scholarly journals Reduction of Inpatient Fall Rate in an Adult Acute Care Setting

2021 ◽  
Author(s):  
◽  
Manjusha Maprel

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries. PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 weeks (T)? Evidence: The literature review revealed that using multimodal risk prevention strategies effectively reduces fall risk and fall-related injuries and thus improves patient safety and outcomes. Intervention: A multimodal fall prevention strategy was developed, according to the Morse Fall Risk Assessment score, utilizing tools such as bed alarm on, lights on, a urinal within reach, purposeful hourly rounding, and bedside reporting during shift change. The oncoming shift nurse checked with the off-going shift nurse at the patient’s bedside to ensure that the fall risk patients’ fall precaution strategies had been initiated and maintained throughout the shift. Outcome: The EBP project did not result in an overall reduction in the fall rates; however, the fall rate with injury was low in the telemetry unit. The project resulted in an increase in the staff’s knowledge and awareness of multimodal fall prevention strategies. Conclusion: The reduction in the incidence of falls after the implementation of the EBP project in the telemetry unit was not statistically significant. However, the result indicated a clinically meaningful improvement in fall-related injury outcomes and increased staff knowledge and awareness of the fall prevention strategies.

2021 ◽  
Author(s):  
◽  
Manjusha Maprel

Practice Problem: Falls are among the most reported hospital-acquired conditions and can lead to severe injuries, increased length of hospital stays, pain, distress, and emotional trauma in the elderly. The Centers for Medicare and Medicaid Services (CMS) identifies falls as preventable and no longer authorizes reimbursement to healthcare systems for treating inpatient fall-related injuries. PICOT: The PICOT question that guided this project was: In adult, acute care patients admitted to the telemetry unit (P), how does implementing evidence-based multimodal fall prevention strategies (I) compared to routine fall prevention strategies (C) affect inpatient fall rate (O) over a period of 6-8 weeks (T)? Evidence: The literature review revealed that using multimodal risk prevention strategies effectively reduces fall risk and fall-related injuries and thus improves patient safety and outcomes. Intervention: A multimodal fall prevention strategy was developed, according to the Morse Fall Risk Assessment score, utilizing tools such as bed alarm on, lights on, a urinal within reach, purposeful hourly rounding, and bedside reporting during shift change. The oncoming shift nurse checked with the off-going shift nurse at the patient’s bedside to ensure that the fall risk patients’ fall precaution strategies had been initiated and maintained throughout the shift. Outcome: The EBP project did not result in an overall reduction in the fall rates; however, the fall rate with injury was low in the telemetry unit. The project resulted in an increase in the staff’s knowledge and awareness of multimodal fall prevention strategies. Conclusion: The reduction in the incidence of falls after the implementation of the EBP project in the telemetry unit was not statistically significant. However, the result indicated a clinically meaningful improvement in fall-related injury outcomes and increased staff knowledge and awareness of the fall prevention strategies.


Author(s):  
Ann Mariya P.R ◽  
Delna Mary George ◽  
Elsamol Francis ◽  
Thasni R.A ◽  
Twinkle Joseph ◽  
...  

To assess the fall of risk among the elderly in selected urban area of Thrissur. Objectives a) To assess the fall risk among the elderly people in selected urban area of Kachery, Thrissur. b) To associate fall risk score with selected demographic variables. c) To correlate fall risk assessment questionnaire score and modified fall prevention checklist for personal risk factors score among elderly individuals. d) To teach the elderly people about fall prevention exercise. Methodology: Non-experimental descriptive research design is adopted in this study. We selected 60 samples through random sampling technique. Standardized fall risk assessment questionnaire built by national aging research institute and modified fall prevention checklist for personal risk factors built by Hamilton county was used to collect the data. Tool was administered by interview method for assessing fall risk. Fall preventive intervention module developed, validated and administered following data collection. The data collected were analyzed by using descriptive and inferential statistics. Result: The demographic profile of elderly people shows that 46.66% belongs to age group between 60-70 years and most of them 58.33% were females. The majority 73.33% of elderly person are at low risk for fall and 26.66% are at high risk for fall in questionnaire and 81.67% of elderly are low risk for fall, 18.33% are risk and there is no elderly person high risk for fall in checklist. The overall fall risk is high among elderly individual alone in home and low in elderly in nuclear families. The risk for fall among elderly based on previous history of fall shows that elderly with visual impairment those who don’t have previous knowledge about fall prevention and elderly age between 91-100 is high risk for fall. The risk for fall based on ability to perform ADL in elderly shows those who living alone in the home high risk for fall. There is significant association between score with selected variables like age, previous knowledge about fall prevention, elderly residing in their home alone. We found that there is perfect positive correlation r=1 between fall risk assessment, questionnaires and checklist score. Discussion: At the end of the study the investigator found that the risk for fall based on the assessment of fall history among elderly people shows that, there is significant association between age (p=0.0273) that is, age group between 91-100 years are high risk for fall. Previous knowledge about fall prevention shows that, elderly without previous knowledge about fall prevention is at high risk for fall (p= 0.03074). In sensory impairment that is, elderly having visual impairment (p=0.998) having risk for fall. The risk for fall among elderly people based on their ability to perform activities of daily living shows that, elderly residing in their home alone shows more risk for fall.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S566-S566
Author(s):  
Gwen Bergen

Abstract Over one in four U.S. older adults (age 65+) reports falling each year with fall-related medical costs estimated at $50 billion. The American Geriatrics Society/British Geriatrics Society Clinical Practice Guideline for Prevention of Falls in Older Persons recommends that healthcare providers assess and manage their patients’ fall risk. The Centers for Disease Control and Prevention’s Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative helps healthcare providers incorporate these guidelines by providing tools on how to screen, assess, and intervene to reduce risk. Evaluations of fall prevention have focused on the clinical process and outcomes. Understanding clinical activities is important in fall prevention but a better understanding of older adult characteristics that increase fall-risk, and attitudes that may affect their adoption of evidence-based interventions could improve the effectiveness of prevention strategies. The five presentations in this session include: 1. Demographic, health and functional characteristics of older adults with increased fall risk. 2. Caregivers of people with chronic conditions or disability as a group with increased fall risk. 3. The most effective and efficient ways of identifying older adults with increased fall risk. 4. Facilitators and barriers to older adults’ adherence to evidence-based fall interventions. 5. Applying knowledge of older adult attitudes to improving an implementation of STEADI-based fall prevention. Multifactorial fall prevention strategies such as STEADI focus on the clinical aspects of fall prevention but their success depends on understanding and incorporating older adult characteristics and attitudes. The information presented in this session can inform fall prevention strategies and improve health.


2013 ◽  
Vol 28 (3) ◽  
pp. 282-290 ◽  
Author(s):  
Serene S. Paul ◽  
Catherine Sherrington ◽  
Colleen G. Canning ◽  
Victor S. C. Fung ◽  
Jacqueline C. T. Close ◽  
...  

Background. In order to develop multifaceted fall prevention strategies for people with Parkinson’s disease (PD), greater understanding of the impact of physical and cognitive performance on falls is required. Objective. We aimed to identify the relative contribution of a comprehensive range of physical and cognitive risk factors to prospectively-measured falls in a large sample of people with PD and develop an explanatory multivariate fall risk model in this group. Methods. Measures of PD signs and symptoms, freezing of gait, balance, mobility, proprioception, leg muscle strength, and cognition were collected on 205 community-dwelling people with PD. Falls were monitored prospectively for 6 months using falls diaries. Results. A total of 120 participants (59%) fell during follow-up. Freezing of gait ( P < .001), dyskinesia ( P = .02), impaired anticipatory and reactive balance ( P < .001), impaired cognition ( P = .002), reduced leg muscle strength ( P = .006), and reduced proprioception ( P = .04) were significantly associated with future falls in univariate analyses. Freezing of gait (risk ratio [RR] = 1.03, 95% confidence interval [CI] = 1.00-1.05, P = .02), impaired anticipatory (RR = 1.01, 95% CI = 1.00-1.02, P = .03) and reactive (RR = 1.26, 95% CI = 1.01-1.58, P = .04) balance, and impaired orientation (RR = 1.28, 95% CI = 1.01-1.62, P = .04) maintained significant associations with falls in multivariate analysis. Conclusion. The study findings elucidate important physical and cognitive determinants of falls in people with PD and may assist in developing efficacious fall prevention strategies for this high-risk group.


2020 ◽  
Vol 40 (6) ◽  
pp. 33-41
Author(s):  
Linda M. Hoke ◽  
Rachel T. Zekany

Background Despite vast evidence describing risk factors associated with falls and fall prevention strategies, falls continue to present challenges in acute care settings. Objective To describe and categorize patient and nurse perspectives on falls and nurses’ suggestions for preventing falls. Methods To improve transparency about the causes of falls, nurses interviewed patients in a 48-bed progressive cardiac care unit who had experienced a fall. A content analysis approach was used to examine responses to 3 open-ended items: why patients said they fell, why nurses said the patients fell, and nurses’ reflections on how each fall could have been prevented. Results Over a 2-year period, 67 falls occurred. Main themes regarding causes of falls were activity (41 falls, 61%), coordination (16 falls, 24%), and environment (10 falls, 15%). Patients said they fell because they slipped, had a medical issue, were dizzy, or had weak legs. Nurses said patients fell because they had a medical issue or did not call for assistance. Conclusions Nurses and patients agreed on the causes of assisted falls but disagreed on the causes of unassisted falls. Nurses frequently said that the use of a bed alarm could have prevented the fall.


BMJ Open ◽  
2020 ◽  
Vol 10 (8) ◽  
pp. e039763 ◽  
Author(s):  
Hardeep Singh ◽  
Arielle Shibi Rosen ◽  
Geoff Bostick ◽  
Anita Kaiser ◽  
Kristin E Musselman

ObjectivesThis study explored: (1) fall circumstances experienced by ambulators with spinal cord injury (SCI) over a 6-month period, (2) the impacts of falls-related injuries and fall risk and (3) their preferences/recommendations for fall prevention.DesignA sequential explanatory mixed-methods design with two phases.SettingA Canadian SCI rehabilitation hospital and community setting.ParticipantsThirty-three ambulators with SCI participated in phase 1 and eight participants that fell in phase 1 participated in phase 2.MethodsIn phase 1, fall circumstances were tracked using a survey that was completed each time a participant fell during the 6-month tracking period. Phase 2 involved photovoice; participants took photographs of factors that influenced their fall risk and how their fall risk impacted their work/recreational activities. Participants discussed the photographs and topics related to fall prevention in an individual interview and a focus group.ResultsOf the 33 participants, 21 fell in 6 months. Falls commonly occurred in the home while participants were changing positions or walking. Most falls occurred in the morning or afternoon. In phase 2, interviews and focus group discussion revealed three themes: (1) falls are caused by bodily impairments (eg, impaired reactive response during slips and trips and weakness and altered sensation in legs/feet), (2) impacts of fall-related injuries and fall risk (eg, psychosocial effects of fall-related injuries, limiting community participation due to the risk of falling and activity-dependent concern of falling) and (3) approaches to fall prevention (eg, fall prevention strategies used, components of fall prevention and utility of professional fall prevention strategies/interventions).ConclusionsFall prevention interventions/strategies should focus on minimising a person’s fall risk within their home as most falls occurred in the home environment. Ambulators with SCI would benefit from education and awareness about common fall circumstances that they may encounter in their daily lives.


2020 ◽  
Vol 51 ◽  
pp. 151188
Author(s):  
Kari Johnson ◽  
Hartford Scholar ◽  
Kathy Stinson ◽  
NEA-BC ◽  
M.A.-L. Sherry Razo ◽  
...  

Author(s):  
Rafael Nogueira Rodrigues ◽  
Eduardo Carballeira ◽  
Fernanda M. Silva ◽  
Adriana Caldo ◽  
Fabio Ceschini ◽  
...  

Increasing life expectancy and the growing number of elderly people have also increased the number of comorbidities common in this population in the same proportion, where the risk of falling is highlighted and has been increasing in a worrying and negative way. However, the practice of physical exercise can improve the prevention and reduction of falls. In this context, this chapter addresses the theme with the objective of identifying how, which, and when physical exercise can contribute in relation to the risk of falling in the elderly. Through analysis of articles and recent reviews, the chapter addresses the influence of strength, power, aerobic, and multicomponent exercises in their various components and possible influences on the risk of falling. There is also a proposal for a specific program for the risk of falling in the elderly, with adjustments in volume and intensity according to the needs of the target audience, based and improved by worldwide guidelines.


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