Miami Dade College Development of a Fall Prevention Program Discussion

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Development of a Fall Prevention Program

Safety for elders is always an overriding concern for healthcare delivery agents since without a safe environment the elder will be injured and therefore their health will decline. Considering the environment and the lack of safety could potentially result in a fall. Fall prevention programs are always being developed for the safety of the elder in different environments. The following assignment will enlighten you as to the elements of a good, evidence-based fall prevention program.

Instructions:

After developing a fall prevention program for a facility in South Florida. Read the following document and answer the questions below: 

you will develop by yourself:

1. how to institute the program?
2. the goals and interventions (such as resources needed, training required and how much it will cost)?
3. a marketing plan?
4. an estimated cost?

FALL PREVENTION PROGRAM

Introduction

Falls are the leading cause of both fatal and non-fatal injuries for older Americans (CDC 2017), so it is significant to develop proper fall prevention programs in health care facilities. This project has been developed to be implemented in the Assisted Living Facility Sun Villages Homes of Hialeah, Florida.

General Information

1. Is this a Nursing Home, SNF, Hospital, etc? Select: _Nursing Home__

2. Name of Facility: _Sun Villages Homes__

3. Name of Corporation: (if needed): ____________

4. Name of Falls Program: Fall Prevention Program

In order to understand the magnitude of the fall problem some statistics could be used as examples:

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• “Over 800,000 patients a year are hospitalized because of a fall injury, most often because of a head injury or hip fracture” (CDC, 2021).
• “Falls are the most common cause of traumatic brain injuries” (CDC, 2021).
• “In 2015, the total medical costs for falls totaled more than $50 billion.11 Medicare and Medicaid shouldered 75% of these costs” (CDC, 2021).

These statistics speak for themselves. The consequences of falls in the elderly go beyond minor bumps and bruises. Falls can cause major trauma and lead to death. According to an article published in 2016, “an estimated 23,000 older individuals die every year as a direct consequence of or from complications after a fall” (MEDCOM, 2016). In addition to the physical consequences, falls can have psychological consequences such as feelings of low self-esteem and worthlessness and depression related to feelings of isolation (Tan, 2018).

Describe three evaluation methods and their purpose.

The first step in implementing a fall prevention plan is the identification of those patients who are at risk of falls. Falls are associated with multiple risk factors, including biological, behavioral, and environmental (Tan, 2018).

• Biological factors: “age, chronic diseases, low vitamin D level, urinary incontinence, gait and balance disorder, hypotension, chronic pain, and altered sensory perceptions” (Tan, 2018).
• Behavioral factors: “ lack of exercise, fear of falling, feelings of anxiety, symptoms of depression, low self-efficacy, history of falls, behavioral disruption associated with dementia, tremors, and impaired cognitive abilities” (Tan,2018).
• Environmental factors: “ hazardous objects like loose wires, slippery floors, poor lighting, and improper use of assistive devices” (Tan,2018).
• Medications side effect: “orthostatic hypotension, increased drowsiness, and lethargy” (Tan, 2018).

To begin, it is necessary to perform an assessment of each resident of the nursing home to evaluate biological and behavioral factors and medication side effects. This requires the use of evidence-based fall risk screening tools. We propose the use of the 30-second chair stand test (CDC, 2017) and the Tinetti Assessment tool (Willy, 2014). The results of these tests must be accompanied by an analysis of the history of falls, medications, comorbidities, and physical examination.

Intervention list: Name at least five (5) interventions that will help reduce the number of falls.

In this project, we have designed interventions aimed at the management of biological, behavioral, and medication factors and other interventions aimed at environmental changes, based on scientific articles published in peer-reviewed journals (Tan,2018), (Willy, 2014). It is necessary to emphasize that these interventions should focus on each resident’s risk factors associated with the risk of falls.

Interventions related to biological, behavioral, and medication factors:

• Balance, gait, and strength training: Establishing a comprehensive exercise program (with or without physical therapy) to help residents enhance/restore muscle strength, balance, and endurance.
• Disease and medication management: Evaluation of how to manage specific conditions to reduce the person’s risk of fall that include changing the type or dosage of a medication that causes dizziness or drowsiness.
• Treating vision and hearing impairments: Include periodic hearing and vision tests, checking the residents’ eyeglasses cleanness, and monitoring the residents wear the eyeglasses daily and during ambulation.
• Managing foot and footwear issues. Guaranteeing the residents receive podiatric services. Provide proper footwear: No-slip-on (with the backs out) and no shoes with slick soles. Having residents wear slippers/no-skid socks.

Interventions related to environmental factors and work organization:

• Identification: Posting signs (e.g., “fall risk”) just above the person’s bed, using color-coded armbands or blankets. 
• Environmental hazards: Include actions such as keep the environment free of hazards, remove clutter from rooms and public areas, arrange rooms to have clear passage-ways, decrease traffic in hallways, proper lighting for resident’s toileting. All staff members should be on the alert for environmental hazards, like spills and trip hazards, and clean them up promptly.

Training list: List some of the training that may be needed. (eg, patient, healthcare, professionals, administration?)

For the implementation of this fall prevention project, it is necessary to educate staff members and residents. Staff members must learn and understand each of the proposed interventions and have sufficient training to carry them out. Health care professionals must know the steps of the assessment and carry out the disease and medication management as described above. The nursing home administration is responsible for carrying out the educational program and the implementation of the program. Residents should be empowered to comply with fall prevention measures focusing on the need to call for help when they need to get out of bed to use the restroom, and focusing on the residents’ awareness of side rails on the bed and any other protective equipment or devices.

References

Center for Disease Control and Prevention (CDC). (2017). Take a Stand on Falls. Retrieved on March 10th, 2021 from https://www.cdc.gov/features/older-adult-falls/index.html.

Center for Disease Control and Prevention (CDC). (2021). Important Facts about Falls. Retrieved on March 10th, 2021, from https://www.cdc.gov/homeandrecreationalsafety/falls/adultfalls.html.

MEDCOM. (2016). Preventing Falls In Long-Term Care: A Comprehensive Approach. Retrieved on March 10th, 2021, from https://www.medcominc.com/long-term-care/preventing-patient-falls-in-long-term-care/.

Tan, A. (2018). Improving practice to reduce falls in the nursing home. American Nurse. Retrieved on March 10th, 2021, from https://www.myamericannurse.com/improving-practice-to-reduce-falls-in-the-nursing-home/.

Willy, B., Osterberg, Ch. (2014). Strategies for Reducing Falls in Long-Term Care. Annals of Long-Term Care: Clinical Care and Aging. 23-32. Retrieved on March 10th, 2021, from https://www.managedhealthcareconnect.com/articles/strategies-reducing-falls-long-term-care.

Center for Disease Control and Prevention (CDC). (2017). 30-second chair stand. Retrieved on March 10th, 2021, from https://www.cdc.gov/steadi/pdf/STEADI-Assessment-30Sec-508.pdf.