results show that other patients have vision problems as well as hearing deficiencies, which increases their chances of falling. Patients with visual impairments fall mainly due to poor balance, lower visual acuity, loss of sensors, and gaining false perceptions of elements of the environment around them (Almegbel et al., 2018). Past research from various authors suggests that assessment of visions of patients when they are being admitted to hospital should be done so that the nurses can quickly identify patients who are at the highest risk of falling. Patients with vision problems should use eyeglasses while in hospitals, and they must ensure that they always walk in areas that have adequate lighting.

Conflicting Results

Many patients that experience falls in the hospital are usually on intravenous therapy with some of them being under four medications such as sedation medication, opioid drugs, antihypertensive drugs, and indwelling catheter. The results show that patients using these drugs are more likely to fall due to the chemicals used to make the drugs and their side effects (AlSowailmi et al., 2018). Nurses and other health staff should monitor patients for some time after they begin any of these types of medication to help them avoid falling. However, most patients should use the drugs under the supervision of qualified physicians as they help them know the side effects of the drugs and what they should do when they feel serious consequences that may lead to their fall. This makes the results to be almost vague because if the patients are always under the care of nurses, how they walk on their own and experience falls is ununderstandable.

The physical and mental health of admitted patients is another risk factor that may lead to falls. Cardiovascular diseases such as dizziness, high blood pressure, and post hypotension constitute a significant cause of falls. The drugs used in the treatment of these diseases have specific effects that are associated with causing injury among the affected patients (AlSowailmi et al., 2018). The drugs have many side effects that can lead to an imbalance among the patients when they are walking; hence they fall and get injured. Most of these diseases also require the patients to take four or more different types of medication, increasing the risk for a fall.

Patients diagnosed with musculoskeletal problems such as those with deficiencies in Vitamin D, weaknesses of lower limbs, fractures, those that have undergone knee replacements, and amputated individuals are most likely to fall in hospitals. From the results in the study, the history of patients with fractured body parts, limbs, and amputated legs shows that they are a known risk of falls among patients (Alshahrani et al., 2018). Replacement of joints among patients has also been a significant risk factor as it increases persistent gait disturbances expanding the number of individuals that fall and seriously get injured when they are allowed to walk with no support from walking aids or trained personnel.

The mental status of patients also can lead to their fall when admitted to the hospital, especially those that tend to overestimate or easily forget specific issues and those that are oriented towards their abilities. Illiterate people form the largest group of people who experience falls in hospitals compared to the literate ones (Alshahrani et al., 2018). Literate people know how to read signs around the hospital that act as a warning and help to avoid different falls that can lead to severe injuries. Illiterate patients, on the other hand, have a past of ignoring signs and warnings, or they do not easily understand them, which makes them vulnerable to falls in the hospitals. This is evidence as to why most old people experience falls in the hospital, especially when they have little knowledge of the dangers that they may face when they do not have adequate reading skills.

Unexpected Finding

The results show that the Body Mass Index also affects patients and increases the risks of falls, especially for overweight individuals. Obese patients have little control of their body, and in case of an emergency, they find it hard to avoid situations where they might fall and injure themselves (Alshahrani et al., 2018). Obese patients both the old and the young report higher cases of falls compared to those with adequate BMIs; hence the nurses in the hospital should work to ensure that the obese patients are put under medication that helps them reduce the fat in their bodies and stay fit.

Cognitive Diseases in Admitted Patients

Cognitive impairment and other psychological problems also cause falls among patients. The most common cognitive diseases are dementia, epilepsy, and Parkinson's disease, and they were stated to be significant risk factors in the study of falls among patients admitted in hospitals (ALMohiza et al., 2018). The drugs to treat these diseases are reported to have many negatives reactions that can lead to imbalance and eventually falls. Better care practices ought to be adopted in all patients that are cognitively impaired for an easy understanding of patients and how they can use them to understand and implement them decreasing it as a risk factor.

The time of fall for patients in hospitals varies from the mornings, evenings, and nights. Patients tend to experience falls mainly in the early mornings after they have woken up and late evenings before going to sleep (ALMohiza et al., 2018). The patients are usually sleepy at these times, and their brains generally function differently from other times of the day; hence they are more likely to concentrate less at these times. Low concentration means that they become unaware of the dangers they may face as they walk along, thus increased chances of falling and suffering from serious injuries.

They are mainly caused by specific environments, such as poor lighting and slippery floors. The results show the possibility of a hazard caused by the immediate environment of an admitted patient (ALMohiza et al., 2018). Lack of adequate lighting in the pavements that the patients are using causes many falls in the hospital. Electrical cords carelessly left on the paths of the patients, as well as loose rugs, cause many cases of falls among patients. Slippery floors, mainly in bathrooms, create falls, and non-slip mats are required in the bathrooms to minimize hazards caused by falls.

Why the Results are Important

Patient falls are caused by different factors and are associated with increased length of stay in the hospital, and more patients being discharged to facilities that provide long-term care. The prevention of falls and the injuries that follow is not an easy task as they are complicated due to them being caused by disabilities and other impairments. Falls that cause damages to the patients create more costs for them and increase their morbidity. Risk factors for falls that may cause injuries to differ based on the strategies in place for the prevention of falls.

References

Almegbel, F. Y., Alotaibi, I. M., Alhusain, F. A., Masuadi, E. M., Al Sulami, S. L., Aloushan, A. F., & Almuqbil, B. I. (2018). Period Prevalence, Risk Factors, and Consequent Injuries of Falling among the Saudi Elderly Living in Riyadh, Saudi Arabia: A Cross-Sectional Study. BMJ Open, 8(1), e019063. https://bmjopen.bmj.com/content/bmjopen/8/1/e019063.full.pdf

AlSowailmi, B. A., AlAkeely, M. H., AlJutaily, H. I., Alhasoon, M. A., Omair, A., & AlKhalaf, H. A. (2018). Prevalence of Fall Injuries and Risk Factors for Fall among Hospitalized Children in a Specialized Children's Hospital in Saudi Arabia. Annals of Saudi Medicine, 38(3), 225-229. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6074307/pdf/asm-3-225.pdf

Asiri, F. Y., Alshahrani, A., Aseeri, M. F., Alam, M. M., Ataalla, S. M., AlMohiza, M. A., & Abdulhamed, I. A. (2018). Fall Risks Factors among Home-Based Health Care Patients in the Aseer Province: Observational study. Biomedical Research, 29(12). https://www.alliedacademies.org/articles/fall-risks-factors-among-homebased-health-care-patients-in-the-aseer-province-observational-study-10520.html

Asiri, F., ALMohiza, M. A., Faia Aseeri, M., Mehtab Alam, M., Ataalla, S. M., Alqahtani, M., & Alshahrani, A. (2018). Fall Prevention Knowledge and Practice Patterns among Home Healthcare Professionals in Southern Saudi Arabia: An Observational Study. Journal of International Medical Research, 46(12), 5062-5073. https://journals.sagepub.com/doi/pdf/10.1177/0300060518789816