Prevention of falls in post-operative patients at shift change in the Med-Surg Trauma unit.
Hospital falls in the United States continue to pose considerable challenges across the health care sector. They are the most common cause of accidental deaths, especially for the elderly, with about 41 fall-related deaths in every 100,000 individuals every year (Quigley, 2015). The effects of anesthesia remain undetermined despite it being among the leading causes of patient falls. The residual pharmacologic and neuromuscular blocking effects of anesthetics can cause postoperative falls (Lam et al., 2016).
I work in the trauma med-Surg unit, where most of our patients have injuries from gunshots, motor vehicle crash, blunt trauma, and falls requiring surgeries. Most falls happen at least expected periods after surgery, like during change of shifts. One of the patients on my unit underwent a surgery that lasted twenty-one hours and got transferred to the unit towards the end of the shift. Being at the end of the shift, everyone got side-tracked because the patient was asleep. He woke up disoriented and fell out of bed, resulting in him going back to surgery.
Post-operative falls are rather rare complications that are often overlooked in clinical settings, thus resulting in bone fracture, traumatic head injury, visceral organ contusion, and skin abrasion. This in-patient adverse events in hospitals increase the length of hospital stay and hospital costs and may also engender unnecessary medical disputes. Therefore, the implementation of preventive strategies for in-patient falls has been an essential practical issue in my unit. Most falls occur more often at the bedside, in the presence of caregivers, and during shift change. Patients that underwent surgery with regional anesthesia significantly increase the risk of post-operative falls (Lam et al., 2016).
References
Lam, C., Hsieh, S., Wang, J., Pan, H., Liu, X., Ho, Y., & Chen, T. (2016). Incidence and characteristic analysis of in-hospital falls after anesthesia. Perioperative Medicine, 5(1). https://doi.org/10.1186/s13741-016-0038-z
Quigley, P. A. (2015). Evidence levels: Applied to select fall and fall injury prevention practices. Rehabilitation Nursing, 41(1), 5-15. https://doi.org/10.1002/rnj.253