Synthia De Jesus fall prevention

Synthia De Jesus

University of Central Florida

NUR 4604L

(Photo: [email protected])

Falls are a Problem

Increased falls not only affect the facility, but the

family too.

Do you know someone that has fallen?

Were there any injuries?

How was the experience while they

recuperated?

Falls affect quality of life of the elderly.

Costs the facility money.

Can cause possible death.

Definitions of Fall

To drop or descend under the force of

gravity, as to a lower place through loss or

lack of support (dictionary.com).

A fall is an unintentional loss of balance

causing one to make unexpected contact

with the ground or floor (agrilife.org).

The Facts

One out of three adults (age 65 or older) fall each

year.

Among older adults, falls are the leading cause of

both fatal and non-fatal injuries

In 2010, 2.3 nonfatal injuries were treated in the

ED, more than 662,000 were hospitalized.

(CDC, 2014)

The Facts Cont.

20-30% people suffer moderate to severe injuries.

In 2010, 21,700 older adults died from

unintentional fall injuries.

Death rate has risen over the last decade

(CDC, 2014)

Cost of Falls

Fall related injuries is one of the 20 most

expensive medical conditions.

The direct medical cost of falls, adjusted to

inflation was $30 million in 2010.

By 2020 cost related to falls will rise to $67.7

billion.

Risk of Falls

Fractures:

Spine

Hip

Forearm

leg

Ankle

Pelvis

Upper arm

Hand

(CDC, 2014)

Subdural hematomas

Excessive bleeding

Death

Risk Factors

Lower body weakness

Difficulty with gait or balance

Medication

Dizziness

Poor vision

Problems with footwear

Postural hypotension

Fear of falling

Tripping hazards

Improper use of assistive devices

Poor lighting

Diabetes

Falls in Spring Hill Village

A look at House B

Jan Feb Mar Apr Total

Days 0 3 3 0 15Evening 3 1 1 0

Nights 1 0 2 1

Total 4 4 6 1

B Unit Falls

0

1

2

3

4

Jan Feb Mar Apr

Num

ber o

f Fal

ls

Falls chart by shift

Days

Evening

Nights

Prevention Interventions

Pain: Are you in pain?

Check for non-verbal indications of pain.

CNA- Notify Nurse if resident is in pain.

Provide any non-pharmacological pain relief as needed

Potty: Do you need to use the bathroom?

Does their brief need changing?

Do they use the urinal or bedpan?

Position: Are you comfortable?

Rearrange any pillows or blankets.

Do they need an extra blanket?

Do they need turning, use of ulcer pressure devices; boots, wedges, etc.

Possessions: Are bedside items within reach?

Kleenex, water pitcher filled, call light within reach

Prevention: Is floor mat in place?

Bed/chair alarm in place and working?

Is body pillow/noodle in place?

Is the resident agitated?

Are they exhibiting exit-seeking behaviors?

Do they need redirection or distraction?

(Photos: [email protected])

Rounds will be individualized for each shift.

Return demonstrations so we are all on the same boat.

Each shift will know what they have to do.

Think about it…..the resident will get more attention.

Less falls makes the unit look better.

The falls we cost less for the facility.

Happy patient(families)=Happy staff

Last but not least……we don’t want our veteran to pass because of falls.

Check-Off

Date:___________________

Name:_________________________________

Department:____________________________

Evaluator:______________________________COMMENTS

Yes No Yes No

INTRODUCTIONS

Knock on door prior to entering - ask permission

Manage up your skill or that of your co-worker

Use good eye contact

EXPLAIN HOURLY ROUNDING UPON ADMISSION

Explain the purpose of hourly rounding (initial visit)

Use key words "very good" care

Describe rounding schedule (6am-8pm q1hr / 8pm - 6am q2hr.)

ADDRESS ENVIRONMENT

Clutter free environment, Use of Mats

PERFORM SCHEDULED TASKS

Complete MD ordered treatments, procedures

Complete nursing care as needed

Administer schedule medications

Update nursing plan of care/ goals for patient

CLOSING

We will round again in an hour

Is there anything else that I can do for you? I have the time

Document your rounding on rounding log

SIGNATURE

SELF ASSES EVALUATOR

Hourly Rounding Competency Checklist

Spring Hill B Unit

Day Shift

Evening Shift

Night Shift

Conclusion

Falls is a current issue in the US and it affects both the facility and

family.

The result of falls causes injuries to patient and cost money to the

facility.

The purpose of rounding is to benefit us and the residents by:

Preventing less stress to family.

Increasing performance scores.

Preventing hospitalizations.

Decreasing expenses made from the facility.

Improving quality of life and well being.

So lets get this ball rolling and decrease our falls in SPRING HILL!!!!

References

AgriLife.org. (2013). Fall prevention for older adults. Retrieved from

http://fcs.tamu.edu/families/aging/fall_prevention/what_is_a_fall.php.

Centers for Disease Control and Prevention. (2014). Older adult falls. Retrieved

from http://www.cdc.gov/HomeandRecreationalSafety/Falls/adultfalls.html.

Dictionary.com. (2014). Fall. Retrieved from

http://dictionary.reference.com/browse/fall.