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Falls remain a significant concern for healthcare professionals across the country. Annually, about 28–35% of individuals aged 65 and older experience falls, and approximately 10–31% of those falls result in injuries (Su-Fei et al., 2018). According to the National Institute on Aging (n.d.), older adults with confusion, neurological issues, or muscle weakness face an increased risk of falls. These conditions are prevalent among patients in the neurology unit at Winter Haven Hospital, where individuals often have conditions such as stroke, dementia, Parkinson’s disease, and peripheral neuropathy. Falls can extend hospital stays by 6–12 days on average, increase treatment costs by about $13,000, and lead to unreimbursed expenses for hospitals (Bouldin et al., 2013). This paper applies the Systems Theory of Organization to examine the impact of patient falls in the neurology unit of Winter Haven Hospital and proposes strategies to address this issue while aligning with the organization’s mission and values.
Systems Theory
Winter Haven Hospital, a part of BayCare Health Systems, serves the Tampa Bay area and aims to provide comprehensive care at every level. The hospital’s neurology unit specializes in treating patients with neurological disorders such as seizures, dementia, alcohol withdrawal, and stroke (BayCare Health System, 2018).
Inputs
Inputs in healthcare include people, materials, resources, and information essential to sustaining the system (Meyer & O’Brien-Pallas, 2010). In the neurology unit, inputs consist of nurses, patients, specialty beds, educational materials, medications, and vital signs equipment.
Throughputs
Throughputs involve interventions that transform inputs to achieve desired outcomes (Meyer & O’Brien-Pallas, 2010). In this setting, throughputs include medical and nursing interventions, which involve the collaborative efforts of staff, equipment, and patient engagement to promote recovery and wellness.
Outputs
Outputs are the final outcomes of the system, returned to the external environment after processing the inputs. In the neurology unit, outputs include patients discharged with improved functionality. While these individuals may not return to their original baseline, the aim is to achieve the highest possible level of independence.
Cycle of Events
The cycle of events represents ongoing processes that sustain and renew the system. By delivering high-quality care, the neurology unit creates positive outcomes that encourage patients to seek future treatment at the organization, thus reinforcing the cycle (Meyer & O’Brien-Pallas, 2010).
Negative Feedback
Negative feedback mechanisms, such as performance indicators and quality care measures, help identify and address deficiencies (Meyer & O’Brien-Pallas, 2010). For instance, the Joint Commission’s evidence-based care standards for stroke patients guide the neurology unit in delivering optimal care and preventing recurrent strokes (The Joint Commission, 2018).
Problem
Patients in the neurology unit are at an elevated risk of falls due to conditions like confusion, neurological issues, and muscle weakness. These challenges often manifest within the throughput stage of the Systems Theory model.
Outcome
A collaborative, multidisciplinary approach can reduce patient falls by 10% within three months by identifying risk factors and implementing a fall prevention program (AHRQ, 2013).
Goals and Objectives
The first goal is to implement an hourly rounding program, where staff address patient needs and ensure environmental safety during routine checks (AHRQ, 2013). Compliance will be monitored using a sign-in sheet and daily audits by charge nurses.
The second goal is to conduct fall risk assessments for all patients during each shift. Nurses will document fall risk scores in patients’ medical records and display them on care boards. Random audits by supervisors will ensure adherence to this practice.
Policies and Procedures
Policies should mandate fall risk screenings at admission, during each shift, and when a patient’s condition changes. Hourly rounds should address patient needs and safety concerns. Collaboration between disciplines can provide additional recommendations to improve fall prevention measures (AHRQ, 2013).
Relevant Professional Standards
Provision 3.4 of the Nurses Code of Ethics (2015) emphasizes the importance of promoting patient safety, including reporting falls and escalating issues as needed. Florida law also requires hospitals to establish patient safety plans with designated safety officers and committees (Florida Legislature, 2018).
Mission and Values
BayCare’s mission to improve community health through compassionate, high-quality care aligns with efforts to reduce falls in the neurology unit. By educating staff and addressing patient-specific risks, the hospital can maintain its commitment to trust, respect, and dignity (BayCare.org, n.d.).
Improving Culture and Climate
The hospital’s culture emphasizes teamwork and a sense of family, while its climate fosters innovation and a people-oriented approach (Differencebetween.com, 2014). Collaborative efforts among staff to reduce falls strengthen bonds and improve patient outcomes.
Conclusion
Enhancing throughput processes, such as staff education and fall prevention strategies, can effectively reduce patient falls in the neurology unit. These measures support the hospital’s mission and values while fostering a culture of safety and trust.
References
Agency for Healthcare Research and Quality (AHRQ). (2013). Preventing falls in hospitals: A toolkit for improving quality of care. AHRQ Publication No. 13. Retrieved from https://www.ahrq.gov/sites/default/files/publications/files/fallpxtoolkit_0.pdf
BayCare Health System, Inc. (2018). Winter Haven Hospital Services. Retrieved from https://baycare.org/hospitals/winter-haven-hospital/services?h=%7BCDB92DF4-A72E-465C-A6CC-7EBC6A16D8C7%7D
BayCare.org. (n.d.). About us. Retrieved from https://baycare.org/about-us
Bouldin, E. L., Andresen, E. M., Dunton, N. E., Simon, M., Waters, T. M., Liu, M., Daniels, M. J., Mion, L. C., … Shorr, R. I. (2013). Falls among adult patients hospitalized in the United States: prevalence and trends. Journal of Patient Safety, 9(1), 13-7.
Florida Legislature. (2018). 2018 Florida statutes. Retrieved from http://www.leg.state.fl.us/Statutes/index.cfm?mode=View%20Statutes&SubMenu=1&App_mode=Display_Statute&Search_String=patient+safety&URL=0300-0399/0395/Sections/0395.1012.html
National Institute on Aging. (n.d.). Prevent falls and fractures. Retrieved from https://www.nia.nih.gov/health/prevent-falls-and-fractures
Nurses Code of Ethics (2015). Professional responsibility in promoting a culture of safety. American Nurses Association. Retrieved from https://www.nursingworld.org/coe-view-only
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