Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
Topic: Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
Patient safety is imperative to foster an environment where nurses and staff strive to create an atmosphere where evidence-based practice is implemented to champion a safe environment for our patients. Falls is are defined as an unintentional change in position resulting in a person coming to rest on the ground or lower level regardless of cause. Recurrent falls are defined as two or more falls within the six-month study period. Falls are a global problem. Each year, about 600,000 falls worldwide result in death, which means that falls are one of the leading causes of traumatic deaths. Due to biological changes, older adults have a higher risk of falling. About half of nursing home residents suffer a fall at least once a year. (Schoberer, D.2022). The unit I am completing my Safety assignment on has 56 residents on the unit, which is staffed with One one Registered Nurse, One one License Practical Nurse, and 4 Certified Nurse Assistants. Most of the rooms are located away from the nursing station. From careful assessment of documented records, we see the need to revise the facility fall prevention protocol and implement ways to improve them to reduce the number of falls on the unit but to achieve this we need management, unit nurses, and staff to work together to ensure that patient safety is always being maintained. It is also imperative that the facility fall protocol is updated and staff educated. Comment by annette hauck: Check APA formatting for writing numericals. Comment by annette hauck: This is a run on sentence. Please visit the writing center to assist you with grammar, which I have stated many times. Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
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The Crown Heights Nursing home and rehabilitation has a fall prevention protocol in place where residents that are at high risk for fall/ or repeated history of fall is placed on Q30, where every 30 minutes a staff is expected to check on them and document where they are and status (fall/ no fall). CNA takes turn sitting in the dining area with residents to redirect and assist residents to prevent falls. A fall prevention protocol was implemented due to the rise in the incidence of falls in the facility. The impact of the falls at times washave been detrimental to the health of the residents from fractured hip which led to a decline in overall health to long hospitalization which directly impacted the facility and is seen as a financial loss when a resident has to go to the hospital for a prolonged period of time but even with a fall prevention protocol, the facility is still recording falls at a high rate which begs to revise the current policy to ensure a better outcome for residents and reduce the number of falls. Comment by annette hauck: Isn’t this mandatory? Comment by annette hauck: Run on sentence.
Since the beginning of 2022, the facility has seen a rise in falls with injuries and hospitalization which led to the fall prevention protocol being put in place. The implementation of checking residents that are at high risk for falls and repeated episodes of falls every 30 minutes and having staff sit in the recreation room with residents was established to encourage frequent monitoring of residents and to have better outcomes. The fall protocol has reduced the number of falls but not significantly. From January 2022 the fall rate was 75 percent to date October 2022 the fall rate in the facility is 63 percent, therefore, the fall prevention protocol has not significantly reduced the incidence of falls in the facility. With fall rates still at a high rate where residents suffer injuries that lead to hospitalization this affects the facility directly, when residents are away the facility lose out financially.
Even though the facility has a fall prevention protocol in place most days it is not implemented due to short staffing. To improve patient safety and reduce falls. Multiple factors result in falls, such as the external environment and the individual’s intrinsic physical and cognitive condition. Impaired balance, mobility, and gait abnormalities are considered significant factors by which interventions to prevent falls are usually modified or aggravated. Among these interventions, exercise combined with vitamin D have shown to reduce falls. (Cao, P. 2018). Many medications that the elderly receive puts them at risk for falls such as antihypertensive, and antipsychotic medication therefore using health information technology to analyze medication use in order to identify residents with a high risk of falling can help to reduce falls in the facility. Consultant pharmacists then reviewed medication and discussed their findings with the nursing staff. Nurse assistants observed and reported symptoms of medication side effects. (Vlaeyen, E.2015). There is a growing evidence base for the effectiveness of fall prevention programs in the nursing home setting. Prevention strategies should aim to reduce falls while at the same time allowing residents to remain as independent, active, and safe as possible. Adequately trained staff have an increased understanding of residents’ often urgent need to reach the toilet because of incontinence or the effects of medication and are more likely to ensure that residents’ personal belongings such as mobility aids, drinks, and books are within easy reach. (Pountney D. 2009). The Crown Heights facility’s fall prevention protocol of rounding on high-risk residents every 30 minutes ignores the other residents, therefore, having staff round every resident on the floor. Incorporating fall prevention into hourly rounds improve patient risk for fall. Hourly rounding is supported by literature as an effective strategy for fall prevention and patient safety. (Dyck, D. 2017) Comment by annette hauck: This seems to be the cause short staff and lack of compliance. Comment by annette hauck: This is an incomplete thought. Comment by annette hauck: These are causes. Comment by annette hauck: Would this work with the population you serve. Comment by annette hauck: grammar Comment by annette hauck: Nursing Assistant are not allowed to assess. Comment by annette hauck: You are monitoring high risk patients every 30 minutes and rounding on everyone hourly? Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
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Fall continues to be a leading health issue in nursing homes The CDC and the National Council on Aging have identified fall prevention
as a priority due to the growing population of adults aged 65 and older. Patient Safety is a health care discipline that emerged with the evolving complexity of healthcare systems and the resulting rise of patient harm in healthcare facilities. It aims to prevent, and reduce risks, errors and harm that occur to patients during the provision of health care. A cornerstone of the discipline is a continuous improvement based on learning from errors and adverse events. (WHO). The effectiveness of the interventions of the hourly rounds can be evaluated through the incident reports. It is mandatory for each fall to be documented as an incident report in the Crown Heights Nursing and rehabilitation facility, the record of each fall is available along with the unit and the resident’s name. Keeping track/evaluating the fall incidence reports is one way to evaluate the effectiveness of hourly rounding. If we see a decrease in the number of fall incident reports that’s an indication that the hourly rounding is effective at decreasing falls in the facility but if the number of fall incident reports remains the same or increases then According to the World Health Organization older persons living in the nursing home setting, evidence shows that health and environment risk-factor assessment with interventions based on assessment results, is highly effective in reducing falls among the elderly. Exercise is shown to be an important component of a multifactorial intervention in preventing falls, particularly when applied consistently for ten weeks or longer but according to the WHO the most effective method to reduce falls Environmental screening and modification programs are shown to be the most effective, doing environmental rounds and assessing the need of residents such as toileting and have personal items are always placed close to the resident. It is imperative that staff work in collaboration with all disciplines to ensure the success of reducing falls in residents, hence improving safety.
This is a satisfactory paper. It does not include all the expected requirements. Please refer to the to the rubric and the assignment. Please go to the writing center to support your writing skills. It will help with your grammar and guide you with formatting content/thoughts in a paragraph. APA formatting is not followed as required. I have posted documents to support APA formatting in announcements on blackboard in the beginning of the semester.
References
Schoberer, D., Breimaier, H. E., Zuschnegg, J., Findling, T., Schaffer, S., & Archan, T. (2022). Fall prevention in hospitals and nursing homes: Clinical practice guideline
Cao, P., Zhao, Q., Xiao, L., Xiao, M., & Kong, L. (2018). The effectiveness of exercise for fall prevention in nursing home residents: A systematic review meta‐analysis. Journal of Advanced Nursing (John Wiley & Sons, Inc.),
Vlaeyen, E., Coussement, J., Leysens, G., Van der Elst, E., Delbaere, K., Cambier, D., Denhaerynck, K., Goemaere, S., Wertelaers, A., Dobbels, F., Dejaeger, E., & Milisen, K. (2015). Characteristics and Effectiveness of Fall Prevention Programs in Nursing Homes:
Nuckols, T. K., Needleman, J., Grogan, T. R., Liang, L.-J., Worobel-Luk, P., Anderson, L., Coles, C., Czypinski, L., & Walsh, C. M. (2017). Clinical Effectiveness and Cost of a Hospital-Based Fall Prevention Intervention:
Dyck, D., Thiele, T., Kebicz, R., Klassen, M., & Erenberg, C. (2017). Hourly rounding for falls prevention: a change initiative.
Pountney D. (2009). Identifying and managing the risks of falls in the nursing home. Nursing & Residential Care, Preventing and Reducing Falls Among Elderly Patients in Long-Term Care
