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Medical Malpractice in Hospitals from failure to prevent Falls.

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When a person enters a hospital for the treatment of sickness or disease, they trust the facility to provide a safe environment. Unfortunately, injuries or deaths caused by preventable incidents like falls can occur, resulting in medical malpractice.

A fall is defined as an event where a patient inadvertently comes to rest on the ground or a lower level. Hospitals are responsible for assessing patients’ fall risks and implementing interventions to ensure their safety.

What Are Falls in Hospitals?

A fall is an event where a patient unexpectedly comes to rest on the ground or another lower surface. Preventing falls requires hospitals to take proactive steps, including thorough fall risk assessments and preventive measures such as bed alarms and clear pathways.

Factors Contributing to Falls in Hospitals

1. Short Staffing

One of the leading causes of falls is short staffing in hospitals. Unlike nursing homes, short staffing in hospitals can be more challenging to identify but still poses a significant risk. Hospitals may prioritize cost savings over patient care, leading to inadequate staffing levels. Short staffing occurs through:

  • Insufficient numbers of Registered Nurses (RNs), Licensed Practical Nurses (LPNs), and Certified Nursing Assistants (CNAs).
  • Reliance on LPNs, who are less expensive to employ than RNs, leading to compromised care.
  • Schedules that barely meet minimum ratios, leaving the hospital vulnerable if staff call out sick.

2. Failure to Properly Assess Fall Risks

Accurate and thorough fall risk assessments are essential for patient safety. When hospitals fail to conduct these assessments or complete them improperly, patients are left vulnerable to falls. This can occur due to:

  • Incomplete assessments by nursing staff.
  • Rushed or skipped assessments caused by short staffing.

Proper fall assessments involve evaluating the patient’s mobility, medications, and overall condition.

3. Failure to Use Bed Alarms

Bed alarms are critical devices that help prevent falls by alerting staff when a patient attempts to leave their bed. Issues contributing to falls include:

  • Malfunctioning bed alarms.
  • Alarms that are not activated or tested.

Ensuring bed alarms are functional and properly used is a vital intervention for fall prevention.

4. Failure to Use Chair Alarms

Chair alarms work similarly to bed alarms by detecting pressure changes and alerting staff when a patient moves unsafely from their chair. Hospitals must:

  • Keep chair alarms in good working order.
  • Test and activate alarms consistently for patients at risk of falling.

5. Clutter in Patient Areas

Clutter, particularly in spaces between the patient’s bed or chair and the bathroom, increases the likelihood of falls. Hospitals should:

  • Remove all unnecessary furniture and items from patient rooms.
  • Ensure clear, obstacle-free pathways for patients.

6. Administering Fall-Risk-Enhancing Medications

Certain medications, such as sedatives, increase fall risks in already vulnerable patients. Examples of negligence include:

  • Administering sedatives without considering a patient’s fall risk.
  • Placing a sedated, high-risk patient in situations like using a bedside commode without proper supervision.

Hospitals must weigh the risks and benefits of medications and provide additional monitoring for high-risk patients.

7. Combination of Factors

Often, falls result from a combination of the above factors. For example, a patient on sedatives, in a cluttered room, without functional alarms or sufficient staff oversight, faces an increased risk of falling.

Interventions to Prevent Falls

Hospitals must implement fall prevention protocols to minimize risks. Key interventions include:

  • Clearing clutter: Ensure pathways are free from obstacles.
  • Placing high-risk patients near nurse stations: Enhances monitoring.
  • Keeping patient doors open: Allows nurses to observe patients more easily.
  • Using alarms: Ensure bed and chair alarms are functional and set to maximum volume.
  • Frequent checks: Staff must check on high-risk patients at intervals specified in hospital protocols.
  • Assistive devices: Harnesses and two-person assists should be used when necessary, as determined by fall risk assessments.

The Role of Fall Risk Assessments

Assessments are essential for identifying patients at risk of falling. These evaluations, often conducted on numeric scales by RNs, guide hospitals in tailoring interventions. Failure to conduct or properly perform assessments is a significant contributor to medical malpractice claims related to falls.

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Falls in hospitals are preventable with proper staffing, accurate assessments, and effective interventions. However, systemic issues like short staffing, neglected protocols, and equipment failures often lead to serious injuries or fatalities. Hospitals must prioritize fall prevention measures to ensure patient safety and avoid medical malpractice.