Patient Safety Initiatives in the Hospital Setting

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  • Topic: Hospital, Patient, Patient safety organization
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Patient Safety Initiatives in the Hospital Setting

Introduction
Patient safety is described by the US Institute of Medicine as “the freedom from accidental injury due to medical care or from medical error” (Mansour, 2012). With that being said, patient safety has long been a major issue for hospitals. In the past many patients have been injured during hospital stays, some being injured severely with death being the result. With the growing trend of lawsuits, hospitals were becoming more and more vulnerable to financial liability when patients were injured on their grounds. No one wants to be responsible for the injury or death of another individual. This is why many hospitals have begun doing their own independent research as well as looking at the research from other patient safety organizations. Patient safety goals are being put into place by organizations such as The Joint Commission, as well as falls reduction campaigns being implemented by the individual hospitals. While regulatory agencies like The Joint Commission require hospitals to identify who is at risk for a fall, and gives minimum standards to go by, it is up to the individual hospital to go beyond these required interventions to reduce the risk of a fall occurring within their facilities. Some ideas to prevent falls include the implementation of a new Clinical Nurse Leader position, purposeful hourly rounding, as well as sensors for beds to ensure they are in the low position. Topic

One of the first ways to prevent falls in patients is to identify who is at risk. According to the United States Department of Veteran Affairs, the major intrinsic, or physiology-based, risk factors for falls include; altered elimination, cognitive impairment, sensory deficits, altered or limited mobility/gait, and impaired balance (2009). Contributing to these risk factors are, for example, medications that act on the central nervous, circulatory, digestive, or urinary systems; age-related conditions that affect sensory organs; history or fear of falling; and fluid and/or electrolyte imbalances (United States Department of Veteran Affairs, 2009) For most hospitals, there is a list of questions that nurses are asked used in documenting about patients on a daily basis to determine the ever changing status some patients have while hospitalized. These questions make up what is called The Morse Falls Scale. A Morse Falls Scale must be done each day, and with any condition change, to determine a patients risk for falling. The Department of Veteran Affairs also states “A score of 0-24 indicates no risk for falls. A score of 25-50 suggests a low risk for a fall while a score of greater than 51 indicates a high risk of falling”(2009). To determine the score a person will have several questions must be asked such as: Does the patient have an IV? Is the IV a saline locked or does it have medications infusing? Has the patient fallen in the last three months? How does the patient ambulate? Are they on bedrest, use the nurse to assist, do they have a weak gait, or do they have an impaired gait? Are they taking diuretics/sedatives/tranquilizers? Is the patient over the age of 70? Are they oriented to their own ability or do they forget their limitations? (2009). Answering the aforementioned questions may seem tedious and like busy work however it is very important in the implementation of effective interventions for at risk patients. Now that you have identified who is at risk and how at risk they are, it is imperative to quickly implement the necessary interventions to prevent those at risk from becoming a statistic and more importantly keep them safe from harm. Even those individuals, who are alert, oriented and are at a low risk for falls should still have preventative measures taken to prevent an accidental fall. One of the leading causes for falls in this group is from hospital staff not lowering the bed down after attending to a patient. Also it...
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