FALLS IN THE GERIATRIC POPULATION MED/SURG ACUTE CARE UNIT.

Slides:



Advertisements
Similar presentations
Arden L Aylor, MD Geriatrics.  Health Maintenance  Quick office screening tools  Advance Directives  Driving issues  Care types  Placement.
Advertisements

Unit 2 Principles of Health and Social Care Practice
Fall Risk Assessment It Starts with You… Preventing Falls
Preventing Older Adult Falls: Understanding Risk Factors & Best Practices Healthy Aging Partnership May 26, 2009 Sally York MN, RNC NorthWest Orthopaedic.
Inpatient Falls Prevention By Nursing Performance Improvement Restraint/Fall Liaison Committee & Judy Mc Hugh, Nursing Performance Improvement Coordinator.
M3 Seminar December “Geriatrics” in a Nutshell Karen E. Hall, M.D., Ph.D. Clinical Assistant Professor of Internal Medicine University of Michigan.
[Hospital Name | Presenter name and title | Date of presentation]
Implementing the FallSafe bundle Dr Frances Healey, RGN, RMN, PhD Associate Director for Patient Safety, NHS England (past) Associate Director, Clinical.
Physical Therapy Treatment Plans also called
National Trend Data on Hospitalization of the Elderly for Injuries, Margaret Jean Hall, Ph.D. Lois Fingerhut, M.A. Melissa Heinen, M.P.H.
2015 National Patient Safety Goals and the Older Adult Julie Pope Nurs 4292 Spring I Columbus State University.
M Purpose Improvement Tools/Methods Limitations / Lessons Learned Results Process Improvement Improving Hospital-Acquired Pressure Ulcers at Discharge.
When People Fall: Prevention for Those at Risk by Marie Boltz, MSN, CRNP, NHA Gerontological Nursing Consultant Reviewed and updated in summer 2012.
Perspectives on the Age Wave: Key Issues, Solutions, and Opportunities Robyn Golden, LCSW Director of Older Adult Programs Rush University Medical Center.
Workplace Violence Among Nurses: The Minnesota Nurse’s Study Epidemiology Nursing 702 Maria-Idalia O. Lens, RN, PHN, MSN, FNP-C.
Nursing Assistant Monthly Copyright © 2013 Cengage Learning. All rights reserved. What’s new? Fall prevention.
Linkages with Primary Care Providers
Client Centred Practice and Management of Risk Falls Prevention Forum for People with Dementia in Gippsland Monday 15 th September 2014 Nicole Tierney.
From Competencies to Outcomes: Nursing Care of Older Adults Christine Mueller, PhD, RN, FGSA, FAAN Professor, University of Minnesota, School of Nursing.
Florida Injury Prevention Programs for Seniors (FLIPS) Senior Fall Prevention Senior Module.
Facts About Falls Jo A. Taylor, RN, MPH. Older Adult Population  34.9 million people 65 years and older in the US (13% of the population)  By 2030,
Chapter 10 Gerontological Nursing Practice Settings.
Chapter 20: Ethical/Legal Principles and Issues
Copyright © 2013, 2009, 2005 by Mosby, an imprint of Elsevier Inc. Chapter 3 Community-Based Nursing Practice.
Falls Prevention in Public Hospitals and State Government Residential Aged Care Facilities Quality Improvement and Enhancement Program (QIEP)
The Impact of Nurse Hourly Rounding on Patient Falls
CHAPTER 4 QUESTIONS OF VALUES AND ETHICS
Implementing Energise for Excellence and responding to the Call To Action on the ward Lesley Marsh Assistant Director of Nursing.
Falls prevention in care homes and at home Dr Raymond F Jankowski.
The Minnesota Falls Prevention Initiative Falls Preconference Session August 20, 2007 Kari Benson, Minnesota Board on Aging Pam Van Zyl York, Minnesota.
Flu Epidemiological Clinical Ethical Philosophical …and older people.
Presented by Dorcas Kiptepkut BSN RN
March 2008 / Nursing Assistant Monthly Falls and Fall Prevention Understanding your role Fall Prevention.
Improving Quality and Safety in the Workplace Starting with Preventing Falls Jessica Fordham, MSN, APRN, FNP-C Mississippi University for Women Graduate.
Trish Prady – Lead Nurse for Quality Safety and Innovation
Chapter 9 Ethics of Caring. Changes Increasing Ethical Dilemmas for Nurses Expanded role of nurses. Medical technology. New fiscal constraints. Greater.
Nicheprogram.org NICHE Nurses Improving Care for Healthsystem Elders An Introduction to NICHE © 2015 NICHE All Rights Reserved.
Florida Injury Prevention Programs for Seniors (FLIPS) Senior Fall Prevention Professional Module.
Care Experience Breakout Sessions Trudi Marshall
HA405: Leadership and Ethics in Health Care Week 2 Seminar
© Copyright, The Joint Commission 2014 National Patient Safety Goals.
Mosby items and derived items © 2007, 2004 by Mosby, Inc., an affiliate of Elsevier Inc. Special Populations.
On Your Own Two Feet Exploring Ways to Reduce Your Risk of Falling Amanda Distefano – Program Coordinator Washington County Health Department.
Rediscovering the Art of Healing Connection by Creating the Tree of Life Poster Teri Britt Pipe, PhD, RN Kenneth Mishark, MD Reverend Patrick Hansen, MA,
Falls prevention in the elderly
Disability, Frailty and Co-Morbidity L. Fried et al. Gero 302 Jan 2012.
Chapter 12: Falls in Older Adults
 Promote health, prevent illness/injury  Broad knowledge base needed to meet patient needs in different health care settings.
Can Nurses Assist Older CHF Patients With Self-Care? Sallie A. Alvarez NGR 5800 American Heart Association.
Learning Outcomes Discuss current trends and issues in health care and nursing. Describe the essential elements of quality and safety in nursing and their.
CHAPTER 4 Questions of Values and Ethics. OBJECTIVES Describe the principles of ethicsDescribe the principles of ethics Examine the relationship of critical.
Impact of Multidisciplinary Team Care on Older People with Polypharmacy Liang-Kung Chen Center for Geriatrics and Gerontology Taipei Veterans General Hospital.
Let’s Prevent Falls! FALL PREVENTION FOR RESIDENTS OF SENIOR RESIDENCE FACILITIES.
Falls and Fall Prevention. Prevalence of Falls in Older Adults  33% of older adults fall each year  Falls are the leading cause of fatal and nonfatal.
The Older Adult: Implications for Nurse Practitioners Angela Phillips DNP, APRN, FNP-BC.
.  Purpose: To decrease the occurrence of patient related falls and related injuries through accurate assessment, identification of patients at risk,
Falls in the Elderly Dr/Rehab F Gwada.
Introduction 2. Pharmaceutical care is a professional patient care practice, which, when provided as an organized service, is experienced, documented,
ETHICAL ISSUES IN HEALTH AND NURSING PRACTICE Present by: Dr.Amira Yahia.
5200 Introduction to Graduate Nursing
Improving Fall Risk Assessment and Intervention David Risius, MSPT Rehab Coordinator Baptist Health Home Health Network.
Multiagency Falls Collaborative for Wales Change Agent Team.
The Southampton Mobility Volunteer programme to increase physical activity levels of older inpatients: a feasibility study (SoMoVe) Dr Stephen Lim Specialist.
Falls Prevention and Management
Falls Risk Preventions
Which of the following statements is correct?
Chapter 12: Falls in Older Adults
Falls Prevention Accreditation ROP Compliance
Chapter 9 Ethical Aspects of Gerontological Nursing
Presentation transcript:

FALLS IN THE GERIATRIC POPULATION MED/SURG ACUTE CARE UNIT

THE PROBLEM - AN INCREASE IN FALLS  Over the past 12 months the fall rate has risen dramatically.  From approximately 12% to 32%.  There has been a large turnover in staffing  One –third of the nursing staff are new grads  The floor is short staffed on overnight shifts  There are seldom techs for the floor at night

THE PLAN….  A change must be implemented to address this issue.  The new policy will require that bed/chair alarms be set and documented with each visit in the room.  Since the current requirement is hourly bed checks, the expectation is that the bed/chair alarms will be documented hourly.

BASIC ON ASSESSMENT….Every time! ■■ Ask about falls history. ■■ Ask about fear of falls. ■■ Check if footwear is safe. ■■ Check call bell is in reach, if able to use. ■■ Check clear communication of mobility status. ■■ Check personal items are in reach. ■■ Check walking aids are in reach, if used. ■■ Check there is no new night sedation. ■■ Cognitive screen, if aged over 70 years. ■■ Check decision to use/not use bedrails is appropriate.

MORE….  By setting and documenting alarms, will increase the likelihood that a nurse or aide will respond to movement.  Will monitor for 6 month period, with periodic checks to see that alarms are being documented in the system.  Assess and re-evaluate.  Make changes as necessary.

BACKGROUND….  Falls are a leading cause of hospital-acquired injury  Prolong or complicate hospital stays ( CDC, 2013)  Falls result from a myriad of factors  These factors complicate the evaluation/management of fall risks  Falls in the elderly result in medical morbidity  They are costly to the health care system.

RISK FACTORS FOR FALLS MAY BE EITHER INTRINSIC… … patient-related  cognitive  confusion  dementia  sex  Male or female?  physiological conditions  vision disturbances  gait and balance disturbances  incontinence  weakness  dizziness.

OR EXTRINSIC… … environmental  Clutter  IV poles and lines  Lighting  Railings  bed position  loose cords  spills

COMORBIDITIES AND HIGH RISK MEDICATIONS… Parkinson's disease Osteoporosis history of stroke arthritis Psychotropics benzodiazepinessedatives anticonvulsants antidepressives (SSRI. TCAs)antihypertensives analgesics /opiates anticholinergics antihistamines Antiarrhythmicsantithrombotics / anticoagulants

KEEP IN MIND SOME STATISTICS….  The population of US adults 65 years and older will double during the next 25 years.  By 2030, it will number 71 million, comprising 20 % of the population.  Approximately one-third of persons 65 years and older experience one or more falls each year. (Naqvi et al, 2009)

 Falls have not only physical consequences, but also financial and emotional implications.  Researched interventions to prevent falls include medication review, fall alarms, and environmental aids.  Nurses play a vital role in developing plans for fall prevention.  More than 70% of these adverse events are considered preventable (Graham, 2012)

WATSON’S THEORY OF HUMAN CARING…  Watson’s nursing theory focuses on the human component of caring (Kearney-Nunnery, 2008).  caring is a moral ideal  caring encompasses a mind-body-spirit engagement between the caretaker and patient.  considers each interaction between the nurse and the patient  role for nursing would be defined by interaction with the population.

INTEGRATION OF WATSON’S THEORY IN NURSING PRACTICE (RIGHT, 2012)  Treat patients as holistic beings  Display unconditional acceptance.  Treat patients with positive regard.  Promote health through knowledge and intervention.  Spend uninterrupted time with the patient.

IT IS EVERYONE’S JOB…. Autonomy—agreement to respect another’s right to self-determine a course of action; support of independent decision making. Beneficence- compassion; taking positive action to help others; desire to do good; core principle of our patient advocacy. Nonmaleficence- avoidance of harm or hurt; core of medical oath and nursing ethics. Fidelity- This principle requires loyalty, fairness, truthfulness, advocacy, and dedication to our patients. It involves an agreement to keep our promises. Justice- this principle refers to an equal and fair distribution of resources. Decisions about diagnosis, therapy, and prognosis for the patient. Based upon the health care professional’s belief about what is in the best interest of the patient.

?

REFERENCE Center for Disease Control (CDC). (2013). Injury and violence prevention and control. Retrieved 9/24/2013 from: Graham, Bridget C. (2012). Examining Evidence-Based Interventions to Prevent Inpatient Falls. MedSurge Nursing. 21:5, Jorgenson, John. (2013). Reducing patient falls: A call to action. Retrieved 9/25/2013 from: Kearney-Nunnery, R. (2008). Advancing your career: concepts of professional nursing (4th ed.). Philadelphia, PA: F.A. Davis. Pp Naqvi, Fatima, Lee, Susan, & Fields, Suzanne D. (2009). An evidence-based review of the NICHE guideline for preventing falls in older adults in an acute care setting. Geriatrics. 64:3, Right, Jocelyn How to Integrate Jean Watson’s Theory of Caring Into Nursing Practice. Retrieved on 9/25/2013 from: practice.html#ixzz2DoEAJs4khttp:// practice.html#ixzz2DoEAJs4k