Ltc Case Study

The purpose of this research paper was to examine the latest research and evidence-based practices related to inpatient falls. Falls among the elderly within a hospital setting has increased within the last decade. Inpatient falls have become the second leading cause of death, causing longer hospital stays and indirect costs for the hospital. The research reviewed multiple studies, which discussed the causes of inpatient falls. A few causes included nurses and staff not knowledgeable of current hospital practices, lack of individualized plan of care, and lack of training related to falls. The findings assisted the writer to revise the current fall policy and procedure for Arrowhead Regional Medical Center (ARMC). A fall reduction program

Problem statement: According to Quality Improvement Organization Health Services Advisory Group, Alabama’s state average for falls without injury is 41.9% with the National average being slightly higher at 45%, falls with injury in Alabama is 3.2% with the National average being 3.4%. Research done by the Alzheimer’s Association (2016) has revealed that “People with dementia are at risk of falls because of their neurological impairments.” Another study completed by Esstmann discusses “The etiology of orthostatic hypotension should be investigated for older adults with known orthostatic

Falls among any individual can cause significant trauma, often leading to an increase in mortality. According to the Centers for Disease Control and Prevention (2012), one in every three adults over the age of 65 falls each year. Long-term care facilities account for many of these falls, with an average of 1.5 falls occurring per nursing home bed annually (Vu, Weintraub, & Rubenstein, 2004). In 2001, the American Geriatric Society, British Geriatric Society, and the American Academy of Orthopaedic Surgeons Panel on Falls Prevention published specific guidelines to prevent falls in long-term

Elderly people are highly susceptible to falling, as more than one in four people over the age of 65 fall at least once a year, and many will fall more than just once (NSW Health, 2011). More than half of the elderly living in aged care facilities fall at least once a year. In 2009, 26% of NSW residents who were aged 65 or over, fell at least once (NSW Health, 2011). Approximately 27,000 hospital admissions and at least 400 deaths of over 65 year olds were due to falls (NSW Health, 2011). More of these hospitalisations were for aged care residents than other elderly people. As well as this, hospitals generally have over 1400 falls cases per year, and aged care facilities experience reports of falls from 60% of residents (Victorian Quality Council Secretariat, 2014). In hospital and aged care settings, there are a variety of falls risks, and causative factors that may lead to falls. For example, there are environmental (extrinsic) and personal (intrinsic) factors (Victorian

Anyone is at risk for a fall, however, falls are especially concerning in the older adult population.

I discovered preventive strategies could be used as a theory to minimise falls in older people using different literature reviews. A fall however can be defined as an unexpected, involuntary loss of balance by which a person comes to rest at lower or ground level (Commodove, 1995). The older population is growing in number, and falling is common in this group up to one-third of people over the age of 65 falls each year, with half reporting multiple falling episodes (Bludau and Lipsitz, 1997). Savage and Matheisk-Kraft, (2001) states that fall-related injury is the sixth highest cause of in older people.

Falls in an acute care setting lead the list of injury related deaths and deaths in the elderly. “A fall is defined as any event which patients are found on the floor (observed or unobserved) or an unplanned lowering of the patient to the floor by staff or visitors” (Kalisch, Tschannen, and Lee, 2012, p. 6). Medicare and Medicaid changes in 2008 list falls as one of the 10 hospital acquired conditions for which hospitals will no longer be reimbursed because falls are considered preventable conditions. Joint Commission accredited hospitals are required to assess for falls risk and implement falls prevention measures.

Patient safety is one of the nation's most imperative health care issues. A 1999 article by the Institute of Medicine estimates that 44,000 to 98,000 people die in U.S. hospitals each year as the result of lack of in patient safety regulations. Inhibiting falls among patients and residents in acute and long term care healthcare settings requires a multifaceted method, and the recognition, evaluation and prevention of patient or resident falls are significant challenges for all who seek to provide a safe environment in any healthcare setting. Yearly, about 30% of the persons of 65 years and older falls at least once and 15% fall at least twice. Patient falls are some of the most common occurrences reported in hospitals and are a leading

The incidence of fall-related injuries in the elderly U.S. population will continue to increase (Quigley, Neily, Watson, Wright, & Strobel, 2017).

A fall is a lethal event that results from an amalgamation of both intrinsic and extrinsic factors which predispose an elderly person to the incident (Naqvi et al 2009). The frequency of hospital admission due to falls for older people in Australia, Canada, UK and Northern Ireland range from 1.6 to 3.0 per 10 000 population (WHO 2012). The prevalence of senior citizen’s falls in acute care settings varies widely and the danger of falling rises with escalating age or frailty. Falls of hospitalized older adults are one of the major patient safety issues in terms of morbidity, mortality, and decreased socialization

The Centers for Medicare and Medicaid Services (CMS) has identified eight adverse conditions, and inpatient injurious falls continues to be the most common adverse condition (as cited in Tzeng, Hu & Yin, 2016). The inpatient falls in the “US hospitals range from 3.3 to 11.5 falls per 1,000 patient days” (as cited in Bouldin et al, 2013, p.13). Roughly 25% of patients are injured when they fall (Bouldin et al, 2013). Since 2005, the USA’s National Patient Safety Goal listed fall prevention as a goal (Bennett, Ockerby, Stinson, Willcocks, & Chalmers, 2014). Since 2008, hospitals no longer receive payments from CMS for health care cost connected to inpatient falls (Bouldin et al, 2013). CMS views inpatient injurious falls as injuries that should never occur (Bouldin et al., 2013). There is no doubt that quality improvement must continue to address inpatient injurious falls. Preventing falls and implementing interventions to lower the rates of falls is a major concern for hospitals and must be included in any quality improvement measure.

Elimination of patient falls is not an easy task otherwise they would have been eliminated by now. Patient falls unfortunately continue to be a challenge and occur within the hospital and nursing home settings at alarming and sometimes deadly rates. The Center for Disease Control estimates that 1,800 older adults living in nursing homes die each year from fall-related injuries. Survivors frequently sustain injuries resulting in permanent disability and reduced quality of life. Annually, a typical nursing home with 100 beds reports 100 to 200 falls and many falls go unreported (CDC, 2015). Falls occur more often in nursing homes because patients are generally weaker, have more chronic illnesses, have difficulty ambulating, memory issues,

Most hospitalized patients of 65 years and above have been established to be more vulnerable to falling within their homes or in a facility. These falls have been attributed to various causative agents that need to be assessed and managed in an attempt to completely avert falls (Wilbert, 2010). Prevention of falls should be mandatory since they cause more danger to patients, including breakage of the main bones and even death. As a result, the patient may develop a more serious condition such as decrease functional immobility in addition to that which caused hospitalization. Most of these falls have been found to be caused by therapeutic impacts and ignored diagnostic information (Naqvi, Lee & Fields, 2009). For instance, a great number of elderly people who are hospitalized are diagnosed with dementia at the time of admission; hence, such information needs to be taken into consideration during the care of such a patient. Dementia is likely to cause disorientation and confusion which may result in recurrent falls. Therefore, falls may be described as the abrupt and unintended loss of uprightness that leads to body displacement towards the ground falls (Wilbert, 2010). The purpose of this paper is to develop a falls prevention, management program that will reduce the number of falls occurring within an organization.

“Fall may be defined as an unexpected event in which the person comes to rest on the ground, floor, or lower level” (Struksness, Lindström, Lord, Slaasletten, Johansson, et al., 2011). In older populations, falls are quite common, but with a mental illness such as dementia, the problem is worsened. This cross-sectional study showed that the most common causes of falls reported by nursing staff were individual factors like physical impairment and mental impairment.

The Center for Disease Control (CDC) reported that more than one third of adults 65 and older fall each year. Half of the elderly people, who fall, do so repeatedly. Aside from the health problems related to falls, nearly $20 billion of direct medical costs are associated with fatal and non-fatal falls (Larson & Bergmann, 2008).