Manual lift and transfer of patients in any setting where health care is delivered is a high-risk activity for both healthcare workers and patients. The issue starts at the bedside when the clinician responds to a need for help. There is a loss of focus for personal safety when a patient struggles to sit upright or stand. Instinctively, clinicians respond to the need for help and bend, reach or overextend their own bodies to render aid.
This action, which is done with the intention to offer help, places both the patient and healthcare worker at risk of injury. In the absence of a documented mobility assessment, the clinician is left to guess the patient’s ability to participate in movement and transfer activities. To prevent patient handling injuries, intervention efforts that begin with a patient assessment of mobility function, which is documented in the electronic medical record (EMR), are proven effective in improving the safety of both patients and healthcare workers.
Patients Emergency Falls in Hospitals
Studies indicate that a fall that occurs while a patient is in the emergency room or hospital can add as many as six days to a hospital stay. The World Health Organization (2019) indicates globally, as many as four out of ten patients are harmed while seeking ambulatory services, and 80% of the harm that occurs is preventable. With this in mind, it is not surprising to find that falls top the list of what is categorized as a preventable injury; with as many as 1,000,000 inpatients falls occurring annually in United States hospitals.
Falls are a priority for emergency departments; however, with all that is known about falls in hospitals, research specific to the environment of the emergency department (ED) is limited. The significance of this quantitative, quasi-experimental direct practice improvement project is to show how the Hillrom BMAT can be utilized as a part of a fall prevention program in the unique environment of the ED to improve patient safety by reducing falls during handling, lift and transfer tasks.
Emergency departments are unique environments with complex patient dynamics and varying skill sets and experience among the workforce. The risk of a patient falling during the lift, transfer, and mobility help is compounded by extrinsic factors, such as lighting, crowded environment, and the overall layout of the space. Unfortunately, tailoring a fall prevention program specific to the ED is challenged by a gap in the literature, with the majority of studies focused on inpatient settings. What is known, is that falls occur more commonly in units where patients are ambulatory. The importance of understanding who falls in the ED, and why, is an important consideration for implementing a successful fall prevention program for this unique population.