Call Don T Fall Final

Topics: Chemotherapy, Oncology, Nursing Pages: 25 (1877 words) Published: April 13, 2015
INCREASING PATIENT
EDUCATION TO DECREASE
INCIDENCES OF FALLS
By Daphenee Ulus RN and
Song Ey Hahn RN

WHY FALLS PREVENTION IS
IMPORTANT


Benefits to the hospital
 The

Joint Commission (goal 13, NPSG.09.02.01)
goal is to encourage patients to actively get
involved in their own care as part of the patient
safety strategy.
 Hospitals are no longer reimbursed for
treatment/care related to falls-related injury.

WHY FALLS PREVENTION IS
IMPORTANT


Benefits to the Patients
 Costs

on average $4233 more for patients who
experienced injuries from falls. ( Ruy et al., 2009)
 Falls can have serious consequences related to
reduced physical functioning and quality of life
( Dunn et al., 1992; Spar et al., 1987)

OUR PROPOSAL


Supplementing our already multi-factorial falls
intervention with patient education to increase
patient compliance and decrease falls.
 This

will be done with an education pamphlet
highlighting specific needs to oncology patients of
10C/S/W
 One-on-one teaching session that are patient
specific highlighting their falls risk
 Visual Cues/Sign to reinforce teaching and to act as
a reminder for patients
 The most frequent barrier to successful intervention
for fall-risk factors is patient compliance as
supported by Fortinsky et al. (2004)

BARRIERS TO OUR PROPOSAL


Cognitive Impairment
 Chemo-induced neurotoxic effects
 CNS involvement
 Past medical history



Language Barrier
 English is not their first language
 Minimal vocabulary of medical terminology



Lack of Desire to Learn
 Depression
 Anxiety
 Unable to focus due to diagnosis



Patient Compliance
Patients do not want to relinquish their usual level of independence and do not realize how much their therapies and illness can weaken them. (Stanghellini et al, 2007)

METHODS ALREADY IMPLEMENTED AT
NYP-WEILL CORNELL
Falls Assessment Documentation
 Rounding (Our new evidence based developed
practiced)
 Falls risk sign on chart and outside patient
rooms
 Bed Alarm
 A multi-interventional plan has positive
correlation to decreasing falls. (Ref. Designing a
Falls Prevention strategy that works)
 Note methods are interventions for health care
providers, but not for patients. Providing patient
centered care consists of patients involvement
as well as the healthcare providers.


ANALYSIS OF FALL MERS FROM APRIL
2010 - APRIL 2011
Data shows a majority of falls were due to
patients failing to call for help before getting
out of bed
 Toileting needs # 1 reason
 # of falls = 117
--- 60 males
--- 57 females
 Age group 60 to 69 with highest incidences
of falls
 Average age – 74 years old


ANALYSIS OF FALL MERS FROM APRIL
2010 - APRIL 2011



Figure 1: Shows the number of falls from April 2010 to April 2011 per agegroup at the Hematology/Oncology/Bone Marrow Transplant Units of NewYorkPresbyterian Weill Cornell. Consistent with the literature, the number of falls increased with age.

ANALYSIS OF FALLS FROM APRIL 2010
TO APRIL 2011

Figure 2: Shows the reasons for falls from April 2010 to
April 2011 at the Hematology/Oncology/Bone Marrow
Transplant Units of NewYork-Presbyterian Weill Cornell.

ANALYSIS OF FALLS FROM APRIL 2010
TO APRIL 2011

Figure 3: Shows the number of falls for male and females
from April 2010 to April 2011 at the
Hematology/Oncology/Bone Marrow Transplant Units of
NewYork-Presbyterian Weill Cornell. Consistent with the
literature males has a higher fall rate than females.

RISK FACTORS FOR OUR ONCOLOGY
PATIENTS


1.

Risk factors that predicts patient falls (Evans et al, 2001) Altered mental status
- Common among patients with cancer due to high fever or CNS involvement

2.

Altered mobility
- Generalized weakness is common due to anemia, nausea, vomiting and diarrhea which often follow chemotherapy. Certain chemotherapies can increase peripheral neuropathy in...

References: Demir, F., Ozsaker, E., & Ozcan, A. (2008). The quality and suitability of written
education materials for patients
Evans, D., Hodgkinson, B., Lambert, L., & Wood, J. (2001). Fall risk factors in the hospital
setting : A systematic review
J., & Tinetti, M. E. (2004, September). Fall-risk assessment and management in clinical
practice: views from healthcare providers
52(9), 1522-1526.
Haines, T. P., Hill, K. D., Bennell, K. L., & Osborne, R. H. (2006, February). Patient
education to prevent falls in subacute care
Holley S. (2002, March). A look at the problem of falls among people with cancer.
Ireland, S., Lazar, T., Mavrak, C., Morgan, B., Pizzacalla, A., Reis, C., & Fram, N. (2010,
September)
Miller, L., & Limbaugh, C. M. (2008, February). Applying evidence to develop medical
oncology fall-prevention program
Ryu, Y. M., Roche, J., & Brunton, M. (2008, November). Patient and family education for
fall prevention: involving patients and families in a fall prevention program on a
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