Fall Prevention

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Falling in adults 65 and older is a complex problem confronting public health, the health care system and families. Statistics alone do not begin to measure the pain, suffering and loss of independence that are experienced by older adults who fall, but a number of trends highlight the magnitude of the problem: * Falling accounts for 80-95% of hip fractures in older adults. * The rate of fatal falls increases dramatically with age. * Falls are the leading cause of injury deaths for older adults. * Among adults 75 and older, those who fall are four to five times more likely to be admitted to a long-term care facility for a year or longer. (Mission Hospital Data, Risk Management, 2012)

For decades, hospitals and other health care organizations have integrated to understand the contributing causes of falls, to minimize their occurrence and resulting injuries or deaths. Today, organizations have begun reaching out to each other for collaboration on the best ways to prevent falls.  Based on Centers for Disease and Prevention (2012) data, each year one in three older Americans (65 and older) falls and about 30% of those falls require medical treatment. Falls are not only the leading cause of fatal and nonfatal injuries but also the most common cause of hospital admission for trauma. More than $19 billion annually is spent on treating the elderly for the adverse effects of falls: $12 billion for hospitalization, $4 billion for emergency department visits, and $3 billion for outpatient care. Most of these expenses are paid for by the Center for Medicare and Medicaid Services through Medicare. It is projected that direct treatment costs from elder falls will escalate to $43.8 billion annually by 2020. (www.cdc.gov ).

Because unanticipated falls by nature cannot be prevented, the goal is to create an environment that would reduce injury, should a fall occur. Our current rates for falls from January 2012 through October 2012 ranged from 2-3 falls per month. By implementing an interdisciplinary Fall Team and using a fall risk assessment tool, the hospital wants to reduce inpatient fall levels by 30%. Current process is that there are not enough nurses to monitor patients on an hourly basis, only every other hour. Patients are not being properly identified as “high-risk” patients. There is not an appropriate amount of lighting, and the clutter is not being cleared by staff members from either hospital equipment to family member belongings, as well as the staff not being able to move trip hazards away from patients area before the staff leaves them by themselves. The staff is not providing the patients with bathroom breaks on a regular basis. The staff is giving the patients undesirable amounts of fluid, which is making the patient get out of bed as well. The staff now needs to be educated on the above concerns, as well as giving them the proper training and resources and appropriate oversight of a fall prevention protocol that we will be putting in place. * Involvement by staff for this project will include the following: doctors, physical therapists, occupational therapists, nurses, and other staff members who transport patients. Physicians often deal with older adult patients who have fallen or fall regularly, yet there are no specific tools readily available to primary practitioners to identify and treat those patients who are at risk for future falls. With the availability of a fall prevention program, the physician has assistance in managing these challenging patients. Physical and occupational therapy for older adults can be utilized in multiple settings across the continuum of care, including acute care, long-term care, and outpatient clinics and in the home. Physical therapists can be very effective in developing, implementing, and overseeing an exercise program and can assist in solidifying a culture of exercise in the long-term care facility....
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