Risks in Healthcare Physical Environment That Increase Patient Fall Risk
Patient falls are a serious problem in healthcare settings, affecting patient safety, quality of care, and healthcare costs. According to the Agency for Healthcare Research and Quality (AHRQ), about one million patients fall in U.S. hospitals each year, and about 30% of those falls result in injuries (AHRQ, 2019). Moreover, patient falls can have negative psychological consequences for patients and their families, such as fear of falling, loss of confidence, and reduced mobility (Healey et al., 2018).
While patient falls can be caused by various factors, such as patient characteristics, medications, and staff practices, the physical environment of the healthcare setting can also play a significant role in increasing or decreasing the risk of falls. The physical environment refers to the design, layout, and condition of the physical space where care is provided, such as the patient room, bathroom, hallway, and common areas. The physical environment can influence patient falls by affecting the patient’s ability to move safely and comfortably, the staff’s ability to monitor and assist patients, and the availability and accessibility of equipment and supplies (Ulrich et al., 2010).
Some examples of physical environmental risks that can increase patient fall risk are:
– Poor lighting: Inadequate or uneven lighting can impair the patient’s vision and increase the risk of tripping or slipping on obstacles or wet surfaces. Poor lighting can also affect the staff’s ability to see and respond to patient needs. Lighting should be adjustable to suit the patient’s preferences and needs, and should provide adequate illumination for both day and night activities. Additionally, lighting should be consistent and avoid creating glare or shadows that can confuse or disorient the patient (Ulrich et al., 2010).
– Clutter: Clutter refers to any unnecessary or excessive items or furniture that can obstruct the patient’s or staff’s movement or access to equipment or supplies. Clutter can create hazards for patients who may trip or fall over them, or who may use them as support instead of appropriate assistive devices. Clutter can also interfere with the staff’s ability to provide timely and effective care. Clutter should be minimized and organized in a way that allows clear pathways and easy access to essential items (Ulrich et al., 2010).
– Flooring: Flooring is an important aspect of the physical environment that can affect the patient’s stability and mobility. Flooring should be slip-resistant, smooth, level, and free of cracks or gaps that can cause tripping or stumbling. Flooring should also be compatible with the use of assistive devices, such as walkers or wheelchairs, and should not create noise or vibration that can disturb or alarm the patient. Additionally, flooring should be easy to clean and maintain to prevent infection and contamination (Ulrich et al., 2010).
– Furniture: Furniture refers to any items that are used for seating, sleeping, working, or storing in the healthcare setting, such as beds, chairs, tables, cabinets, or shelves. Furniture should be designed and arranged in a way that supports the patient’s comfort, safety, and independence. Furniture should be adjustable to suit the patient’s height, weight, and preferences, and should provide adequate support and stability for the patient’s posture and movement. Furniture should also be placed in a way that allows sufficient space for maneuvering and transferring, and that does not obstruct the staff’s visibility or access to the patient (Ulrich et al., 2010).
– Equipment: Equipment refers to any devices or tools that are used for diagnosis, treatment, monitoring, or prevention in the healthcare setting, such as monitors, pumps, IV poles, oxygen tanks, or alarms. Equipment should be selected and used in a way that meets the patient’s needs and preferences, and that does not pose any risks or complications for the patient. Equipment should be checked regularly for proper functioning and maintenance, and should be secured or stored appropriately when not in use. Equipment should also be integrated with the furniture and flooring in a way that does not create clutter or hazards for the patient or staff (Ulrich et al., 2010).
By addressing these physical environmental risks, healthcare settings can reduce the incidence and severity of patient falls, and improve patient outcomes and satisfaction. However,
