Consider physiological and environmental risk factors for falls. Patients at greatest risk for OH are the elder population 65 and older. “Orthostatic hypotension (OH) is associated with significant morbidity and mortality among older people. (Lampela, Lavikainen, Huupponen, Leskinen & Hartikainen, 2013)” Several risk factors must be taken into consideration when assessing fall risk.
A comparison was not done with other fall risk assessment tools to evaluate the different discriminative power and the effectiveness of different tools. A comparison with other tools would be useful to verify the power of other risk factors and tools in the geriatric population. Fall prevention and assessments recommended by National Guidelines Clearinghouse should include a fall risk assessment especially if the patient has a history of falls. A functional assessment test was also recommended to visually observe the patient 's mobility for those not confined to bed
Problem Identification Getting out of bed is one of the dangerous things that the elderly patients do when they are admitted in the hospital. Study conducted by Ambrose, Paul & Hausdorff, (2013) on patient falls reveals that a majority of falls in the elderly patients occur between 0700 and 1900, especially when they are getting out of bed to use the rest room. The cause of their falls is mainly due to unsteady gait, memory loss, confusion that comes with age. Memory loss and vision problems which occurs during old age in the elderly patients puts them at risk for falls. Other factors that can lead to falls are; Presence of throw rugs, psychotropic medications, lack of Vitamin D, and weakness of the lower extremities.
This program, called the Nijmegen Falls Prevention Program, included one hundred thirteen elderly clients with a history of falls. Exercise sessions were held twice a week for five weeks with fall monitoring done before and after the experiment. Control assessments were also done continuously thru the study to determine client changes in standing balance, balance confidence, and obstacle avoidance skills. The results of the Nijmegen Falls Prevention Program showed that the number of falls within the exercise group dropped by a significant forty six percent! Not only less falls, but obstacle avoidance skills dramatically improved as did balance
Present the Evidence: Prevention of Patient Falls According to the Centers for Disease Control (CDC), each year, one third of those who are 65 and older fall (2013). These falls contributed to $34 billion in direct medical costs in 2013 (cite). With these statistics, it is apparent that health care professionals and health care settings need to make fall prevention a priority in their facilities. The aim of this paper is to explore a fall prevention policy and practice guidelines to evaluate recent evidence and offer recommendations.
Capstone Project: Falls Prevention and Risk Assessment of the Elderly Population while in Long Term Care facility Evidence Based Practice – NUR 4775L Dr. Susan Poole, DNP, CNE November 22, 2015 Capstone Part I: Falls Prevention and Risk Assessment of the Elderly Population while in Long Term Care facility Introduction to Problem According to Centre for disease Control (CDC) more than 1.4 million people 65 and older live in nursing homes. If current rates continue, by 2030 this number will rise to about 3 million (CDC, 2014). Nursing home residents are at an increases risk for falls depending on the acuity of their illness and their mental state.
It also provided the use of critical thinking and clinical judgment on how to prevent falls, support, and be accountable for a client professionally. The practical knowledge I have learned helped me become aware of assessing and assisting a client. As a nurse, our job is to provide “safe, compassionate, competent and ethical care” (p.8) and collaborate as an interprofessional team to deliver safe care and prevent risks from happening while offering quality nursing care (CNA, 2017). I will always provide the professional care under the code of ethics to promote health and wellness for an older adult and prevent risks from happening. As well as following the plan of care, use communication strategies, be aware, acknowledge, and accommodate individuals with different diseases such as with dementia, to promote fall prevention strategies (RNAO, 2017).
Evidence Based Practice Proposal- Section D: Solution Description The Edmonson Psychiatric Fall Risk Assessment Tool (EPFRAT) to have higher sensitivity in assessing fall risk in the geri-psychiatric population (Edmonson et. al, 2011). This project of EPFRAT will let the progress of a fall risk prevention protocol to provide the safest environment and best quality of care possible for the geriatric psychiatric inpatient.
The elderly in nursing home are at an increased risk for falls, more than any other area. An average of 5% of all persons over the age of 65 reside in nursing homes. On average, over 1,800 people over the age 65 fall while in nursing homes every year and 20% of all fall related deaths occur from falls while living in nursing homes (Centers of Disease Control & Prevention, 2012). Falls result in decrease of quality of care through decline in functional ability, fear, restricted activities, and serious injury (U.S. Department of Health and Human Services, 2014). Not only does falls have an effect the overall quality of the persons whom live there and their families, but it also effects the facility and the staff.
Hence, the role of a community physiotherapist can include making a referral to an occupational therapist (WCPT, 2003) as he or she could help in assessing and modifying the home environment to make it an elderly friendly apartment. Apart from physiotherapists, occupational therapists can also help in facilitating the patient’s safety. In addition, the bathroom which is the location of the fall should be assessed and identified for any hazards to prevent future falls. A study by Cumming et al. (1999), it was shown that occupational therapists were able to impede future falls in the elderly by visiting the patients’ homes so that the patients will be able to live safely.
SAVAHCS “Fall Prevention Program” utilizes the interventions discussed in the literature review and includes a post fall assessment (PFA). Post fall huddles (PFHs) are discussed within the Fall Prevention Program, however, they are not consistently used. The PFA currently captures information discussed in the literature including intrinsic and extrinsic factors and includes the physical attributes of the patient, and extrinsic environmental factors. In a cyclic process, patients are assessed for fall risk. If a patient is found at risk, he/she is placed on the hospital’s
The conclusion of the article was that hourly rounding that has leadership involvement and staff that buy into the program is an effective fall prevention program. This conclusion was based off the results from the study. This review was of good quality. Hourly rounding and patient falls was a study that was conducted to see if hourly rounding was an effective fall prevention strategy. The study involved 2 units.
Cooper, C., Selwood, A., & Livingston, G. (2008). The prevalence of elder abuse and neglect: a systematic review. Age and ageing, 37(2), 151-160. Department of Heath (2000) No Secrets: Guidance On Developing and Implementation of Multi-Agency Policies and Procedures to Protect Vulnerable Adults from Abuse.
Elder abuse can be referred to as a single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. Elderly people often get abuse by people who should be their protector and carer, in most circumstances many elderly adults are abused in their own homes, in relatives’ homes, and even in facilities responsible for their care. If you suspect that an elderly person is at risk from a neglectful or overwhelmed caregiver, or being preyed upon financially, it’s important to speak up. Learning about the warning signs of elder abuse, what the risk factors are, and how you can prevent and report the problem it’s very vital in protecting the elderly from abuse, some of these abuse are;