Fall Risk Prevention in Health Care

The fall risk prevention has always been an ongoing issue for the health care sector. There are numerous facts that evidence the appearance of a number of various complications among patients experienced falls in the acute care setting (Shorr et al., 2012). Accidental falls are one of the most frequent accidents resulting in the significant deterioration of the state of a patient. Regarding the elderly patients, the problem becomes more complex as the consequences of fall are usually more significant for them.

For these reasons, the fall risk prevention becomes one of the major concerns aimed at the promotion of the health of a patient and decrease of the number of complications resulting from the accidents of this sort. There are several preventive measures that are intended to monitor the state of a patient and provide the needed assistance. The usage of bed alarms or frequent rounding is taken as one of the possible variants to improve the situation in the given sphere. However, there are still debates related to the efficiency of the given measures.

Besides, the article Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial also delves into the investigation of the practical utility and viability of the implementation of bed alarms to reduce the number of falls. The paper tends to “investigate whether an intervention aimed at increasing bed alarm use decreases hospital falls and related events” (Shorr et al., 2012, 692). The necessity of the given investigation is proved by the continuous debates about the efficiency of the measure and its advantages comparing with the practice of frequent rounding. The paper introduces the credible data to analyze the issue and provides the results to prove or refute the practicability of the further usage of bed alarms in the acute care setting to reduce the number of possible complications.

Resting on the main goal of the study, the authors suggest the pair-matched, cluster randomized trial over 18 months (Shorr et al., 2012). The term will be enough to collect the needed data and fix all possible changes of the setting. Therefore, nursing units were distributed randomly on the basis of fall rates. The usage of a computer and random allocation of units promotes the increase of the credibility of the obtained information and helps to exclude numerous external factors that could distort the results of the study. Furthermore, the patients participating in the study and outcome assessors were blinded while some of the last ones may also have become unblinded (Shorr et al., 2012). The given research design guarantees the efficiency of the analysis and increases the feasibility of the results obtained in the course of the investigation.

The study implies the constant monitoring of sixteen nursing units in an urban community hospital. It introduced the possibility to involve a significant number of participants into the experiment to obtain the reliable data. The sample was collected from 27 672 patients who became the main participants of the research (Shorr et al., 2012). They were separated into two control groups. The members of the first one were trained and explained how to use the standard bed alarm system while the rest of the participants were just provided with bed alarms. The given number of participants helps to create the adequate sample size that contributes to the better investigation of the issue. Additionally, the adequacy of the given size is also proved by the existence of two control groups that help to compare the results of the intervention and make a certain conclusion.

The investigators used the statistical data about the fall rates at Methodist Healthcare University Hospital. It was recorded during the eight-month period. Sixteen medical units with 349 beds provided the information about a number of patients using the bed alarm system. The authors used the electronic medical record of the hospital to gather the primary data about the usage of the tool and the impact it had on the state of patients (Shorr et al., 2012). They also analyzed the nursing documentation in the medical records, audits of orders for alarms, and direct observations to collect the needed data (Shorr et al., 2012). The given method and tools prove the credibility of the sample and provide numerous possibilities for the further analysis of the obtained results. Furthermore, the authors of the research took part in the investigation contributing to its development.

Analyzing the study, it is possible to admit the feasibility of the main assumptions and the wide range of possibilities for cogitations introduced by the chosen methods and sample. Yet, there are still several limitations resulting from the character of the investigation. First, the given pattern complicates the determination of the most common reasons for falls as the researchers are interested in the recording of the fall rate and the effect bed alarm has on it. For this reason, the paper could not provide the essential information that could be useful while creating the plan of preventive measures.

Additionally, the authors tend to compare the efficiency of the bed alarm system with the efficiency of usual care that implies rounding, monitoring, etc. However, the given pattern makes this task more complex as it is difficult to obtain the data related to the efficiency of usual care in the same settings. Another significant limitation of the study is its inability to use a blinded manner to guarantee the greater credibility of the results. Finally, the authors themselves admit the low fall rates that prevented them from the precise assessment of the data and its analysis. (Shorr et al., 2012).

In the course of the study, the investigators come to the conclusion that the intervention aimed at the improvement of the fall rates might have the positive effect in case patients are explained the basic principles of the usage of bed alarms. In this regard, the study proves the authors hypothesis and accepts the efficiency of the tool. At the same time, the investigators conclude that alarm signals may after a patient had already fallen (Shorr et al., 2012). This fact introduces the necessity of the further investigation of the issue to determine the perspectives and applicability of bed alarms as the main remedy to decrease the fall rates.

To summarize, the given paper provides the credible information related to the usage of the bed alarm system and its impact on the question of fall risk prevention. It proves the relative efficiency of the tool and provides the rationale for its further development. However, the paper does not make the final conclusion about the necessity of the usage of bed alarms to prevent patients falls. For these reasons, it is possible to suggest the further investigation of the issue to gather more information about the peculiarities of bed alarms and frequent rounding.

Reference

Shorr, R., Chandler, M., Mion, L., Waters, T., Liu, M., Daniels, M.,…Miller, S. (2012). Effects of an intervention to increase bed alarm use to prevent falls in hospitalized patients: a cluster randomized trial. Annals of Internal Medicine, 157(10), 692-699.

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